Jananee Muralidharan, Shalini G Hegde, Santu Ghosh, Ankita Mondal, MC Arjun, Tinku Thomas, Sunita S Kurpad, Charles Davis, Harshpal S Sachdev, Anura V Kurpad
{"title":"印度公共分配系统中强制强化大米:伦理视角","authors":"Jananee Muralidharan, Shalini G Hegde, Santu Ghosh, Ankita Mondal, MC Arjun, Tinku Thomas, Sunita S Kurpad, Charles Davis, Harshpal S Sachdev, Anura V Kurpad","doi":"10.20529/ijme.2023.064","DOIUrl":null,"url":null,"abstract":"In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mandatory fortification of rice in the public distribution system in India: an ethics perspective\",\"authors\":\"Jananee Muralidharan, Shalini G Hegde, Santu Ghosh, Ankita Mondal, MC Arjun, Tinku Thomas, Sunita S Kurpad, Charles Davis, Harshpal S Sachdev, Anura V Kurpad\",\"doi\":\"10.20529/ijme.2023.064\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.\",\"PeriodicalId\":35523,\"journal\":{\"name\":\"Indian journal of medical ethics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian journal of medical ethics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20529/ijme.2023.064\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian journal of medical ethics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20529/ijme.2023.064","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Mandatory fortification of rice in the public distribution system in India: an ethics perspective
In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.
期刊介绍:
The Indian Journal of Medical Ethics (formerly Issues in Medical Ethics) is a platform for discussion on health care ethics with special reference to the problems of developing countries like India. It hopes to involve all cadres of, and beneficiaries from, this system, and strengthen the hands of those with ethical values and concern for the under-privileged. The journal is owned and published by the Forum for Medical Ethics Society, a not-for-profit, voluntary organisation. The FMES was born out of an effort by a group of concerned doctors to focus attention on the need for ethical norms and practices in health care.