eCatalogue of indicators for micronutrient programmes

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Legislation in place for mandatory large-scale fortification of wheat or maize flour
This indicator provides information on documentation of legislation that requires that all or some of the wheat and maize flour available for human consumption through large-scale domestic production or importation is fortified with vitamins and minerals.
Legislation mandating large-scale flour fortification with vitamins and minerals creates an enabling environment for effective fortification of wheat or maize flour. Without legislation, millers are not required to fortify flour that is produced and importers are not required to import fortified flour or fortified flour products into the country. Thus, legislation can also effectively remove from the market non-fortified products produced domestically or imported, which leads to higher consumption of fortified foods. Country-wide fortification is usually not achieved without legislation. Legislation enables regulatory authorities to monitor fortification for compliance with the standard and this helps ensure quality. It also creates a business environment where all millers must fortify and therefore incur similar costs and helps secure the sustainability of the programme (1). In an environment of voluntary fortification, only those who choose to fortify bear the cost. Mandating fortification ideally broadens the reach of this intervention, so that all segments of the population benefit independently of socioeconomic status or education level (2).
Documentation that a law was approved by the legislative body in the country (e.g. Parliament) mandating large-scale fortification of wheat or maize flour: Yes/No Considerations for the calculations: • Legislation that allows voluntary fortification, whereby producers and importers choose whether or not to fortify flour, is different from mandatory fortification (the government requires that all or some wheat or maize flour types available in the country are fortified with some specifications). A country with voluntary fortification would be classified as “No” for this indicator, regardless of whether there was legislation allowing voluntary fortification. • The legislation may mandate food fortification and set out specific rules for the addition of vitamins and minerals to flour. The law may list the vitamins and minerals that may be added to flour.
law, legislation, mandate, mandatory
Food fortification
Activity
Policies
School age children, 12-23 months, 24-35 months, 36-47 months, 48-59 months, 6-11 months, Adolescents, Men, Other (not any of the above, post-menopausal women, elderly), Women of reproductive age
None,
Copper, Folate, Iron, Niacin, Selenium, Vitamin A, Thiamine (vitamin B1), Vitamin B12, Riboflavin (vitamin B2), Vitamin B6, Vitamin C, Vitamin D, Vitamin E, Vitamin K, Zinc
Market-based
Legislation may specify which flour type (e.g. 80% extraction, top-grade or first-grade flour, nixtamalized maize flour, precooked refined maize flour) requires fortification and which does not. In other words, not all flour produced or imported into the country will necessarily be required to be fortified under mandatory legislation. It is possible that the law mandating fortification of flour changes or is revoked. If the latter occurs and no other legislation is in place to require flour fortification, this indicator changes to “No legislation in place”.
Collecting data for this indicator is relatively easy and feasible. It is also easy to monitor changes to the legislation, as it is publicly available.
The existence of legislation mandating flour fortification does not guarantee that flour fortification will occur or that quality flour will be available for the population. The legislation may not be well implemented in spite of its approval.
In one country, there is legislation that makes large-scale fortification of wheat flour compulsory within the food industry. It is mandatory to fortify all white and brown bread flour with eight micronutrients (six vitamins and two minerals). In 2003, the legislation came into effect requiring any person who manufactures, imports or sells bread flour to fortify or be guilty of an offence punishable by fine. This applies to large-scale millers. For this indicator, the response was “Yes”, legislation is in place for mandatory large-scale fortification of wheat flour with vitamins and minerals
1. Zimmerman S, Baldwin R, Codling K, Hindle P, Montgomery S, Pachón H et al. Mandatory policy: most successful way to maximize fortification’s effect on vitamin and mineral deficiency. Indian J Community Health. 2014;26:369–74. 2. Bower C, Stanley FJ. Case for mandatory fortification of food with folate in Australia, for the prevention of neural tube defects. Birth Defects Res A Clin Mol Teratol. 2004;70:842–3.
© World Health Organization 2019