Strategies

Iodine

The most common approach to controlling iodine deficiency is salt iodization. The cost of adding potassium iodide or potassium iodate to salt ranges between USD 0.02 and 0.07 per kilogram of salt amounting to about 5% of the cost. In most countries this cost is absorbed by consumers within the retail price (although markups in excess of extra cost are not uncommon). The best results have been achieved in countries where salt iodization has been made mandatory resulting in virtual elimination of iodine deficiency disorders. Depending on the country, the cost of controlling iodine deficiency disorders ranges between USD 0.25 and $ 5.00.
[Taken from Costs and Benefits for Reducing Vitamin and Mineral Definciency]

Vitamin A

The most widely used method for controlling vitamin A deficiency is through the prophylactic supplementation of children aged 6-59 months twice yearly. From 1998 up this year in many high burden countries, this was integrated within polio national immunization days. Adding a vitamin A supplement component to polio NIDs is generally estimated to increase the cost by 2% to 10% depending on the country. In order to provide full coverage against vitamin A deficiency, two doses are required annually. However since polio NIDs are held once per year other campaigns have been used in some countries to provide a second dose. The production cost per single capsule (excluding delivery costs) is low - about USD 0.02 each. As national Polio NIDs are phased out, alternative mechanisms for vitamin A delivery are being developed. The most promising is the approach of integrating vitamin A supplementation with an “essential package of health services” that would provide the necessary infrastructure for vitamin A supplement distribution. There isn’t yet much hard information on the incremental cost of integrating vitamin A supplementation within essential packages of health services. But it has been estimated to cost between $1.00 and $ 10.00 per child per year1 to provide full protection depending on the country.
[Taken from Costs and Benefits for Reducing Vitamin and Mineral Definciency]

Iron

The use of supplementation as a means for controlling iron deficiency anemia is relatively difficult. Iron cannot be delivered at one time in a large dose as can vitamin A, and must be taken daily – for example by pregnant women – a high risk group. Costs are in the range $10-14 / per head. However compliance and coverage are often not good unless backed up by good support mechanisms (as is the case in for example Nepal). So the fortification of staple foods such as flour is often the method of choice in many countries. The per capita cost of fortifying wheat flour with iron typically ranges around $0.12.
[Taken from Costs and Benefits for Reducing Vitamin and Mineral Definciency]

Benefits

The benefits of controlling vitamin and mineral deficiency can also be modeled in terms of economic impact. Controlling iodine deficiency and iron deficiency have a direct impact on cognitive development of children and, in the long term, on economic productivity of the workforce. We estimate that African nations lose between 0.4% and 2.7% of their GDP annually as a direct outcome of vitamin and mineral deficiency. Fully controlling vitamin and mineral deficiency in Africa could contribute significantly to improved GDP performance.
[Taken from Costs and Benefits for Reducing Vitamin and Mineral Definciency]

Fortification of staple foods with iron, vitamin A and other key vitamins and minerals is projected to provide African consumers with 1/3rd or more of their daily needs for essential vitamins and minerals. A comprehensive food fortification can reach more than 50% of the continent’s population, promising significant reductions in VMD at a 1-3% incremental food cost.
[From Food Security]

See the Food Security pdf for detailed explanations of strategies to provide adequate vitamins and minerals. The listing gives specific information on existing programs, developing programs, locations, and opportunities.

According to the NEPAD Nutrition Concept Note, "A number of opportunities for national teams to cost-effectively invest in improving nutrition, health and productivity are already apparent within proposed NEPAD and CAADP initiatives, including:

• Nutritional enhancements to optimize investments in the Pan African Cassava Initiative
  and NERICA Initiative through developing methods to improve nutrient content.
  
• Ensuring maximal nutrition impact of the Home Grown School Feeding Initiative through
  local fortification of foods and a package of educational activities and health
  interventions,
  
• Large scale industrial fortification of processed foods including vegetable oil, sugar, salt,
  maize meal and wheat flour with vitamins and minerals
  
• Business models to promote the cultivation, production, distribution and marketing of
  high-nutrient-density foods for vulnerable groups such as children 6-24 months and HIV
  infected populations, including small grains, vitamin A rich foods such as orange sweet
  potatoes and red palm oil, and low-cost locally-produced mixes or snacks
  
• Enhanced effectiveness of Agricultural extension services by ensuring the complementary
  capacity to deliver essential nutrition education and services to rural communities.
  
• Integrated support for community action to leverage communications channels, expand
  service delivery infrastructure, and empower communities to generate their own progress
  towards good nutrition and health.
  
• Product development and expansion of sustainable business models for rural small-scale
  fortification of maize meal, millet, sorghum and cassava flours.
  
• Coordinated national and regional advocacy and public education strategies to harness the
  emerging media and communications channels.
  
• A comprehensive package of essential nutrition interventions to be integrated into health
  services and other appropriate public delivery mechanisms, including Education
  Development Plans.
  
• Sustainable national outreach strategies or Child Health Weeks to ensure access for
  under-5 children with twice–yearly Vitamin A supplementation and other essential
  actions, as a lead programme in a community-level child survival initiative.

last updated 25 May 2006