Developing a Grain Fortification Social Marketing Toolkit for Advocates Worldwide Open Access

Abstract

Nearly 30% of the world's population suffers from micronutrient deficiencies.¹ One of the most effective interventions to reduce micronutrient deficiencies is fortifying staple foods, like cereal grains, with vitamins and minerals. A successful fortification program depends on the participation of key stakeholders who must be reached and encouraged to take action in favor of grain fortification. Social marketing campaigns have the potential to foster behavior change to support fortification in a broad range of stakeholders.

The Food Fortification Initiative (FFI) advocates for fortification of cereal grains and provides technical assistance to countries in pursuit of this goal. FFI identified gaps in the communication support it provides to countries interested in fortifying their wheat and maize flour and rice.

The goal of this special studies project is to create a toolkit for country leaders and nongovernmental proponents of fortification to support their social marketing and advocacy efforts. This toolkit will guide them through the design, implementation, and evaluation of a social marketing campaign.

The toolkit is based on a literature review of the best practices from the field of social marketing. It also includes several case studies, the most substantial from Armenia. A flour fortification social marketing strategy for Armenia was developed with UNICEF Armenia during the summer of 2013. The Armenia social marketing strategy drew on a literature review, market research, key informant interviews, and participant observation. The toolkit also highlights case studies from New Zealand, South Africa, and the United States of America.

This toolkit is designed to support the development, implementation, and evaluation of social marketing campaigns based on best practices and to increase the likelihood of a fortification program's success. It also expands the capacity of FFI to offer more advocacy and communications support to countries interested in starting a fortification program. FFI plans to pilot test the toolkit and to market and promote its use.

Table of Contents

Table of Contents Chapter 1: Introduction.............................................. 1 Introduction and Rationale ............................................ 1 Purpose Statement ......................................................... 6 Significance Statement ................................................... 6 Definition of terms .......................................................... 7 Chapter 2: Literature Review ..................................... 9 Nutrition Campaigns .................................................... 14 Fortification Campaigns with Consumers ................... 18 Health Advocacy with Policy Makers .......................... 21 Conclusion...................................................................25 Chapter 3: Fortification Advocacy Toolkit.............. 27 Introduction..................................................................30 Chapter 1: Framework Development ...................... 33 Chapter 2: Market Research & Strategy Development .. 41 Chapter 3: Activity Development ............................. 56 Chapter 4: Monitoring, Evaluation, and Implementation .. 90 Chapter 4: Discussion & Conclusion....................... 98 Public Health Implications .......................................... 98 Recommendations.......................................................99 Conclusion................................................................100 References...............................................................101 Appendix: Methods & Results .............................. 105 Case Study: Armenia ............................................... 106 Case Study: South Africa ......................................... 109 Case Study: New Zealand ....................................... 110 Case Study: United States of America ..................... 110 Ethical Considerations ............................................ 112

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	fortification micronutrient deficiency communication social marketing
Committee Chair / Thesis Advisor	Winskell Enger, Kate, Emory University
Committee Members	Zimmerman, Sarah, Food Fortification Initiative
Partnering Agencies	Emory University schools, faculty or affiliated programs International Non-governmental organization (e.g., CARE, Inc.)

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