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Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress

Background: Initiatives to tackle micronutrient deficiencies (MNDs) in low-and middle-income countries (LMICs) have increased steadily in recent years. Commodities such as staple foods (e.g., cereals) and condiments (e.g., salt) have been targeted as ‘vehicles’ for industrial fortification through n...

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Autores principales: Lalani, Baqir, Ndegwa, Michael, Bennett, Ben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730650/
https://www.ncbi.nlm.nih.gov/pubmed/33260569
http://dx.doi.org/10.3390/ijerph17238862
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author Lalani, Baqir
Ndegwa, Michael
Bennett, Ben
author_facet Lalani, Baqir
Ndegwa, Michael
Bennett, Ben
author_sort Lalani, Baqir
collection PubMed
description Background: Initiatives to tackle micronutrient deficiencies (MNDs) in low-and middle-income countries (LMICs) have increased steadily in recent years. Commodities such as staple foods (e.g., cereals) and condiments (e.g., salt) have been targeted as ‘vehicles’ for industrial fortification through numerous projects and initiatives. However, mixed experiences with delivery, coverage and sustainability have been found. Methods: Using an online survey of 71 key stakeholders (from 35 countries) consisting of the public/private sector, academia and civil society, this study sought to unpack the ‘business model’ for fortification initiatives to identify the key drivers of success and constraints faced by stakeholders in LMICs. Bivariate analysis was conducted to identify factors associated with the coverage of the target market and the perceived success and sustainability of fortification initiatives. Results: We identified four key factors contributing to the success of fortification initiatives. The first involves the size of the firm. Large firms had a significantly higher (p 0.05) self-sustaining index (perceived level of sustainability of the fortification initiative) than smaller sized firms. In addition, a higher perceived success score (p 0.05) was associated with non-targeted initiatives compared to those specifically targeted at a certain cohort of the population, further illustrating the benefits of producing at scale. Secondly, a significant relationship was found between whether standards were enacted and the coverage of the target market by the project/firm (p 0.05).). The third key factor relates to the ability to source adequate testing for the fortified produce in-house. A positive correlation was found for post-mix in-factory testing and the self-sustaining index (p 0.05). Finally, delays to importation and high charges were cited as key constraints to the use of premix. Conclusions: We argue therefore that a successful ‘business model’ for industrial fortification initiatives invariably consist of: (i) the involvement of larger sized firms that have the advantage of benefiting from economies of scale; (ii) the availability and application of agreed standards by the producer; (iii) high quality assurance/compliance monitoring (including post-mix testing where relevant), and; (iv) the ability to procure premix in a timely/cost-effective manner. These criteria are likely to be important factors that contribute to the success of fortification initiatives in LMICs.
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spelling pubmed-77306502020-12-12 Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress Lalani, Baqir Ndegwa, Michael Bennett, Ben Int J Environ Res Public Health Article Background: Initiatives to tackle micronutrient deficiencies (MNDs) in low-and middle-income countries (LMICs) have increased steadily in recent years. Commodities such as staple foods (e.g., cereals) and condiments (e.g., salt) have been targeted as ‘vehicles’ for industrial fortification through numerous projects and initiatives. However, mixed experiences with delivery, coverage and sustainability have been found. Methods: Using an online survey of 71 key stakeholders (from 35 countries) consisting of the public/private sector, academia and civil society, this study sought to unpack the ‘business model’ for fortification initiatives to identify the key drivers of success and constraints faced by stakeholders in LMICs. Bivariate analysis was conducted to identify factors associated with the coverage of the target market and the perceived success and sustainability of fortification initiatives. Results: We identified four key factors contributing to the success of fortification initiatives. The first involves the size of the firm. Large firms had a significantly higher (p 0.05) self-sustaining index (perceived level of sustainability of the fortification initiative) than smaller sized firms. In addition, a higher perceived success score (p 0.05) was associated with non-targeted initiatives compared to those specifically targeted at a certain cohort of the population, further illustrating the benefits of producing at scale. Secondly, a significant relationship was found between whether standards were enacted and the coverage of the target market by the project/firm (p 0.05).). The third key factor relates to the ability to source adequate testing for the fortified produce in-house. A positive correlation was found for post-mix in-factory testing and the self-sustaining index (p 0.05). Finally, delays to importation and high charges were cited as key constraints to the use of premix. Conclusions: We argue therefore that a successful ‘business model’ for industrial fortification initiatives invariably consist of: (i) the involvement of larger sized firms that have the advantage of benefiting from economies of scale; (ii) the availability and application of agreed standards by the producer; (iii) high quality assurance/compliance monitoring (including post-mix testing where relevant), and; (iv) the ability to procure premix in a timely/cost-effective manner. These criteria are likely to be important factors that contribute to the success of fortification initiatives in LMICs. MDPI 2020-11-28 2020-12 /pmc/articles/PMC7730650/ /pubmed/33260569 http://dx.doi.org/10.3390/ijerph17238862 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lalani, Baqir
Ndegwa, Michael
Bennett, Ben
Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title_full Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title_fullStr Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title_full_unstemmed Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title_short Unpacking the ‘Business Model’ for Fortification Initiatives in Low- and Middle-Income Countries: Stakeholder Identified Drivers of Success and Constraints to Progress
title_sort unpacking the ‘business model’ for fortification initiatives in low- and middle-income countries: stakeholder identified drivers of success and constraints to progress
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7730650/
https://www.ncbi.nlm.nih.gov/pubmed/33260569
http://dx.doi.org/10.3390/ijerph17238862
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