Preventing Neural Tube Defects in Nicaragua through Rice Fortification

Organization: 
INCAP
Organization Location: 
Managua, Nicaragua

Neural tube defects (NTDs) are a group of preventable birth defects that result in severe neurologic and functional disabilities and usually death. The incidence of NTDs in Nicaragua is nearly ten-fold higher than in the United States, where NTDs are prevented through mandatory fortification of staple foods with folic acid. This project will prevent neural tube defects in Nicaragua through fortification of rice – a staple food – with folic acid. We will support twelve early adopter rice mills that collectively produce 60% of rice in Nicaragua with training and equipment to enable local production of fortified rice, as well as a comprehensive branding campaign to promote the purchase and consumption of fortified rice. By establishing high consumer demand, high acceptability, and relatively low costs, the program will harvest market forces to drive sustainable production and consumption of fortified rice. Our project is innovative because it implements a sustainable rice fortification program in Nicaragua – the second poorest country in the Western Hemisphere. While rice is a staple for more than 2/3 of the world, to date no national rice fortification program has been successfully implemented in a low-income country, due to challenges in cost and market acceptability. Wheat flour fortification programs exist in low-income countries; however, the impact of these interventions is limited in countries with low wheat consumption such as Nicaragua.Considering that low-income countries suffer more than twice the incidence of NTDs as high-income countries due to malnutrition, creative strategies for folic acid fortification are urgently needed.

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