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Government of Ethiopia, Nutrition International and partners introduce double-fortified salt to reduce neural tube defects in Ethiopia
January 16, 2026
This peer-reviewed study evaluated whether double-fortifying iodized salt with folic acid can safely and effectively improve folate status in adult women without affecting their iodine status. Conducted as a community-based, household-randomized, dose-response trial among non-pregnant Ethiopian women aged 18-49, participants received different levels of folic acid in their iodized salt over a 26 week period. Findings show that this intervention can significantly reduce folate insufficiency among women of reproductive age and help prevent neural tube defects, while maintaining iodine status — providing strong evidence for the safety, effectiveness and scalability of double-fortified salt as a public health strategy.
These results directly support ongoing efforts in Ethiopia, where the Government, Nutrition International and key partners are in the process of introducing DFS with iodine and folic acid (DFS-IoFa) at scale — a global first aimed at reducing neural tube defects and improving maternal and child health by building on the established universal salt iodization platform.