Guidelines for the development, implementation, monitoring, and evaluation of a vitamin A sugar fortification program

This document presents Part I of a 3-part manual of guidelines for establishing and implementing a vitamin A sugar fortification program. Part I describes why it is important to prevent and reduce vitamin A deficiency and how to go about establishing such a program. Existing strategies are discussed, and the basic elements to be considered in establishing an appropriate program are described in detail. Part I also offers an overview of the entire food fortification program for use by managers, and discusses technical aspects of the program, including the operations involved in sugar fortification, determinates for both the efficiency and efficacy of interventions, and guidelines for determining program costs. Part II of the manual (PN-ABY-871) is written specifically for technical personnel and covers general aspects of the fortification process as well as procedures for manufacturing the vitamin A premix and for adding it to sugar; a detailed description of quality control procedures is included. Part III (PN-ABY-872) is written primarily for laboratory personnel and presents field and laboratory methods for estimating the content of vitamin A in the premix and in fortified sugar; it also provides details on how to determine retinol levels in biological samples critical in evaluating program impact. (Author abstract, modified)