Viet Nam - Iron Fortified Fish Sauce

Iron deficiency anaemia affects 40% of women of reproductive age and 45% of children under five years of age in Vietnam. Anaemia prevalence is found to be high in all regions of the country, but is greatest in rural areas, especially the Central Highlands region and Mekong River Delta. Fish sauce is a particularly good vehicle for food fortification, as the daily consumption is high and fortification can be achieved with only minor modification of the production process. Both efficacy and effectiveness studies of fish sauce fortified with NaFeEDTA produced results that pointed to a significant reduction of the prevalence of iron deficiency anaemia among those women who regularly consumed fish sauce. The price is also affordable – an additional two US cents per litre. The project will also help the government to reach its national iron deficiency anaemia targets and the fish sauce producers to implement Good Manufacturing Practice standards. The project will assist 20 of the country’s largest fish sauce factories to develop their production of NaFeEDTA-fortified fish sauce and to establish their quality control systems. These factories will fortify their ‘normal’ quality fish sauce, which is the type usually consumed by the at-risk population – the low income and the poor. A quality assurance and control program, implemented in the factories, will ensure consistent quality of the iron-fortified fish sauce from manufacturer to consumer. A further project component will support the development of a social marketing and education campaign on the key role of iron for good health and on the benefits of iron-fortified fish sauce – the campaign’s objective being to change the behaviour of low income and poor consumers from using non-fortified to using iron-fortified fish sauce. To generate institutional support to the project, iron fortification steering committees (made up of volunteers) will be established at provincial level with the primary purpose of conducting advocacy among local policy and decision-makers. At the national level advocacy will be conducted by the National Fortification Alliance. A system will be established to monitor progress in implementation of all components and evaluate its impact on at-risk populations. The project will also support capacity building at both national and provincial levels within the Ministry of Health.