Ebata Ayako, Thorpe Jodie, Islam Ainee, Sultana Sabiha, Mbuya Mduduzi N N
Institute of Development Studies, Library Road, Brighton BN1 9RE, United Kingdom.
Innovision Consulting, House 26, Road 6, Block J, Pragati Sharani, Baridhara, Dhaka, Bangladesh.
Food Policy. 2021 Oct;104:102127. doi: 10.1016/j.foodpol.2021.102127.
Micronutrient deficiency is a pertinent global challenge that affects billions of people and has deleterious health effects. Large-scale food fortification (LSFF) is a cost- effective way to tackle micronutrient deficiency and improve health outcomes, particularly in low- and middle-income countries (LMICs). However, the success of LSFF in LMICs is often hampered by limited compliance with fortification mandates by the private sector, who supply fortified foods. In this paper, we use a case study of the edible oil produced in Bangladesh to analyze the factors facilitating and impeding this compliance by for-profit actors. We identified four bottlenecks that disincentivize private sector actors' decision to comply. First, fortified and non-fortified products co-exist in the market, disincentivizing producers to invest in fortification. Second, the lack of traceability reduces the risk for large-scale producers' non-compliance with the regulation. Third, small-scale producers face economic pressures that prevent them from adequately fortifying oil products. Lastly, law enforcement is currently inconsistent, allowing the supply of under-fortified oil in the market. Given the evidence, we recommend to strengthen the control of bulk item fortification through more frequent and rigorous surveillance at the production level. This will ensure that resource constrained consumers who also have the greatest potential to benefit from added nutrients, remain able to access affordable and nutrient-enriched food.
微量营养素缺乏是一个严峻的全球性挑战，影响着数十亿人，并对健康产生有害影响。大规模食品强化（LSFF）是解决微量营养素缺乏问题和改善健康状况的一种经济有效的方式，尤其是在低收入和中等收入国家（LMICs）。然而，在低收入和中等收入国家，大规模食品强化的成功往往受到私营部门（即强化食品供应商）对强化规定遵守程度有限的阻碍。在本文中，我们以孟加拉国生产的食用油为例，分析了营利性行为主体遵守规定的促进因素和阻碍因素。我们确定了四个阻碍私营部门行为主体做出遵守决定的瓶颈。第一，强化产品和非强化产品在市场上共存，这使得生产商缺乏投资强化的动力。第二，缺乏可追溯性降低了大规模生产商违规的风险。第三，小规模生产商面临经济压力，无法对油品进行充分强化。最后，目前执法力度不一致，使得市场上存在强化不足的油品供应。基于这些证据，我们建议通过在生产层面进行更频繁、更严格的监管，加强对大宗商品强化的控制。这将确保那些资源有限但最有可能从添加营养素中受益的消费者，仍然能够获得价格合理且营养丰富的食品。
