Nandeep E R, Mahajan Hemant, Mummadi Mahesh Kumar, Sairam Challa, K Venkatesh, Kadiyam Jayachandra, Meshram Indrapal, Pagidoju Sreenu, Reddy Venkata Raji, Panda Hrusikesh, Pullakandham Raghu, Geddam J J Babu, Gavaravarapu Subbarao M, R Hemalatha, Reddy N Samarasimha
Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Beside Tarnaka Metro Station, Hyderabad, India.
Maternal and Child Health Nutrition Division, ICMR-National Institute of Nutrition, Beside Tarnaka Metro Station, Hyderabad, India.
PLOS Glob Public Health. 2024 Aug 7;4(8):e0003533. doi: 10.1371/journal.pgph.0003533. eCollection 2024.
Food fortification with micronutrients is one of the cost-effective and sustainable methods to prevent micronutrient deficiencies at community level. The rice fortified with iron, folic acid, and vitamin B12 is being supplied through various social welfare schemes in India in a phased manner and planned to cover the entire country by March 2024. We have conducted a situational analysis to assess the rollout of fortified rice supplied through the Public Distribution System (PDS) and to evaluate the accessibility, availability, acceptability, and utilization of fortified rice by the beneficiaries of the PDS. This was a mixed-method, sequential exploratory study conducted in six districts from six different states of India that had begun distribution of fortified rice through PDS in pilot mode during 2020-2021. In each district, the district supply officer of the PDS, Food Corporation of India (FCI) or State Food Corporation (SFC) warehouse supervisor, and four Fair Price Shop (FPS) dealers were interviewed. Under each FPS, a minimum of seven beneficiary households were randomly selected and interviewed using a structured questionnaire. The in-depth interviews were conducted with different stakeholders using theme guides. All the interviewed stakeholders were aware about their roles and responsibilities and purpose to distribute fortified rice. There was a continuous supply of fortified rice (across all visited districts) to beneficiaries through a well-established system. Acceptability and compliance to intake of fortified rice was good with no reported gastrointestinal adverse outcomes following fortified rice intake. There was an efficient roll-out of fortified rice though PDS with a good compliance to intake of fortified rice. It is feasible to design and conduct a study to assess the impact of fortified rice on anemia and iron storage at the community level.
通过添加微量营养素强化食品是在社区层面预防微量营养素缺乏的经济高效且可持续的方法之一。印度正在通过各种社会福利计划分阶段供应强化铁、叶酸和维生素B12的大米，并计划到2024年3月覆盖全国。我们进行了一项情况分析，以评估通过公共分配系统（PDS）供应的强化大米的推广情况，并评估PDS受益者对强化大米的可及性、可得性、可接受性和利用率。这是一项混合方法的序贯探索性研究，在印度六个不同邦的六个地区开展，这些地区在2020 - 2021年期间已开始以试点模式通过PDS分发强化大米。在每个地区，采访了PDS的地区供应官员、印度粮食公司（FCI）或邦粮食公司（SFC）的仓库主管以及四名平价商店（FPS）经销商。在每个FPS下，至少随机选择七户受益家庭，并使用结构化问卷进行访谈。使用主题指南对不同利益相关者进行了深入访谈。所有接受采访的利益相关者都清楚自己在分发强化大米方面的角色、责任和目的。通过完善的系统持续向受益者供应强化大米（在所有走访地区）。对强化大米的可接受性和摄入量的依从性良好，摄入强化大米后未报告胃肠道不良后果。通过PDS高效推广了强化大米，对强化大米摄入量的依从性良好。设计并开展一项研究以评估强化大米对社区层面贫血和铁储存的影响是可行的。
