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Consumption of fortified wheat- or maize-flour products over the past 7 days
This indicator assesses the consumption of food products made with fortified wheat or maize flour during the previous 7 days, by the target population.
Once flour is fortified, it must be consumed in order to improve nutritional intake. People do not eat flour directly, they eat food products made with flour, such as bread, rotis, chapatis, noodles, pasta, tortillas and arepas. This indicator helps monitor the food products made with fortified wheat or maize flour that are consumed by the target group(s). It can be useful to understand recent intake of products made with wheat or maize flour among the target group(s). It is important to understand the likely impact of results suggesting the target population(s) are not consuming food products made from fortified flour as expected, as they might indicate the need for revisions to the foods fortified as part of the national programme. While other recall methods, such as 24-h dietary recalls, can provide information on quantities consumed, these methods involve more expertise and interviewer/participant burden.
The percentage of individuals in the target population who have consumed food products made with fortified wheat or maize flour over the last 7 days
Numerator: the number of individuals in the target population surveyed who report consuming food products made with fortified flour over the past 7 days
Denominator: the number of individuals from the target population surveyed
• Divide the numerator by the denominator. Multiply the result by 100 to convert the number into a percentage.
Considerations for the calculations:
• The foods made with fortified flour may be calculated and reported separately by specific food (e.g. bread, noodles) or type of food (e.g. type of bread), depending on how question(s) are asked and what is important programmatically in a given context. For example, bread may be reported separately from noodles. Similarly, types of bread may be reported separately, such as sandwich bread and sweet breads.
• The indicator is reported for each target group separately (e.g. non-pregnant women of childbearing age, adolescent girls).
• The question can be framed as the number of days or the number of times that the food was consumed. For example, “Over the last seven days, on how many days did you consume tortillas?” and “Over the last seven days, how many times did you consume tortillas?”
• The information on consumption frequency can be reported. For example, the number of participants for each target group who report consuming foods can be organized as follows: 0 days, 1–2 days, 3–4 days or 6–7 days.
access, consumption, coverage, diet, fortified flour, intake
Food fortification
Outcome
Receipt (coverage) by beneficiaries
School age children, 12-23 months, 24-35 months, 36-47 months, 48-59 months, 6-11 months, Adolescents, All, 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
It is easier for survey participants to understand and answer questions that are narrowly targeted to one type of food product compared to a list of all possible foods produced with fortified flour. The food that is expected to be consumed the most might be used as a proxy for all foods made from fortified wheat or maize flour.
By law, not all types of flour may require fortification with vitamins and minerals. Therefore, it is important to inquire only about those products that are made with the flour type that is supposed to be fortified (e.g. this might result in specifying only certain types of bread in a survey question, or only certain brands of tortillas).
Recall time periods other than the last 7 days might be useful, for example the last 24 h, last 3 days or last 2 weeks. If a different recall period is used, then the time period for the indicator should be adjusted accordingly.
It is preferable to refer to the exact number of days the recall refers to and not ask about intake “over the last week”. The phrasing “last week” has multiple interpretations, including the last 7 days, last Monday to Friday (or the work week), last Sunday to Saturday and other variations.
The information can be elicited in a few questions, which are feasible to include in survey questionnaires.
This indicator does not quantify intake of wheat or maize flour. Therefore, the contribution to the diet of the nutrients in the products cannot be estimated.
In a country, 2268 women of reproductive age participated in a survey. They were asked whether they consumed bread made from wheat flour (a staple food commonly sold in the bakery) over the past 7 days. The results for any fortified bread intake were presented for the country as a whole, by urban/rural residence, and by region of the country. For the country as a whole, 2053 reported they consumed bread made from wheat flour over the past 7 days and the calculation was as follows:
Numerator: 2053
Denominator: 2268
Calculation: 2053/2268 * 100 = 91% of women surveyed consumed bread made from fortified wheat flour.
1. WHO/FAO. Guidelines on food fortification with micronutrients. Geneva: World Health Organization, 2006.