GENERAL nutrition levels in Zambia indicate that one in every two children under five years of age suffer from iron deficiency.

The justification is that children experience rapid physical growth. Thus, sexual maturation significantly increases.

They develop a need for micronutrients, especially iron, while adolescent girls' growth spurt occurs before menarche - first menstrual periods.

Adolescent children continue to grow in height. Linear growth particularly of the long bones is not complete until the age of 18 and peak bone mass is not achieved until the age of 25.

At two years of age, many of the children who survive under such nutritional stress are stunted due to lack of Vitamin A with little chance of recovery.

Moreover, in some parts of the world children, especially girls, are discriminated against in access to food, health care and education.

Women are also vulnerable to iron deficiency due to their biological nature as they lose blood at certain times of the month.

With this scenario, the ministry of Health, through the Department of Nutrition Commission of Zambia, has seen it fit to improve the nutrition status of women and children which will translate into long-lasting benefits for women and children themselves.

The intervention effort being executed through the ministry of Health is on fortification of maize meal with Vitamin A.

It was chosen because it is a staple food and almost all the groups of people that need these extra nutrients use maize meal at home.

The National Food and Nutrition Commission of Zambia says that fortifying maize meal at both hammer mills and large millers is another way to ensure that households have access to the nutrients that help the body function properly.

In most developing countries women spend a large proportion of their reproductive years pregnant, lactating or pregnant and lactating.

The nutritional demands during pregnancy and lactation are multiple to support fetal growth and breast milk production.

These added nutritional requirements specific to pregnancy and lactation manifest themselves both at the macronutrient and the micronutrient level.

More calories are needed to achieve adequate pregnancy weight gain and to build stores for lactation.

More iron is needed because of the growth of the foetus and the placenta and the expansion of the plasma volume.

Closely-spaced reproductive cycles, negative energy balance and micronutrient deficiencies can lead to a condition known as maternal depletion syndrome.

Nutritional stress is greatest when an adolescent woman is pregnant and lactating.

Recently, the National Food and Nutrition Commission of Zambia, in conjunction with Panos, held a three-day workshop for media personnel from both print and electronic media at which nutritionists and technocrats in the mealie meal fortification project brainstormed some of the benefits of fortification and plans by Government to formulate law to make fortification mandatory for a period of three years.

In her paper, project officer for the maize meal fortification project, Eustina Besa, said plans to fortify maize meal had been outstanding since the 1990s and that in 1997 a consultative meeting was held with millers at which it was resolved that fortification should be voluntary to allow some issues to be tackled.

A team was constituted to organised money to initiate the project as such a proposal was made to Gain, a department that was created to basically complement existing programmes to reduce micronutrient malnutrition.

The project is scheduled to run for three years based on a five-year micronutrient control strategic plan.

Subsequently, a memorandum of understanding (MOU) was signed on February 27, 2006, between Gain and the ministry of Health as the executing agency.

After three years, Gain-funded activities will be incorporated into the current nutrition programmes and the commission's steering committee will also provide policy guidelines on the overall implementation programme.

In his opening remarks, acting executive director of the National Food and Nutrition Commission Freddie Mubanga underscored the importance of fortifying maize meal, which was aimed at reducing the high rates of micronutrient deficiencies.

Mr Mubanga cited the impact of micronutrient deficiencies on individuals and countries which can be devastating in that it can increase deaths and diseases among children and women of child-bearing age.

It can also have an overall impact on the a country's economy by harming human resource.

Mr Mubanga alluded to maize fortification as another milestone in Government's efforts to improve the nutritional and health status of the Zambian people through the National Food and Nutrition Commission with support from cooperating partners.

"Other interventions like supplementation and dietary improvement changes are available but fortification has proven to be more effective because of its wide coverage and low cost," he said.

Mr Mubanga said Zambia has scored successes through food fortification and gave an example of Zambia Sugar's fortified sugar, which has been in existence since 1998 and has greatly contributed to the improved levels of Vitamin A.

He, however, said although maize meal fortification for commercial millers is mandatory, the law by itself is inadequate.

There is need for it to be interpreted in terms that stakeholders, especially beneficiaries, will understand.

He urged the media to play its role in ensuring that correct information on fortification is disseminated to the masses.

On whether fortification of maize meal has been imposed on the masses, Mr Mubanga said it was not. Instead, it was a felt need by the ministry of Health rather than leaving it open to consumers to make a choice.

Mr Mubanga elaborated that issues of public health override those of consumer choice. Otherwise, the nation will continue having stunted children if the necessary measures are not taken.

In her presentation, National Institute for Scientific and Industrial Research Food Technology Research Unit principal officer, Rodah Zulu, said maize meal was identified as a vehicle for fortification of Vitamin A because it is widely consumed and does not change people's ways of life.

The masses may ask why fortification?

To answer this question, Dr Zulu described fortification as an efficient way of increasing people's consumption of vitamins and minerals.

She said it does not require the majority population to change their eating habits. Normal eating patterns can continue despite the fortification of maize meal.

Dr Zulu traced the history of food fortification in Zambia back to 1978 when authorities found it prudent to fortify slat with iodine as an intervention effort during an outbreak of goitre.

Universally, all salt for human consumption or animals in the United States is fortified with iodine.

The same year, under the food and drug Act, a law was passed for mandatory fortification of margarine with Vitamin A and D.

It has been so since that time, but there have also been instances of voluntary fortification such as wheat flour B1, B2, niacin and Iron.

Dr Zulu explained that the choice of fortificant and chemical form is picked with consideration that they may with the interactions especially with metabolic utilisation.

The cost of fortification should not affect the affordability of food or it is competitively with the unfortified alternative foods.

Bioavailability is another requirement of the fortificant. The fortificant should be sufficiently absorbed from the food vehicle and be able to improve the micronutrient status of the target population.

On safety of the fortificant, the level of consumption required for fortification to be effective should be compatible with a healthy diet.

And Chief Science and Technology Officer, Dorothy Mulenga, explained in greater detail the differences between fortification and genetic modification.

Dr Mulenga said the two concepts were not similar and their definitions were totally different.

Genetic modification (GM) involves taking hereditary materials - DNA - from one living organism and inserting it into another organism while fortification involves addition of essential nutrients to a food, whether or not normally contained in the food, to prevent or correct a demonstrated deficiency of one or more nutrients in the population.

HIV/AIDS focal person Beatrice Kawana, in her presentation, advised people living with the virus to include fortified foods in their diets because they have a major role to play in the management, treatment and care.

Mrs Kawana said fortified foods have no contradictions with anti-retroviral drugs (ARVs) but that instead nutrition helps to reinforce the effect of any medication. Hence, the importance of knowing food and drug interactions.

Mrs Kawana stressed that minerals and vitamins are for protection from diseases and rich sources include fruits, vegetables and fortified foods.

"Vitamins and minerals keep the body functioning well and strengthen the immune system," she said.

When all was said and done, media practitioners were challenged to embark on research-based reporting in order to tackle some myths and misconceptions about maize fortification.

The burden really is on the scribes to go out and gather as much information as possible from relevant authorities to disseminate to the masses for them to widen their scope of understanding on the concept of fortification before the project is implemented.