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Community Perceptions of Zinc Biofortified Flour during an Intervention Study in Pakistan

Institute of Health Professions Education and Research, Khyber Medical University, Peshawar 25100, Pakistan
Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, UK
Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Rothamsted Research, Department of Sustainable Agricultural Sciences, Harpenden, Hertfordshire AL5 2JQ, UK
Department of Pulmonology, Rehman Medical Institute, Peshawar 25000, Pakistan
Author to whom correspondence should be addressed.
Academic Editors: Hajo Haase, Robert E. Black and Christine McDonald
Nutrients 2022, 14(4), 817;
Received: 22 December 2021 / Revised: 31 January 2022 / Accepted: 11 February 2022 / Published: 15 February 2022
(This article belongs to the Special Issue Zinc Supplementation and Fortification: The Unfinished Agenda)
Zinc-biofortified flour may be a cost-effective approach to improve zinc status of populations in low-resource settings. The success of biofortification programmes is subject to acceptability and uptake by consumers. This study explored community leaders’ and community members’ (n = 72) experiences and attitudes towards the flour provided during a cluster randomised controlled trial of zinc biofortified wheat in rural Pakistan (BiZiFED2). Focus group discussions (n = 12) were conducted and thematic analysis applied using an inductive, semantic, contextualist approach. Five themes were identified: (1) Contribution to food security; (2) Better sensory and baking properties than local flour; (3) Perceived health benefits; (4) Willingness to pay for the flour; and (5) Importance of trusted promoters/suppliers. Although the participants were blind to whether they had received control or biofortified flour, referred to collectively as “study flour”, the results indicated that the study flour performed well in terms of its taste and bread making qualities, with no adverse reports from participants in either arm of the BIZIFED2 RCT. Participants suggested that they would buy the biofortified wheat if this was available at a fair price due to perceived health benefits, reporting positive sensory characteristics and cooking attributes when compared to the flour available in the local markets. Overall, there was a positive reception of the programme and flour among the participants, and members of the community hoped for its continuation and expansion. View Full-Text
Keywords: zinc; biofortification; deficiency; Pakistan; qualitative; community zinc; biofortification; deficiency; Pakistan; qualitative; community
MDPI and ACS Style

Mahboob, U.; Ceballos-Rasgado, M.; Moran, V.H.; Joy, E.J.M.; Ohly, H.; Zaman, M.; Lowe, N.M. Community Perceptions of Zinc Biofortified Flour during an Intervention Study in Pakistan. Nutrients 2022, 14, 817.

AMA Style

Mahboob U, Ceballos-Rasgado M, Moran VH, Joy EJM, Ohly H, Zaman M, Lowe NM. Community Perceptions of Zinc Biofortified Flour during an Intervention Study in Pakistan. Nutrients. 2022; 14(4):817.

Chicago/Turabian Style

Mahboob, Usman, Marena Ceballos-Rasgado, Victoria Hall Moran, Edward J. M. Joy, Heather Ohly, Mukhtiar Zaman, and Nicola M. Lowe. 2022. "Community Perceptions of Zinc Biofortified Flour during an Intervention Study in Pakistan" Nutrients 14, no. 4: 817.

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