TABLE 2.
Percentage of Country-Grain Combinationsa With Documented Items in Fortification Legislation, Standards, and Monitoring Documents (N=72)
| Item | Eligible (N) | % (n) Fully Meeting | % (n) Partly Meeting | % (n) Not Meeting |
|---|---|---|---|---|
| General | ||||
| 1. Food vehicle stated in legislation | 72 | 97% (70) | – | 3% (2) |
| 2. Public health objective/purpose | 72 | 69% (50) | – | 31% (22) |
| 3. Accepted international norms | 72 | 54% (39) | – | 46% (33) |
| 4. Definitions specific to fortification | 72 | 76% (55) | – | 24% (17) |
| 5. Repeals of prior documentationb | 59 | 71% (42) | – | 29% (17) |
| 6. Effective date/grace period | 72 | 72% (52) | – | 28% (20) |
| Micronutrients/Premix | ||||
| 7. Nutrients required | 72 | 100% (72) | – | 0% (0) |
| 8. Fortificants (chemical compounds) | 72 | 88% (63) | – | 13% (9) |
| 9. Fortification levels | 72 | 42% (30) | 54% (39) | 4% (3) |
| 10. Bioavailability of fortificants | 72 | 31% (22) | – | 69% (50) |
| 11. Nutrient stability | 72 | 54% (39) | – | 46% (33) |
| Costing | ||||
| 12. Cost sharing of fortification | 72 | 19% (14) | – | 81% (58) |
| 13. Financial responsibility of monitoring and enforcement | 72 | 35% (25) | – | 65% (47) |
| Labeling | ||||
| 14. Labeling required | 72 | 78% (56) | – | 22% (16) |
| 15. Guidance on health claims | 72 | 50% (36) | – | 50% (36) |
| Internal Monitoring (conducted by industry during production) | ||||
| 16. Sampling process outlinedb | 31 | 71% (22) | 29% (9) | 0% (0) |
| 17. Industry QA/QC justified/required | 72 | 64% (46) | – | 36% (26) |
| 18. Applicability of qualitative tests | 72 | 29% (21) | 1% (1) | 69% (50) |
| External Monitoring (conducted by government at production sites) | ||||
| 19. External monitoring justified | 72 | 64% (46) | – | 36% (26) |
| 20. Protocols and systems described | 72 | 33% (24) | 28% (20) | 39% (28) |
| 21. Roles and responsibilities clarifiedb | 56 | 45% (25) | 7% (4) | 48% (27) |
| 22. Timeline for inspections outlined | 72 | 26% (19) | 13% (9) | 61% (44) |
| 23. Sampling process outlinedb | 45 | 67% (30) | 33% (15) | 0% (0) |
| 24. Applicability of qualitative tests | 72 | 19% (14) | 1% (1) | 79% (57) |
| 25. Registration requirements | 72 | 38% (27) | – | 63% (45) |
| Commercial Monitoring (conducted by government at market or distribution sites) | ||||
| 26. Commercial monitoring justified | 72 | 47% (34) | – | 53% (38) |
| 27. Protocols and systems described | 72 | 19% (14) | 21% (15) | 60% (43) |
| 28. Roles and responsibilities clarifiedb | 63 | 32% (20) | 0% (0) | 68% (43) |
| 29. Timeline for inspections outlinedb | 44 | 14% (6) | 25% (11) | 61% (27) |
| 30. Sampling process outlinedb | 28 | 71% (20) | 29% (8) | 0% (0) |
| Import Monitoring (conducted by government at ports/points of entry) | ||||
| 31. Import monitoring justified | 72 | 64% (46) | – | 36% (26) |
| 32. Protocols and systems described | 72 | 35% (25) | 26% (19) | 39% (28) |
| 33. Roles and responsibilities clarifiedb | 59 | 42% (25) | 2% (1) | 56% (33) |
| 34. Sampling process outlinedb | 29 | 62% (18) | 38% (11) | 0% (0) |
| Enforcement/Penalties | ||||
| 35. Enforcement roles and responsibilities clarified | 72 | 69% (50) | – | 31% (22) |
| 36. Incentives to start fortification | 72 | 14% (10) | – | 86% (62) |
| 37. Incentives to continue fortification | 72 | 10% (7) | – | 90% (65) |
| 38. Penalties to compel compliance | 72 | 68% (49) | – | 32% (23) |
| 39. Penalties objectively definedb | 49 | 31% (15) | – | 69% (34) |
| 40. Enforcement includes feedback | 72 | 18% (13) | – | 82% (59) |
| Laboratory | ||||
| 41. Analytical methods identified | 72 | 60% (43) | – | 40% (29) |
| 42. Recognition of laboratory variation | 72 | 11% (8) | – | 89% (64) |
| 43. Quantitative analysis of "marker" micronutrients such as iron | 72 | 36% (26) | – | 64% (46) |
| Reporting | ||||
| 44. Dissemination of monitoring results described | 72 | 31% (22) | – | 69% (50) |
Abbreviations: QA/QC, quality assurance/quality control.
a
Country-grain combination refers to the unit of analysis; countries that mandate the fortification of multiple cereal grains will contribute more than one country-grain combination (e.g., Philippines-wheat and Philippines-rice).
b
The number eligible differs for these items due to a “not applicable” option on the scoring checklist.