Flour fortification with iron: a mid-term evaluation

Public Health. 2008 Mar;122(3):313-21. doi: 10.1016/j.puhe.2007.05.002. Epub 2007 Jul 23.

Abstract

Objectives: Iron-deficiency anaemia is a major nutritional problem in Iran. A programme of flour fortification with iron was launched in 2001. A mid-term evaluation was conducted in 2004 to determine the effectiveness and coverage of this programme.

Methods: To determine the effectiveness of the program, a field trial was conducted in which blood hemoglobin and ferritin levels were measured in a sample population from Bushehr (intervention) and Fars (control) provinces. The target population was women aged 15-49 years. The coverage of the programme was determined using a cross-sectional study that measured iron content in samples of flour and bread from Bushehr province.

Results: Five hundred and sixty-seven and 296 women were studied in the intervention and control provinces, respectively. Women in the intervention province had a lower prevalence of low ferritin levels compared with women in the control province (P=0.04). Women from the two provinces did not differ in terms of haemoglobin levels and iron-deficiency anaemia. The coverage of fortified flour and bread was 100% and 99.7%, respectively.

Conclusions: This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels. The final evaluation is likely to provide more useful information regarding the effect of this programme on a number of anaemia indicators.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / epidemiology
  • Cross-Sectional Studies
  • Female
  • Ferritins / analysis*
  • Flour*
  • Food, Fortified*
  • Hemoglobins / analysis
  • Humans
  • Iran / epidemiology
  • Iron Compounds / administration & dosage
  • Iron Compounds / therapeutic use*
  • Male
  • Middle Aged
  • Nutritional Status
  • Prevalence
  • Program Evaluation

Substances

  • Hemoglobins
  • Iron Compounds
  • Ferritins