Towards universal salt iodisation in India: achievements, challenges and future actions

Abstract

India is one of the first countries to introduce salt iodisation, but the national programme has experienced major setbacks. The purpose of this paper is to review the national efforts towards universal salt iodisation (USI) in India and highlight key challenges in programme implementation. A brief historical overview of the salt iodisation programme is provided and the current status of the household usage of iodised salt and population iodine status is described. The present status of the USI programme together with the challenges being faced towards achieving USI are classified in five categories, which represent the five guiding principles crucial to sustained USI programme success: ensuring political commitment, forming partnerships and coalition, ensuring availability of adequately iodised salt, strengthening the monitoring system and maintaining continuous advocacy, education and communication. A future agenda towards the achievement of USI is also proposed.

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“…The USI programme has achieved significant global success, with an estimated eradication of iodine deficiency in 34 countries, and delivery of iodised salt to more than 70% of households across the world (Unicef 2008). India has also celebrated significant success in decreasing levels of iodine deficiency (Rah et al 2015), however progress in addressing this MiND appears to be slowing (Miller & Welch 2015).…”

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“…The USI programme has achieved significant global success, with an estimated eradication of iodine deficiency in 34 countries, and delivery of iodised salt to more than 70% of households across the world (Unicef, 2008). India has also celebrated significant success in decreasing levels of iodine deficiency (Rah et al, 2015), however progress in addressing this MiND appears to be slowing (Miller and Welch, 2013). Iodised salt only reaches an estimated 71% of Indian households (Rah et al, 2015), falling well short of the 90% coverage required to achieve USI status.…”

“…India has also celebrated significant success in decreasing levels of iodine deficiency (Rah et al, 2015), however progress in addressing this MiND appears to be slowing (Miller and Welch, 2013). Iodised salt only reaches an estimated 71% of Indian households (Rah et al, 2015), falling well short of the 90% coverage required to achieve USI status. The 30% of households which are currently not receiving iodised salt are likely to be those in the most remote areas-meaning there are significant distribution and access barriers-and of low socioeconomic status.…”

Knowledge, attitude and practices regarding iodine deficiency disorders

“…The proportion of households consuming adequately iodized salt (at least 15 ppm at the household level) in Andhra Pradesh has increased from 31.5% in 2005 to 63.5% in 2009, showing the positive impact of USI in Andhra Pradesh. [7] Although the problem of IDD exists and universalization of the iodized salt program has been accepted in Khammam, no information is available regarding the knowledge, attitudes and practices of the people toward this problem. Therefore, this study was undertaken with the objective to assess the baseline information on these aspects, i.e., to explore in more detail the knowledge related to IDD and the health benefits of iodine, attitudes and practices relating to storage and use of iodized salt in the community.…”