FORTIMAS: Fortification Monitoring and Surveillance

When

04 March 2013 - 07 March 2013

Where

Location: Protea Balalaika, Johannesburg, South Africa

Region: Africa

Summary

Meeting participants helped develop a manual to track trends in two areas:

1. Household coverage of quality fortified flour and foods made with fortified flour

2. Health outcomes that can reasonably be improved through fortification

They decided to name the system FORTIMAS for Fortification Monitoring and Surveillance.

FORTIMAS users will assess trends in a limited number of program coverage and micronutrient status indicators in easy-to-reach target populations. Large-scale surveys, such as the Demographic and Health Surveys (DHS), are usually conducted at 5 to 10 year intervals. The FORTIMAS system will help countries identify trends in the interim period, such as whether maximum household coverage is reached and sustained in a given geographic area, and whether the health status of those who regularly consume fortified flour is improving.

A key benefit of FORTIMAS is that it can be used with data already collected for other purposes. For example, information on the number of newborns with neural tube defects (NTDs) is regularly gathered by large birthing hospitals in capital cities. The number of NTDs can be compared year after year in these hospitals to identify success or potential problems with the flour fortification program.

Developing this guide has been a project of Smarter Futures, a partnership among the Ministry of Foreign Affairs of the Netherlands, FFI, AkzoNobel, Helen Keller International (HKI) and the International Federation for Spina Bifida and Hydrocephalus (IF).

Meeting Report

Participants

Participants included leaders from the government and scientific communities in South Africa, Tanzania, Uganda, Ghana, Mozambique, and Nigeria as well as representatives from the Regional Office for Africa of the World Health Organization (WHO/AFRO), the Micronutrient Initiative (MI), the Global Alliance for Improved Nutrition (GAIN), Helen Keller International (HKI) and the International Federation for Spina Bifida and Hydrocephalus (IF).

Complete participant list

Presentations

• Background - Events and Processes Leading to Meeting To Develop FORTIMAS manual

• Overview for Developing A Flour Fortification Program Monitoring and Surveillance System

• Quality Assurance and Quality Control: Updates and Recent Developments

• Review of Evidence of Flour Fortification Impacting Serum Folate, Neural Tube Defects, Serum Ferritin, and Hemoglobin

• Review of Technical Issues: Organization, Premixes, Production, QA/QC, Monitoring, Surveillance

Sponsors

Smarter Futures, a partnership that includes the Ministry of Foreign Affairs of the Netherlands, AkzoNobel, FFI, Helen Keller International (HKI) and the International Federation for Spina Bifida and Hydrocephalus (IF).