Potential Contributions of Edible Oil and Wheat Flour Fortification on Reducing Inadequate Micronutrient Intake in Ethiopia

In 2022, Ethiopia enacted the mandatory fortification of wheat flour and edible oil to counter inadequate micronutrient intake as a risk factor for micronutrient deficiencies. This study aimed to model the potential contributions of fortifying wheat flour and edible oil to reducing the risk of micronutrient inadequacy. The 2015/16 Ethiopian Household Consumption-Expenditure Survey was used to estimate apparent micronutrient intakes of nine micronutrients and triangulated to existing food consumption and micronutrient surveys. Population risk for inadequate micronutrient intake was assessed overall using a mean adequacy ratio and for individual micronutrients included in the fortification standards. Potential contributions of fortification were assessed by comparing two scenarios across subpopulations: assuming no fortification and full compliance with the fortification policy. The reach of fortifiable wheat flour (39%) and edible oil (70%) suggests that fortifying these vehicles could reduce the risk of inadequate micronutrient intake by 44%, with variation between micronutrients, geographies, urban/rural residence, and socioeconomic status. Even under optimistic fortification scenarios, however, micronutrient gaps would remain for the rural poor. Sustained efforts are needed to drive the implementation of Ethiopia's fortification policy and to coordinate fortification with other interventions targeting populations beyond the reach of fortified foods.