Assessing Coverage of Population-Based and Targeted Fortification Programs with the Use of the Fortification Assessment Coverage Toolkit (FACT): Background, Toolkit Development, and Supplement Overview

Friesen, Valerie M; Aaron, Grant J; Myatt, Mark; Neufeld, Lynnette M.

doi:10.3945/jn.116.242842

Cited by 30 publications

(35 citation statements)

References 13 publications

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“…The Fortification Rapid Assessment Tool (FRAT) is a tool that has contributed to planning for food fortification initiatives in developing countries [31] while the Fortification Monitoring and Surveillance (FORTIMAS) tool was developed to monitor the implementation and impact of food fortification initiatives in developing countries [32]. Assessments of population-level quality, coverage and consumption of fortified foods using standardized methods have been conducted using the Fortification Assessment Coverage Toolkit (FACT) since 2013 [33,34], and the resulting data have been used to inform decision making related to program improvement in more than 16 countries to date. Nevertheless, fit-for-purpose fortification data are still urgently needed across many countries to inform planning, implementation, redesign and evaluation of impacts.…”

Section: Quality Coverage and The Potential For Impact Of Lsff Progmentioning

confidence: 99%

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

et al. 2020

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Large-scale food fortification (LSFF) is a cost-effective intervention that is widely implemented, but there is scope to further increase its potential. To identify gaps and opportunities, we first accessed the Global Fortification Data Exchange (GFDx) to identify countries that could benefit from new fortification programs. Second, we aggregated Fortification Assessment Coverage Toolkit (FACT) survey data from 16 countries to ascertain LSFF coverage and gaps therein. Third, we extended our narrative review to assess current innovations. We identified 84 countries as good candidates for new LSFF programs. FACT data revealed that the potential of oil/ghee and salt fortification is not being met due mainly to low coverage of adequately fortified foods (quality). Wheat, rice and maize flour fortification have similar quality issues combined with lower coverage of the fortifiable food at population-level (<50%). A four-pronged strategy is needed to meet the unfinished agenda: first, establish new LSFF programs where warranted; second, systems innovations informed by implementation research to address coverage and quality gaps; third, advocacy to form new partnerships and resources, particularly with the private sector; and finally, exploration of new fortificants and vehicles (e.g. bouillon cubes; salt fortified with multiple nutrients) and other innovations that can address existing challenges.

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Section: Quality Coverage and The Potential For Impact Of Lsff Progmentioning

confidence: 99%

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

et al. 2020

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“…Monitoring the reach of programs is necessary to understand the potential for both benefits and risks. Some tools (e.g., the FACT toolkit) have already been developed to assess fortification program reach, and these tools can be modified to fit different applications and settings. Program coverage data may also be collected using special modules that can be added to planned surveys.…”

Section: Suggested Program Indicators and Data Collection Mechanismsmentioning

confidence: 99%

Weighing the risks of high intakes of selected micronutrients compared with the risks of deficiencies

Engle‐Stone

Vosti

Luo

et al. 2019

Annals of the New York Academy of Sciences

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Several intervention strategies are available to reduce micronutrient deficiencies, but uncoordinated implementation of multiple interventions may result in excessive intakes. We reviewed relevant data collection instruments and available information on excessive intakes for selected micronutrients and considered possible approaches for weighing competing risks of intake above tolerable upper intake levels (ULs) versus insufficient intakes at the population level. In general, population‐based surveys in low‐ and middle‐income countries suggest that dietary intakes greater than the UL are uncommon, but simulations indicate that fortification and supplementation programs could lead to high intakes under certain scenarios. The risk of excessive intakes can be reduced by considering baseline information on dietary intakes and voluntary supplement use and continuously monitoring program coverage. We describe a framework for comparing risks of micronutrient deficiency and excess, recognizing that critical information for judging these risks is often unavailable. We recommend (1) assessing total dietary intakes and nutritional status; (2) incorporating rapid screening tools for routine monitoring and surveillance; (3) addressing critical research needs, including evaluations of the current ULs, improving biomarkers of excess, and developing methods for predicting and comparing risks and benefits; and (4) ensuring that relevant information is used in decision‐making processes.

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“…Motivated by the need for such information for its own programmes, the Global Alliance for Improved Nutrition (GAIN) developed the Fortification Assessment Coverage Toolkit (FACT) in 2013 for carrying out coverage assessments of fortification programmes (3,4).…”

Section: Why Does Coverage Matter?mentioning

confidence: 99%

The Fortification Assessment Coverage Toolkit (FACT)

Friesen¹,

Nutrition²,

Mbuya³

et al. 2019

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Assessing Coverage of Population-Based and Targeted Fortification Programs with the Use of the Fortification Assessment Coverage Toolkit (FACT): Background, Toolkit Development, and Supplement Overview

Cited by 30 publications

References 13 publications

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

Weighing the risks of high intakes of selected micronutrients compared with the risks of deficiencies

The Fortification Assessment Coverage Toolkit (FACT)

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