Evaluation of Global Experiences in Large-Scale Double-Fortified Salt Programs

Area of Science:

• Public Health Nutrition
• Food Fortification Science
• Micronutrient Deficiency Interventions

Background:

• Double-fortified salt (DFS) delivers essential iron and iodine to combat deficiencies.
• This review is part of a series examining DFS as a public health intervention.
• DFS leverages a universally consumed product for nutrient delivery.

Purpose of the Study:

• To systematically evaluate global DFS distribution programs.
• To identify opportunities, risks, and challenges associated with DFS implementation.
• To assess programmatic experiences with DFS in various global contexts.

Main Methods:

• A narrative review of DFS programs worldwide.
• Data sourced from literature searches and key informant interviews.
• Programmatic experiences assessed in India and several other countries.

Main Results:

• Product color change was a significant challenge impacting consumer acceptance in 9 out of 14 reviewed programs.
• Other identified challenges include salt quality issues and lack of formulation standards.
• Programmatic experiences varied across social safety net and open market programs.

Conclusions:

• Future DFS programs require improved technology for better consumer acceptance and performance with varied salt quality.
• Establishing and enforcing DFS formulation quality standards and regulatory protocols is essential.
• Strong government policy support and attention to quality production are critical for program success.