Large-scale food fortification (LSFF) presents a promising intervention in Madagascar, where approximately 75% of the population lives below the poverty line and faces multiple malnutrition burdens. For instance, 39.8% of children under age five are stunted, and 37.8% of reproductive age women suffer from anemia (Development Initiatives 2022). These trends persist despite a long history of nutrition programs and alliances, including the introduction of a mandatory salt iodization program in 1995, several national nutrition policies and action plans since 2004, and the country’s participation in the Scaling Up Nutrition (SUN) movement since 2021. Moreover, despite several voluntary standards in place, progress in implementing mandatory LSFF for widely consumed foods remains stalled, lagging behind LSFF in many other African countries.