Increasing food fortification in Pakistan

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Department for International Development

Problem: Malnutrition, particularly micronutrient deficiency, is a major challenge in Pakistan, where a large proportion of the population is anaemic or deficient in vitamins A and D. To address this problem, the UK’s Department for International Development (DFID) is funding a five-year Food Fortification Programme, running from 2016 to 2021. The aim is to fortify 95% of the commercially milled wheat flour that is routinely consumed by at least one quarter of Pakistan’s population and 95% of the oil/ghee consumed almost universally by 98% of the population.

Approach: Common worked with Mott MacDonald to assess the effectiveness of various incentive schemes designed to encourage millers to fortify their flour. The incentives included the free provision of equipment, different levels of subsidy to reduce the cost of the fortifying premix, and a marketing campaign to increase consumer demand for fortified foods. We developed a discrete choice experiment and a behaviour change survey to test all these options with millers in Pakistan, with data collected by VTT Global.

We discovered that the millers’ preferences strongly depended on whether the government regulates the fortification of flour. In scenarios where fortification was mandatory, they favoured a marketing campaign over subsidies and equipment. Without regulation, they had no clear preference for one incentive over another. Importantly, in either scenario they did not seem to differentiate between different levels of financial support: they were as likely to fortify with 50% subsidy as 80%. The results of the study will be used to inform the programme’s approach to ensuring the maximum number of industrial millers fortify flour and oil, with resources deployed on the most effective strategies.