Diversified food fortification portfolios can enhance coverage of micronutrient-vulnerable populations in West Africa

Abstract Food fortification is central to addressing micronutrient deficiencies in West Africa and elsewhere. Yet evidence remains limited on whether current staple food fortification vehicles equitably reach vulnerable populations and whether candidate vehicles warrant inclusion. We analysed household consumption and expenditure surveys from ten countries in West Africa to estimate vulnerability to inadequate intake of five micronutrients, assessing wheat flour and edible oil as current standard vehicles and rice, maize, millet and sorghum as candidates. Vulnerability to inadequate intake was high across all ten countries: on average, households were probably vulnerable to around three to four of the five priority micronutrients assessed (mean probability of inadequacy 0.56–0.73), with Mali and Niger the most affected. More than half the population was vulnerable to inadequate iron, zinc and folate, and vulnerability was consistently higher in poorer households. Wheat flour and edible oil showed limited reach among poorer populations and low consumption among those most in need. Rice showed high coverage and alignment with vulnerability profiles across countries, while millet and sorghum showed potential to reduce inadequacy in the Sahel. These findings support the expansion of the regional vehicle portfolio through prioritization aligned with vulnerability and vehicle access.