Micronutrient deficiencies in food aid beneficiaries: A review of seven African countries.

In order to identify micronutrients likely to be deficient in food aid beneficiary populations and to guide the formulation of food aid products, this review was undertaken to summarize published data about micronutrient deficiencies in food aid beneficiaries as compared to the general population in seven African countries (Niger, Ethiopia, Kenya, Uganda, Rwanda, Zambia, and Zimbabwe). These countries were identified by SUSTAIN as having received significant quantities of United States Public Law 480 (P.L. 480) Title II fortified and blended food aid products from 2001– 2006. Information was drawn from agency reports, personal communications, national survey data, and academic literature, primarily published since the year 2000. Among food aid beneficiaries in these countries, vitamin A and iron deficiencies were most prevalent. Deficiencies in zinc, folate (particularly in pregnancy), vitamins B-12, C, and D, thiamine, riboflavin, and calcium are likely prevalent based on low intake and physical signs of deficiency documented in the literature. In some cases, food aid rations provide insufficient quantity and quality of micronutrients, especially when used over extended periods of time as the sole food source. In nearly all the countries reviewed, deficiencies in vitamin A, iron, iodine, and other micronutrients are also quite common in the general population (those not receiving food aid). Micronutrient status information for food aid beneficiaries came mainly from studies in refugee/emergency settings, with few published studies found documenting the nutritional status of non-emergency food aid recipients. Useful insights were obtained by the review although limited micronutrient data were available for food aid beneficiaries. The micronutrient status of food aid beneficiaries should be monitored, with food aid products formulated to match the deficiencies present. Where possible, the use of anthropometry, simplified dietary assessment methods, and physical inspection are recommended to estimate micronutrient status where biochemical tests are not feasible. Agencies that currently monitor the nutritional status of food aid recipients are urged to make reports available to researchers, relief agencies, and the public.