This report examines the potential to scale up micronutrient fortification in Pakistan in order to reduce micronutrient deficiencies. Findings from the 2011 National Nutritional Survey reveal that very little progress has been made with respect to micronutrient deficiencies among women and children in Pakistan, with the exception of gains in iodised salt use and large reductions in moderate to severe urinary iodine deficiency rates. One in five pregnant and lactating women and one in three children under the age of five were anaemic due to iron deficiency in 2011. Night blindness affected 16% of pregnant women, and more than 50% of children were vitamin A deficient. About 40% of women and children were deficient in zinc, and 70% of pregnant women and 40% of children were deficient in vitamin D. Moreover, persistent high rates of stunting (44%) and wasting (15%) among children under five are an important reminder that this could be a major bottleneck in addressing child survival in Pakistan.

Food fortification is safe and cost-effective in the prevention of micronutrient deficiencies and has been widely practiced in developed countries for well over a century. Commissioned by the United Kingdom’s Department for International Development (DFID) in Pakistan, this scoping study was undertaken by an international team of consultants to investigate and compare options for food fortification initiatives in Pakistan. The study focused on three areas: the regulatory environment for food fortification, the private sector role and potential agricultural solutions. Phase 1 of the study was a descriptive analysis to map the current landscape for food fortification, Phase 2 included the appraisal of selected options for fortification with respect to evidence on potential impact and feasibility of implementation and Phase 3 included an economic analysis of these options.