Flour fortification with iron: a mid-term evaluation.
OBJECTIVE
Iron-deficiency anaemia is a major nutritional problem in Iran. A programme of flour fortification with iron was launched in 2001. A mid-term evaluation was conducted in 2004 to determine the effectiveness and coverage of this programme.


METHODS
To determine the effectiveness of the program, a field trial was conducted in which blood hemoglobin and ferritin levels were measured in a sample population from Bushehr (intervention) and Fars (control) provinces. The target population was women aged 15-49 years. The coverage of the programme was determined using a cross-sectional study that measured iron content in samples of flour and bread from Bushehr province.


RESULTS
Five hundred and sixty-seven and 296 women were studied in the intervention and control provinces, respectively. Women in the intervention province had a lower prevalence of low ferritin levels compared with women in the control province (P=0.04). Women from the two provinces did not differ in terms of haemoglobin levels and iron-deficiency anaemia. The coverage of fortified flour and bread was 100% and 99.7%, respectively.


CONCLUSIONS
This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels. The final evaluation is likely to provide more useful information regarding the effect of this programme on a number of anaemia indicators.
Sadighi
Jila
J
Institute for Health Sciences Research, Tehran, Iran. jsadighi@ihsr.ac.ir
Sheikholeslam
Robabeh
R
Mohammad
Kazem
K
Pouraram
Hamed
H
Abdollahi
Zahra
Z
Samadpour
Koroush
K
Kolahdooz
Fariba
F
Naghavi
Mohsen
M
D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000032:analysis*; D005433:Flour; D005527:Food, Fortified; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007492:Iran / Q000453:epidemiology; D058085:Iron Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015995:Prevalence; D015397:Program Evaluation
D006454:Hemoglobins; D058085:Iron Compounds; D005293:Ferritins