Addressing micronutrient malnutrition in urban settings through national, mandatory food fortification programs: A unique opportunity to impact change.

Access to nutritious foods for those living in poor urban settings is often more of a problem than the availability of these foods. This chapter describes a proven and effective strategy to impact food quality in urban settings through the implementation of national, mandatory food fortification programs. By leveraging what large sectors of the urban population already have access to and are already consuming on a regular basis, no new delivery mechanisms are needed, limited behavior change is required, and no additional responsibilities are placed on the healthcare system. Based on Project Healthy Children’s experience assisting governments to design and implement national fortification programs, this chapter describes micronutrient malnutrition, particularly in the context of urban settings, and the various interventions that exist to address it. The chapter proceeds to discuss why fortification is a well-suited strategy for urban populations touching on new design and implementation opportunities that exist around small-scale fortification. Broad steps necessary to design a program and critical components needed to successfully implement in urban settings are outlined. Finally, the chapter concludes with important lessons learned from past programs in East Africa.