{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:25:57Z","timestamp":1781767557132,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP4105"],"award-info":[{"award-number":["OPP4105"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000023","name":"Government of Canada","doi-asserted-by":"publisher","award":["0143\u2010ISG"],"award-info":[{"award-number":["0143\u2010ISG"]}],"id":[{"id":"10.13039\/501100000023","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Double fortified salt (DFS; with iron and iodine) was introduced in social safety net programmes (SSNPs) in Madhya Pradesh (MP) and Gujarat states in 2018. Nutrition International (NI) provided critical support for the intervention. An impact evaluation in MP found high DFS uptake, exceeding 90%. Conduct a process evaluation of the DFS programmes in MP and Gujarat states to identify success factors, challenges, and recommend considerations for scale\u2010up. Twenty\u2010eight qualitative interviews were conducted with NI staff, national and state level government officials, and DFS producers in 2022. Enabling\u00a0environmental factors included national\u2010level support for food fortification, consensus that anaemia was essential to address, and institutional trust in NI for technical assistance. In programme implementation, the primary challenges were reports of black specks in DFS and the darkening of food cooked with DFS. NI supported the government in improving handling practices, ensuring a regular and stable supply, introducing quality monitoring efforts\u00a0and launching targeted behaviour change communication (BCC) campaigns regarding the value of DFS. Long\u2010term implementation of the programmes is a weak point, as DFS production is more expensive than iodised salt, there is no existing market outside of institutional demand, and BCC must be long\u2010term, high\u2010quality, and requires resourcing for continued high uptake among SSNP beneficiaries. Strong government buy\u2010in and technical support along the supply chain to address quality issues and beneficiary acceptance were key factors for the successful introduction of DFS. Comparative studies of DFS programmes should be conducted to improve confidence in the success factors that lead to high DFS uptake.<\/jats:p>","DOI":"10.1111\/mcn.13646","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T01:44:20Z","timestamp":1717638260000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Introducing double fortified salt in social safety net programmes in Madhya Pradesh and Gujarat in India: Success factors, challenges\u00a0and lessons learned"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-4909","authenticated-orcid":false,"given":"Becky L.","family":"Tsang","sequence":"first","affiliation":[{"name":"Food Fortification Initiative Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Independent Consultant Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mini","family":"Varghese","sequence":"additional","affiliation":[{"name":"Nutrition International New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakshi","family":"Jain","sequence":"additional","affiliation":[{"name":"Nutrition International New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Lopez","family":"de Romana","sequence":"additional","affiliation":[{"name":"Nutrition International Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet","family":"Chadha","sequence":"additional","affiliation":[{"name":"Nutrition International Ontario Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Bhatnagar N. &Kanoria K.(2020 October 24).Fortifying India: The impact and potential of food fortification in India. Dalberg Advisors.https:\/\/dalberg.com\/our-ideas\/fortifying-india-challenges-and-opportunities-for-large-scale-food-fortification-in-india\/"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa133"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13243"},{"key":"e_1_2_10_5_1","unstructured":"D.O. No.5\u20105\/2011\u2010MDM\u20101\u20101 (EE.5). (2011).https:\/\/pmposhan.education.gov.in\/Files\/OrderCirculars\/DFS_MDM.pdf"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/156482650202300209"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12773"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxaa377"},{"key":"e_1_2_10_9_1","unstructured":"Food Fortification Resource Center. (2022).Guidebook on food fortification for food safety officers.Food Safety and Standards Authority of India.https:\/\/ffrc.fssai.gov.in\/assets\/media_gallery\/file\/guidebook_on_food_fortification_for_fso.pdf"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu6093601"},{"key":"e_1_2_10_11_1","unstructured":"Global Fortification Data Exchange. (2022a).Fortification legislation.https:\/\/fortificationdata.org\/interactive-map-fortification-legislation\/#"},{"key":"e_1_2_10_12_1","unstructured":"Global Fortification Data Exchange. (2022b).Nutrient levels in fortification standards.https:\/\/fortificationdata.org\/map-nutrient-levels-in-fortification-standards\/"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxaa175"},{"key":"e_1_2_10_14_1","volume-title":"National Family Health Survey (NFHS\u20105), 2019\u20132021","author":"International Institute for Population Sciences\u00a0& ICF","year":"2022"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-20-00448"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.29392\/joghr.3.e2019075"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab245"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-022-2639-6"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxaa192"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0379572117707890"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxaa284"},{"key":"e_1_2_10_22_1","unstructured":"No. 5\u20104\/2011 ND\/Tech Mandatory use of Double Fortified Salt (DFS) in National Programmes\u2014ICDS. (2011).http:\/\/icds-wcd.nic.in\/icdsimg\/icdsdtd22022012.pdf"},{"key":"e_1_2_10_23_1","unstructured":"Nutrition International. (2017).\u00a0Social and behavior change intervention strategy for double fortified salt project in Madhya Pradesh."},{"key":"e_1_2_10_24_1","unstructured":"Nutrition International\u00a0& AMS. (2021).\u00a0Program evaluation of demonstration project on reducing iron deficiency anaemia through provisioning encapsulated ferrous fumarate (EFF) double fortified salt (DFS) in selected districts of Madhya Pradesh: Findings from endline survey."},{"key":"e_1_2_10_25_1","unstructured":"Public Health Foundation of India. (2017).\u00a0Formative research and development of behaviour change intervention strategy for double fortified salt (DFS) project in tribal districts of Madhya Pradesh."},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13391"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxaa279"},{"key":"e_1_2_10_28_1","volume-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity (WHO\/NMH\/NHD\/MNM\/11.1)","author":"World Health Organization","year":"2011"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13646","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.13646","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:41:36Z","timestamp":1775817696000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.13646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/mcn.13646"],"URL":"https:\/\/doi.org\/10.1111\/mcn.13646","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,5]]},"assertion":[{"value":"2023-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13646"}}