FORTIMAS: An Approach for Tracking the Population Coverage and Impact of a Flour Fortification Program

How to use FORTIMAS?

The primary aim of the guide is to propose a population-level data collection approach to help answer the question, “is the micronutrient status of those who regularly consume sufficient quality fortified flour improving?”. During the planning stages of FORTIMAS, it may be useful to “work backwards” from the ultimate aim and review the issues that need to be addressed to achieve it. Flow Diagram 1 (see below) illustrates this approach. Also, keep in mind that Box 1 (see below) lists the essential preconditions for an effective flour fortification program that must be met before embarking on collecting primary data or using existing data to track the population coverage and impact of the intervention.

If you are new to the FORTIMAS approach, read the entire document, including the Preface. When linking the flow diagram to the guide, please note that Chapter 4 (Sections IV, V, and VI) describes data collection, analysis, interpretation and dissemination. Chapter 3 (Section I and Table 4) lists potential indicators to track. Chapters 2 and 3 (Sections II to IV) discuss the selection and use of sentinel sites and data collection points to collect population-level data. Chapter 3 (Sections V and VI), and Chapter 4 (Section VII) as well as several annexes assist in developing the FORTIMAS implementation plan.

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Birth Defects surveillance: A manual for program managers

A new manual was published by the World Health Organization along with the National Center on Birth Defects and Developmental Disabilities from the US Centers for Disease Control and Prevention (CDC), and the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). Using the manual will help a country expand an existing hospital-based surveillance program into a population-based program. It can also be used in a country that is beginning a population-based registry. Read more


Smarter Futures is a public-private-civic partnership that supports similar partnerships of flour millers, governments, vitamin and mineral suppliers, international organizations, and academic institutions to make fortification of wheat flour a reality in Africa. The aim of Smarter Futures is to improve health in Africa through the enrichment of wheat and maize flour with essential vitamins and minerals.