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There is a quiet health revolution underway across several villages in the tribal-dominated Salumbar and Sarada blocks of Udaipur district in Rajasthan, where widespread malnutrition, especially among the women and children, has had devastating effects on their physical well-being. The National Family Health Survey-3 has noted high levels of anaemia among both women and men in the state, in addition to registering very high rates of stunting and wasting thus creating a need for fortification in their food.
The next step was to make sure that people in the villages start using fortified flour (‘atta’). Wheat flour is chosen as the vehicle for fortification with vitamins and minerals because it is the major staple cereal and its consumption is very high in this region. Since September 2012, households dotting the arid countryside of Rajasthan have been motivated to consume wheat flour fortified with micronutrients, such as iron, folic acid and vitamin B12. Despite all these concerted efforts, in some villages the usage of fortified flour is taking time to pick up.
On their part, the anganwadi workers and Accredited Social Health Activists (ASHAs), who give valuable nutritional advice to village women, are pitching in to increase the usage of fortified flour.
Like Anita, in Singhavat village, Sumitra, 30, an anganwadi worker, has not only been making ‘rotis’ from fortified wheat for her own family but has been conscientiously motivating others to follow her example.

Today, Jha is happy to share that in the last eight-nine months, usage of fortified flour has stabilised. Since September 2012, households dotting the arid countryside have been motivated to consume wheat flour fortified with micronutrients, such as iron, folic acid and vitamin B12, as part of a novel initiative introduced in the region by Global Alliance for Improved Nutrition (GAIN) and Institute of Health Management Research (IHMR), Jaipur, which is being implemented by the Bhoruka Charitable Trust (BCT). Not only is food fortification easy and cost-effective for the food producers to implement, it is also an inexpensive way to provide good nutrition to the consumers, too.
These discussions also highlighted the role in reduction of malnutrition reduction through the fortification of wheat flour milled at their chakkis was highlighted. But, when we looked into the matter we realised that a few millers, in their enthusiasm of improving nutrition, were mixing higher quantity of premix to the wheat flour, as they felt that if it is good for health then why stop at adding just one spoon! In fact, since the last two years she has played a key role in convincing women of the benefits of consuming the fortified wheat flour. “I tell them how it helps in reducing anaemia among women and gives ‘takat’ (strength) to their children.
The idea was to convince them of the advantages of adding the micronutrient-rich premix to the flour so that they could become “agents of change” and lead the community in improving their health and by recommending fortification of wheat flour to their regular customers. Some people started complaining that the dough made from the fortified flour was turning black and that the ‘rotis’ were very dry in texture.

It was then explained to the millers that adding higher quantity of premix would affect the colour and texture of flour and hence would impact the acceptability. It was reiterated that it was of utmost importance to adhere to the correct dosing of premix while milling the grains to ensure that the quality of flour is not compromised. Therefore, those who consume fortified wheat flour are generally the ones who are more educated and aware and have learnt about these through the wall writings or from the flex board at the ‘chakki’,” he adds. Anemia affects 74 percent of children under age 3, according to the agency, as well as more than 90 percent of adolescent girls and 50 percent of women.Since September 2012, however, households dotting the arid countryside around Udaipur have been motivated to use wheat flour fortified with micronutrients, such as iron, folic acid and Vitamin B12 as part of an initiative introduced in the region by the Global Alliance for Improved Nutrition, which has offices around the world, and the Indian Institute of Health Management Research in the Rajasthani city of Jaipur. He added that these customers seemed to be the more educated people.Nevertheless, Jha is happy to say that in the last eight to nine months, use of fortified flour has stabilized in the area.

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