Small and Medium Enterprises’ Perspectives on Food Fortification Amid the Growing Burden of Malnutrition

Jimena Monroy-Gomez, Chiara Ferraboschi, Kesso Gabrielle van Zutphen, Breda Gavin-Smith, Daniel Amanquah, Klaus Kraemer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The need for a profound food system transformation has never been greater. The growing burden of malnutrition has become the new normal, with two billion people who are overweight, over 140 million children under five who are stunted and over two billion people affected by hidden hunger. Food fortification has been recognized as a cost-effective strategy to address micronutrient deficiencies. Small and medium enterprises (SMEs) play a strategic role in the food supply chain in low- and middle-income countries, accounting for over 80% of food sales. It is therefore critical to create an enabling environment to facilitate SMEs’ involvement in food fortification practices as a potential solution to tackle all forms of malnutrition. This review highlights SMEs’ relevance as agents of change in the food system through food fortification practices and their indirect yet key role in producing nutritious, tasty and affordable foods. It discusses their challenges (e.g., access to long-term finance, sustainable technical assistance, limited capacity), presents solutions and discusses how different actors can help SMEs to overcome these challenges. Furthermore, it presents a relevant public–private partnership case study to demonstrate how SMEs can address the growing burden of malnutrition through food fortification practices, nutrient profiling schemes and demand generation.

Original languageEnglish
Article number3837
Issue number18
Publication statusPublished - 16 Sept 2022


  • burden of malnutrition
  • food fortification
  • food industry
  • food systems
  • micronutrient deficiencies
  • nutrient profiling
  • public health
  • public–private partnership
  • small and medium enterprises


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