National Micronutrient Survey in Jordan
National survey shows improvements in the iron status of children and identifies high rates of vitamin D deficiency
Micronutrient malnutrition is a public health problem in Jordan; the fortification of wheat flour has been in place since 2002 to address key micronutrient deficiencies.
Wheat flour in Jordan is currently fortified with ten micronutrients (iron, zinc, and vitamins A, D, B1, B2, B3, B6, B9 (folic acid), B12), making Jordan’s wheat fortification program one of the most nutritionally comprehensive in the world.
To assess the impact of the program, GAIN and UNICEF funded a national micronutrient survey in 2010. This survey was implemented by the Jordan Ministry of Health, the US Centers for Disease Control and Prevention (CDC), the Jordan Bureau of Statistics, the Jordan University of Science and Technology, and GAIN.
By comparing iron and vitamin A deficiencies in preschool-age children to a similar survey in 2002, the survey identified a decrease among preschool-age children of iron deficiency from 26.2% in 2002 to 13.7% in 2010 and iron deficiency anemia from 10.1% in 2002 to 4.8% in 2010. In contrast to iron deficiency and iron deficiency anemia, no reductions were observed in vitamin A deficiency for preschool-age children.
Though this survey assessed national nutrition trends and did not permit attribution to particular interventions, it is likely that wheat flour fortification was a contributing factor in these reductions.
In women of reproductive age, no significant changes in the iron status indicators were observed between 2002 and 2010, with current rates of 35.1% and 19.1% for iron deficiency and iron deficiency anemia, respectively. Vitamin A status was not collected in 2002 for women and thus no comparisons made.
Though disappointing, this finding matches global trends in nutritional data which show a lag in improvement in women’s nutritional status, particularly related to iron deficiency and anemia.
In addition to observing trends, this survey also provided key evidence related to high levels of vitamin D deficiency in women (60.3 percent), validating the Jordanian government’s decision to add vitamin D to wheat flour vitamin and mineral premix in 2010.
