Food Fortification Strategies to Address Micronutrient Deficiencies in Cambodia: A Scoping Review of Policy Implementation, Industry Capacity, and Public Health Outcomes

YEM, Sokha
TUN, sreypeov
kem, sokunthea

Indonesian Journal of Public Health Nutrition (IJPHN)
Vol. 6, No. 2

Background: Micronutrient deficiencies remain a major public health challenge in Cambodia, with iron deficiency anaemia, iodine deficiency disorders, zinc deficiency, and vitamin A deficiency disproportionately affecting women of reproductive age and children under five. Food fortification—the deliberate addition of essential micronutrients to commonly consumed foods—has been widely recognised as a cost-effective population-level intervention to address nutritional gaps. Objective: To systematically map and synthesise existing evidence on food fortification strategies in Cambodia, focusing on policy implementation, industry production capacity and compliance, regulatory enforcement, and public health outcomes. Methods: A scoping review was conducted following the Arksey and O’Malley methodological framework and reported according to the PRISMA extension for Scoping Reviews guidelines. Six databases (Scopus, PubMed/MEDLINE, Web of Science, EMBASE, Cochrane Library, and Google Scholar) and grey literature sources were searched. Two independent reviewers conducted screening, achieving substantial agreement. Evidence from peer-reviewed studies, national surveys, policy documents, and technical reports (2010–2025) was synthesised across three domains: (1) policy and governance, (2) industry capacity and compliance, and (3) public health outcomes. Results:  Fifty-two sources were included. Cambodia has implemented universal salt iodisation and wheat flour fortification and has piloted rice fortification and fish sauce iodisation. Improvements in iodine status have been observed in line with expanded program coverage. However, reductions in anaemia and other micronutrient deficiencies remain modest and uneven. Compliance is higher among large-scale producers than small and medium enterprises. The multifactorial nature of anaemia—including genetic, infectious, and nutritional causes—limits the impact of iron-focused fortification strategies. Conclusion: Food fortification in Cambodia shows clear benefits in reducing iodine deficiency but requires strengthened regulatory enforcement, improved industry compliance, expanded fortification vehicles, and integration within broader nutrition strategies to maximise public health impact.