President Samia’s leadership in food fortification and maternal health recognized

President Samia Suluhu Hassan was recently presented with the Gates Foundation Goalkeepers Award for her leadership in advancing maternal, newborn, child, and adolescent health and nutrition. This recognition highlights Tanzania’s progress in addressing malnutrition and improving health outcomes under her leadership.

In her speech, she reaffirmed the government’s commitment to strengthening health and nutrition programs, with a particular focus on food fortification as a key intervention.

Food fortification, the process of adding essential vitamins and minerals to commonly consumed foods, ensures that Tanzanians receive critical nutrients through staple foods like maize and wheat flour.

Recognizing its importance, the government recently passed the National Fortification Mandate, making it a legal requirement for all commercial millers who pack and sell maize and wheat flour, regardless of the mill size, to source nutrient premix and to start fortifying their flour effective immediately. This law, firmly backed by the President, underscores the urgent requirement for widespread fortification compliance among millers across Tanzania.

Over the past six years, Tanzania has made notable strides in key health indicators. According to the Tanzania Demographic and Health Survey (TDHS 2022), maternal mortality has declined from 556 to 104 per 100,000 live births, while under-five mortality has dropped from 67 to 43 deaths per 1,000 live births. Infant mortality has also fallen from 43 to 33 deaths per 1,000 live births. However, neonatal mortality remains a concern, with only a slight reduction from 25 to 24 deaths per 1,000 live births.

While these improvements signal progress, malnutrition continues to affect a significant portion of the population, particularly among children. Stunting among children under five has decreased from 34 percent to 30 percent, while wasting has declined from 4 percent to 3 percent, and the prevalence of underweight children has fallen from 14 percent to 12 percent.

These reductions indicate that nutrition interventions, including food fortification, are making an impact. Yet, a considerable percentage of children remain affected by malnutrition, which can have long-term consequences on their cognitive development, educational attainment, and economic productivity later in life.

To sustain and accelerate these gains, there is a need for continuous investment in nutrition programs, particularly those that ensure equitable access to fortified foods.

Food fortification has been recognized as one of the most effective strategies to address micronutrient deficiencies at scale. The government has implemented policies requiring commonly consumed foods such as flour and cooking oil to be fortified with essential vitamins and minerals. Despite these policies, challenges persist in achieving full compliance and ensuring that all Tanzanians benefit from fortified foods.

Millers often struggle to access affordable, high-quality premix. Some resort to using low-cost, low-quality premix that does not provide adequate nutritional benefits, while others find high-quality alternatives too expensive to purchase consistently.

Sanku, a social enterprise working to improve nutrition in Eastern Africa, is addressing these barriers by ensuring that all millers have the necessary tools to fortify their flour affordably. In alignment with the government’s commitment to nutrition, Sanku recently launched the first-ever Nutrient Premix Blending Factory in East and Central Africa, based in Dar es Salaam.

The facility has the capacity to produce approximately 150 metric tons of nutrient premix per month, serving millers in Tanzania, Kenya, Ethiopia, Uganda, and beyond. By making high-quality premix accessible and affordable, the facility helps millers comply with food fortification standards while improving the nutritional quality of their products.

This is a significant step toward ensuring that even the smallest millers can participate in fortification efforts, contributing to nationwide improvements in nutrition.

Beyond supplying premix, Sanku provides the Dosifier technology at no cost to millers, ensuring precise nutrient addition to flour, a staple food for millions of Tanzanians. The Dosifier technology guarantees that the right amount of vitamins and minerals is added to the flour, maintaining consistency and compliance with fortification standards.

The effectiveness of this approach was demonstrated in Morogoro, where a 2015 baseline study found that only 2.5 percent of households consumed fortified flour.  After Sanku installed 70 Dosifier machines in the region, a 2017 end-line study by Helen Keller International showed that 90 percent of households in Morogoro Municipal District were consuming fortified flour. This model has since expanded, and Sanku’s efforts now reach 10 million people across Eastern Africa every day.

Nonetheless, sustaining food fortification requires ongoing collaboration between the government, private sector, and development partners. While large-scale fortification programs have been implemented, challenges such as supply chain disruptions, regulatory enforcement, and the affordability of fortified products.

For small and medium-sized millers to remain consistent in fortification, they need continued technical support, reliable access to high-quality premix, and a stable policy environment that incentivizes fortification efforts.

Food fortification remains a cost-effective solution to improving nutrition since it does not require behavior change from consumers. Fortified foods are consumed as part of daily diets, ensuring that individuals receive essential nutrients without altering their eating habits.

As Tanzania scales up its fortification efforts, strengthening partnerships between government institutions, millers, and organizations like Sanku will be critical. With continued investment and collaboration, fortification can play a key role in improving health outcomes, particularly for vulnerable communities, and ensuring that all Tanzanians have access to nutritious food.