Assessment, views and challenges of zinc and iron fortification of locally milled maize flour sold in Nairobi, Kenya

Abstract

Introduction: Low nutrient intake of Zinc and Iron is a global problem affecting the health and social economic wellbeing of world population. There is an advocacy for food fortification as one method of dealing with these two serious micronutrient deficiencies. Kenya has not been left behind. A legal notice of June 2012 made fortification of maize flour with zinc and iron mandatory for all maize millers. Limited studies have been done to evaluate compliance to the Kenyan gazette notice on micronutrient fortification standards for maize flour. Objectives: Assessment of Iron and Zinc concentration in maize flour, consumers views and miller challenges on fortification of locally milled maize flour, sold in Nairobi, Kenya. Methods: A cross sectional survey approach was used. The study was carried out in Nairobi County, Kenya. 35 Samples of fortified maize flour were randomly purchased to give a representative sample. Atomic Absorption Spectrometry was used to analyze amounts of Zinc and Iron in the maize flour samples. 384 consumers were interviewed from Nairobi County. Four maize flour millers and a Kenya Bureau of standards personnel responded to the questionnaire. Zinc and iron levels were compared against recommended fortification standards. Data on consumers was extracted, entered on excel spreadsheet and imported into R statistical software package for analysis. Data is presented in prose, charts, and tables. Results: From the study, of the 35 samples analyzed, overall, 14.29% of the samples met the minimum legal requirement of zinc and iron. The amount of iron ranged between1.08 ppm to 19.02 ppm against a minimum of 15ppm, the amount of zinc ranged from 10.64ppm to 56.25ppm against a minimum of 20ppm. Pearson’s correlation between zinc and iron fortification, was negative at a coefficient of 0.487787. Of the respondents who had knowledge on fortification, 61 % were female. There existed a positive relationship (p-value = 0.0248) between knowledge of fortification and age bracket. Consumers believed fortification improved their health at 66%. Major reasons given for fortification non-compliance were corruption and cost at 40% and 30% respectively. Although the media played a major role in creating fortification awareness at 41 %, 62.9% of respondents were not aware of the mandatory maize flour fortification with Iron and Zinc. Of the four millers interviewed, it was clear, there are no government incentives to support the mandatory fortification. Conclusion: The study showed that Maize flour available for public consumption in Nairobi County is not adequately fortified. Consumer knowledge on mandatory fortification to be increased. Millers are not adequately prepared to fortify maize flour adequately. Recommendations: The fortification process to be integrated into the overall food safety mechanisms to ensure conscious and constant monitoring during production. Consumer awareness to be created on the benefits of consuming fortified foods. The government to routinely publish the list of products that are complying and taking disciplinary actions on milers who do not comply. Government incentives such as subsidized costs of laboratory analysis would ensure increased monitoring.