title: Beyond Effectiveness--The Adversities of Implementing a Fortification Program. A Case Study on the Quality of Iron Fortification of Fish and Soy Sauce in Cambodia.
abstract: Fortification of fish and soy sauces is a cost-effective strategy to deliver and increase iron intake in the Cambodian diet, as both are widely consumed by the entire population. In order to qualify as fortified sauces recognized by international regulations, iron content must be between 230 and 460 mg/L, whilst nitrogen and salt should contain no less than 10 g/L and 200 g/L respectively. This survey aims to analyze the progress of the fortification program. Through a better understanding of its obstacles and successes, the paper will then consider approaches to strengthen the program. Two hundred and fifty two samples were collected from 186 plants and 66 markets in various provinces. They were then analyzed for iron, nitrogen and salt content. The study demonstrates that 74% of fortified fish and soy sauces comply with Cambodian regulations on iron content. 87% and 53.6% of the collected samples do not have adequate level of nitrogen and salt content, respectively. The paper will discuss additional efforts that need to be implemented to ensure the sustainability of the project, including the need to: (i) comply with International Codex; (ii) adopt mandatory legislation; and (iii) ensure enforcement.
authors.affiliation: United Nations Children's Fund (UNICEF), No. 11 Street 75, Sangkat Sraschark, Phnom Penh 12100, Cambodia. alaillou@unicef.org.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Laillou
authors.affiliation: Reproductive and Child Health Alliance (RACHA), No. 160 Street 71, Tonle Bassac, Chamkar Mon, Phnom Pen 12100, Cambodia. pfannersimon@gmail.com.
authors.forename: Simon
authors.initials: S
authors.lastname: Pfanner
authors.affiliation: Reproductive and Child Health Alliance (RACHA), No. 160 Street 71, Tonle Bassac, Chamkar Mon, Phnom Pen 12100, Cambodia. ctheary@racha.org.kh.
authors.forename: Theary
authors.initials: T
authors.lastname: Chan
authors.affiliation: National Sub-Committee of Food Fortification, Ministry of Planning, 386 Monivong Blvd, Phnom Penh 12100, Cambodia. chantumch@gmail.com.
authors.forename: Chantum
authors.initials: C
authors.lastname: Chea
authors.affiliation: National Sub-Committee of Food Fortification, Ministry of Planning, 386 Monivong Blvd, Phnom Penh 12100, Cambodia. borathmam@yahoo.com.
authors.forename: Borath
authors.initials: B
authors.lastname: Mam
authors.affiliation: Reproductive and Child Health Alliance (RACHA), No. 160 Street 71, Tonle Bassac, Chamkar Mon, Phnom Pen 12100, Cambodia. psambath@racha.org.kh.
authors.forename: Pol
authors.initials: P
authors.lastname: Sambath
authors.affiliation: National Institute of Public Health, No. 2 Sangkat Boeungkak, Phnom Penh 12100, Cambodia. svonthanak@gmail.com.
authors.forename: Saphoon
authors.initials: S
authors.lastname: Vonthanak
authors.affiliation: UMR 204 "Prevention of Malnutrition and Associated Diseases", IRD-UM2-UM1, Institute of Research for Development (IRD), BP 645, Montpellier cedex 34394, France. franck.wieringa@ird.fr.
authors.forename: Frank
authors.initials: F
authors.lastname: Wieringa
mesh_terms: D002160:Cambodia; D005396:Fish Products / Q000032:analysis*; D005527:Food, Fortified / Q000592:standards*; D033161:Government Regulation; D006801:Humans; D007501:Iron / Q000008:administration & dosage* / Q000032:analysis; D019266:Iron, Dietary / Q000008:administration & dosage* / Q000032:analysis; D009584:Nitrogen / Q000032:analysis*; D015397:Program Evaluation; D017673:Sodium Chloride, Dietary / Q000032:analysis*; D045730:Soy Foods / Q000032:analysis*
chemical_list: D019266:Iron, Dietary; D017673:Sodium Chloride, Dietary; D007501:Iron; D009584:Nitrogen
keywords: Cambodia; Codex; compliance; fortified sauces; iron; quality control