title: Anaemia control: lessons from the flour fortification programme.
abstract: OBJECTIVE
  Anaemia is an important public health problem in Iran; therefore, a programme of flour fortification with iron was launched in two pilot provinces. The present study was conducted in January 2009 to evaluate the effectiveness and process of this programme.
  
  
  METHODS
  A 'before-and-after study' was conducted to evaluate the effectiveness of the flour fortification programme, and the process of the programme was evaluated using a cross-sectional study.
  
  
  METHODS
  To evaluate the effectiveness of the programme, blood haemoglobin and ferritin levels were measured in sample populations from Bushehr and Golestan provinces. The target population was women aged 15-49 years. Iron content was measured in samples of flour and bread to evaluate the flour fortification process in these two national pilot provinces.
  
  
  RESULTS
  The total study population was 600 women from Bushehr province and 652 women from Golestan province. Similar trends were found in the indicators of anaemia/iron deficiency among the women studied in both provinces. The flour fortification programme only appears to have had a beneficial effect on ferritin levels (iron deficiency) in the two provinces. The prevalence of iron-deficiency anaemia before and after the intervention did not differ significantly in either province. Interestingly, the prevalence of anaemia (low haemoglobin) was significantly higher after the intervention in women from both provinces. The coverage of fortified flour and bread was 90% and 98.7% in Bushehr province, and 94.1% and 95% in Golestan province, respectively.
  
  
  CONCLUSIONS
  In areas where anaemia is not mainly due to iron deficiency, an iron fortification programme might decrease the prevalence of iron deficiency without affecting the prevalence of anaemia.
authors.affiliation: Institute for Health Sciences Research, Academic Centre for Education, Culture and Research, P.O. Box 13145-483, Tehran, Iran. jsadighi@ihsr.ac.ir
authors.forename: J
authors.initials: J
authors.lastname: Sadighi
authors.forename: K
authors.initials: K
authors.lastname: Mohammad
authors.forename: R
authors.initials: R
authors.lastname: Sheikholeslam
authors.forename: M A
authors.initials: MA
authors.lastname: Amirkhani
authors.forename: P
authors.initials: P
authors.lastname: Torabi
authors.forename: F
authors.initials: F
authors.lastname: Salehi
authors.forename: Z
authors.initials: Z
authors.lastname: Abdolahi
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D001939:Bread / Q000032:analysis; D005260:Female; D005293:Ferritins / Q000097:blood; D005433:Flour / Q000032:analysis; D005527:Food, Fortified; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007492:Iran; D019266:Iron, Dietary / Q000008:administration & dosage*; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D015397:Program Evaluation; D012494:Sampling Studies; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D005293:Ferritins