title: Large-scale fortification of condiments and seasonings as a public health strategy: equity considerations for implementation.
abstract: Fortification of staple foods with vitamins and minerals is an effective approach to increase micronutrient intake and improve nutritional status. The specific use of condiments and seasonings as vehicles in large-scale fortification programs is a relatively new public health strategy. This paper underscores equity considerations for the implementation of large-scale fortification of condiments and seasonings as a public health strategy by examining nonexhaustive examples of programmatic experiences and pilot projects in various settings. An overview of conceptual elements in implementation research and equity is presented, followed by an examination of equity considerations for five implementation strategies: (1) enhancing the capabilities of the public sector, (2) improving the performance of implementing agencies, (3) strengthening the capabilities and performance of frontline workers, (3) empowering communities and individuals, and (4) supporting multiple stakeholders engaged in improving health. Finally, specific considerations related to intersectoral action are considered. Large-scale fortification of condiments and seasonings cannot be a standalone strategy and needs to be implemented with concurrent and coordinated public health strategies, which should be informed by a health equity lens.
authors.affiliation: Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland. zamorag@who.int.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Zamora
authors.affiliation: Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
authors.forename: Mónica Crissel
authors.initials: MC
authors.lastname: Flores-Urrutia
authors.affiliation: Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland.
authors.forename: Ana-Lucia
authors.initials: AL
authors.lastname: Mayén
mesh_terms: D003212:Condiments; D005527:Food, Fortified; D000069576:Health Equity; D006801:Humans; D018673:Nutrition Policy / Q000639:trends; D011634:Public Health / Q000379:methods / Q000639:trends; D015980:Public Health Practice; D017365:Spices
keywords: condiments; equity; fortification; implementation; social determinants of health