Term of Reference – KAP Survey


Despite economic improvement in the Asian region and more particularly in Vietnam, several studies have shown that anemia and vitamin A deficiencies in Vietnam are still a public health problem. Iron status has improved in Vietnam over the last decade but a large part of the population continues to be deficient in zinc and vitamin A or have marginal status for all bio-indicators tested. Laillou A., Pham T. V., Tran N. T., Le H. T., Wieringa F., et al.(2012) showed that the marginal status of vitamin A deficiency amongst women of reproductive age was 13.6% while the prevalence of zinc deficiency was 67.2%. The General Nutrition Survey (National Institute for Nutrition [NIN], 2012) revealed that iron deficiency anemia affected 28.8% of non-pregnant women and 36.5% of pregnant women.

The proportion of marginal deficiency highlights the importance of continuing fortification and other interventions to prevent the population from falling back into deficiency. The large differences in prevalence of micronutrient deficiencies between the different regions highlight the problems in implementing interventions for populations most in need. Fortifying widely consumed foods, especially condiments and vegetable oil, with iron and vitamin A is an opportune way to overcome a low quality diet.

With the support of GAIN and the World Bank, the National Institute of Nutrition (NIN) in Vietnam began to support fortification fish sauce with iron in 2005, following studies commissioned by International Life Sciences Institute, which showed the positive impact of fish sauce fortification. In addition, the government issued a standard for voluntary fortification of several staples and condiments to reduce micronutrient deficiencies. However, the privatization of the state-run fish sauce industry in the early years of the project negatively impacted the industry’s participation and it became necessary to revise the micronutrient fortification strategy.

A market survey in Vietnam commissioned in 2009 by GAIN showed the potential for a multiple food fortification strategy due to highly concentrated industries for soy sauce, fish sauce, vegetable oil, and flavoring powders. Therefore, in 2011, GAIN and the NIN entered into a second grant agreement to catalyze the fortification of multiple food vehicles in Vietnam to help control and address micronutrient deficiencies. A recent industry assessment conducted in 2014 by GAIN and the NIN reinforced the learning from 2009.

The current program runs through October 2015 and comprises of industry technical assistance and support, a large-scale social marketing campaign, evidence generation to inform policy and advocacy, and monitoring and evaluation. The social marketing campaign is mostly focused on raising awareness and changing behavior of consumers and local stakeholders about vitamin and mineral deficiencies and the problems they cause. It encourages the consumption of fortified foods as a simple way to tackle micronutrient deficiencies. Besides, it also promotes the involvement of relevant industries in food fortification.

Research Goal and Objectives

1. Research goal

The goal of this KAP Survey is to gain a complete understanding of the common practices, attitudes and the level of knowledge of consumers as well as associated factors with the consumption of fortified foods. It also investigates the extent to which the social marketing campaign has contributed to changing behavior of consumers.

2. Research objectives

Specific objective of this KAP survey is threefold:

· To understand the knowledge, attitude and practices (KAP) of consumers, about micronutrients (vitamin A, iron and zinc) and fortified foods (soy sauce, fish sauce, vegetable oil, and flavoring powders);

· To examine the associated factors (opportunity, ability and motivation - OAM) with the consumption of fortified foods amongst consumers;

· To assess campaign coverage and differences in demand for fortified foods between those exposed and those not exposed to the campaign.

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