Eye health in Tanzania: An essential oil

November 25, 2016
By Martine Letarte, Québec Science

Corn, cassava and pulses are the main food sources in rural Tanzania. Meat is scarce for rural populations, and don’t expect to find carrots, kale or squash at the local market! Animal products – particularly offal –, green vegetables and orange fruits and vegetables are the best sources of vitamin A. As a result, Tanzanians are severely deficient in this essential micronutrient.

The consequences are disastrous: among children, vitamin A deficiency stunts growth and increases the risk of mortality from illnesses like measles and diarrhea. Their vision is particularly at risk. “Inadequate vitamin A intake can cause xerophthalmia, an illness that makes children’s corneas opaque and ultimately destroys them,” explains Nadira Saleh, project manager, Eastern, Southern and Central Africa, at Mennonite Economic Development Associates (MEDA), a nongovernmental organization (NGO) that uses economic development to fight poverty. Pregnant women are at risk of night blindness.

However, in recent years, the government has implemented measures to provide its population with an adequate intake of this precious vitamin. It is providing free supplements to children under the age of five. It also enacted a law in 2012 obligating companies that produce vegetable oil to add vitamin A to their product, since it readily dissolves in fats.

“However, we have seen that it is difficult to reach all of the children to give them supplements, and it is hard to apply the law in remote, poorer areas, where small- and medium-sized businesses dominate oil production,” explains Nadira Saleh. These companies do not always have the knowledge or technologies required to fortify their product.

Critical regions

The MEDA team decided to work first with small sunflower oil producers in Manyara, a region in northern Tanzania where the rates of vitamin A deficiency are particularly high. Between 39% and 51% of children between the ages of six months and five years are deficient. Local producers make unrefined oil; it was necessary to ensure that this raw product could easily be fortified. A first! A pilot project was carried out in 2012-2013 and was successful.

The initiative, supported primarily by Canada's International Development Research Centre, was then rolled out on a larger scale in Manyara as well as the region of Shinyanga, where 31% to 39% of children between the ages of six months and five years are deficient in vitamin A. Today, three companies produce fortified oil thanks to MEDA’s project, and over 15,000 litres have already been sold.

Changing habits

The idea of consuming fortified sunflower oil is currently making headway, especially since the NGO led a large-scale marketing campaign. “Even in Shinyanga, where the population traditionally did not use sunflower oil, but rather less expensive oils, we are now seeing a lot of people buying our product,” says Goodluck Mosha, manager of the Tanzania project for MEDA.

To encourage even more of the population to come on board, the NGO created e-vouchers sent by text message to enable consumers to purchase fortified oil at a similar cost to regular oil. The strategy is working, but MEDA's expectations have still not been met.

Nadira Saleh has a hypothesis: “Very often, low-income Tanzanians do not purchase containers of oil. Instead, they go to merchants and ask them to pour the small amount they need right away. As a result, many people are not taking advantage of our discount and are buying unfortified, less expensive oil.”

Since last summer, MEDA has been trying a new tactic: giving vouchers to merchants. Merchants can then pass the savings on to their customers, even when they buy small quantities of bulk oil. If the project is successful with the few retailers targeted, the NGO hopes that more will follow.

Another major challenge is increasing the number of stores in targeted regions where fortified oil is available. Currently, nearly 200 merchants sell the oil, and MEDA hopes to reach 300, or even 400, to enable some 400,000 Tanzanians to benefit from the project. “A number of retailers have expressed their interest, but when the time comes to purchase supplies, they postpone the project,” explains Goodluck Mosha. “They lack capital, and small retailers generally do not have access to credit in Tanzania. We will have to be perseverant and patient.” 

MEDA’s ultimate goal? To create long-term demand for the fortified product among the residents of Manyara and Shinyanga. The NGO then hopes to withdraw from the project and watch businesses grow thanks to a well-oiled business model!

The original French version of this article was published in the October 2016 issue of Québec Science.