Regulatory Monitoring Systems of Fortified Salt and Wheat Flour in Selected ASEAN Countries.

Objectives: An increasing number of countries in the Association of Southeast Asian Nations (ASEAN) are adopting or in the process to adopt mandatory food fortification to overcome vitamin and mineral deficiencies. The objective of this study was to review regulatory monitoring systems for iodized salt and fortified wheat flour in selected ASEAN countries. Methods: Regulatory monitoring includes monitoring activities at production level, customs warehouses, and retail stores by regulatory authorities. Producers also monitor during production as part of quality control and assurance. We reviewed regulatory monitoring systems through desk reviews in Philippines, Indonesia, Cambodia, Viet Nam and Malaysia and through interviews with stakeholders in the Philippines and Indonesia. Results: Challenges in regulatory monitoring systems include inefficient and ineffective government monitoring, lack of legal definitions of roles and responsibilities of agencies and industry, and a focus on end-product testing rather than process control and internal quality assurance systems. Conclusions: Without appropriate enforcement and quality assurance mechanisms, i.e., regulatory monitoring, to create a safe and fair environment for food fortification, national legislation will not necessarily lead to high coverage of fortified products and associated health outcomes.

Monitoring of Flour Fortification Programs: Case Studies in Three Countries.

Objectives: Although monitoring should be an integral part of any fortification program, little is publicly known about the design, implementation, and results of flour fortification monitoring systems. The objectives are to assess the monitoring systems in three countries including the strengths and weaknesses of each system, how weaknesses are addressed, and lessons learned. Methods: South Africa, Indonesia, and Chile were selected using predetermined criteria (e.g., mandatory fortification legislation, represent different world regions, importation of flour, and existence of a functioning flour fortification monitoring system). Eight categories of regulatory and household/individual monitoring were assessed. Results: The monitoring systems for each country had different strengths and weaknesses. Overall, strengths included having a structured plan for at least some aspects of monitoring, an adequate number of trained inspectors, and the ability to modify regulations and protocols. Monitoring weaknesses included an insufficient multiple agency approach with poor communications within and between organizations, absent commercial monitoring, and lack of laboratory resources and funds. None of the countries had a cohesive monitoring program with regular collection of regulatory and household/individual monitoring information. Conclusions: A functioning flour fortification program depends on having an effective monitoring system in place. Critical to a successful monitoring system was the planning, budget, human resources, and political will necessary to implement monitoring and review monitoring data on a regular basis.