Coordinating Nigeria's micronutrient deficiency control programs is necessary to prevent deficiencies and toxicity risks

Nigeria has an alarming prevalence of micronutrient deficiencies that has persisted over decades. National Micronutrient Deficiency Control (MNDC) guidelines describe several interventions to address the issue. This study identified and described currently implemented interventions, assessed coverag...

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Bibliographic Details
Published in:Annals of the New York Academy of Sciences 2019-06, Vol.1446 (1), p.153-169
Main Authors: Anjorin, Olufolakemi, Okpala, Oluchi, Adeyemi, Olutayo
Format: Article
Language:English
Subjects:
Control programs
Coordination
deficiency
Deficiency Diseases - epidemiology
Deficiency Diseases - prevention & control
Diet
Dietary supplements
fortification
Humans
Intakes
Micronutrients
Micronutrients - deficiency
Micronutrients - toxicity
Nigeria
Nigeria - epidemiology
Nutritional Status
Public health
Risk
Risk reduction
supplementation
Toxicity
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Summary:Nigeria has an alarming prevalence of micronutrient deficiencies that has persisted over decades. National Micronutrient Deficiency Control (MNDC) guidelines describe several interventions to address the issue. This study identified and described currently implemented interventions, assessed coverage and coordination of the interventions, and considered the risk of overdosage and gaps. Methods included reviews of policy and program documents, key informant interviews, market, and pharmacy visits. The study found that an array of MNDC interventions were being implemented, including public health supplementation, mandatory fortification, point‐of‐use fortification, biofortification, promotion of dietary diversity, voluntary fortification, and ad hoc individual supplement use. Insufficient coordination existed for government, private, and civil society interventions within the health sector and between health and other sectors. Dosages of micronutrients supplied by different interventions were set independently of each other and target populations overlapped. Inadequate implementation of various interventions appeared to reduce the risk of excessive micronutrient intakes, but increased the risk of deficiencies. The risk of excessive intakes will likely increase with improved implementation and scale‐up. There is a need to develop effective coordination structures for MNDC in Nigeria that will critically examine the landscape, decide modalities for different interventions, and ensure that both deficiencies and risk of excessive intakes are minimized.
ISSN:0077-8923
1749-6632
DOI:10.1111/nyas.14055