National Iodine Deficiency
Disorders Control Programme
Dr. Subhash Pandey
State Nodal Officer
Directorate of Health & Family Welfare,
Chhattisgarh, Raipur.
Presentation Overview
Part A:
About National Iodine Deficiency Disorders
Control Program
Part B:
Facts about Iodine and Iodized Salt
Part C:
Chhattisgarh State at a Glance
Part -A
About National Iodine Deficiency Disorders
Control Program
GOALS
To Reduce the prevalence of Iodine Deficiency
Disorders below 10% in the entire country by
2012
Achieve Universal Access to Iodized Salt
Source: 11th Five Year Plan, Govt. of India
OBJECTIVES
1. Surveys to assess the magnitude of the
Iodine Deficiency Disorders
2. Supply of Iodated salt in place of common
salt.
3. Re-survey after every 5 years to assess the
extent of Iodine Deficiency Disorders and
the impact of iodated salt.
4. Laboratory Monitoring of Iodated Salt and
Urinary Iodine Excretion
5. Health Education & Publicity
Spectrum of Iodine Deficiency
Disorders
Foetus:
1. Abortions
2. Still Births
3. Congenital Anomalies
4. Increased PNMR
5. Neurological Cretinism
6. Myxedematotous Cretinism
Spectrum of Iodine Deficiency
Disorders
Neonate:
Neonatal Goitre
Neonatal Hypothyroidism
Child & Adolescent:
Juvenile Hypothyroidism
Impaired Mental Function
Retarded Physical development
Adult:
Goitre with its complication
Hypothyroidism
Impaired Mental Function
Iodine Deficiency – A Disease of The Soil
Effect on people
:
HUMANS
Health &
Socioeconomic impact
Effect on animals
:
LIVESTOCK
Clinical & Reproductive
disorders,
decreased productivity
Low Availability
of iodine
:
PLANTS
Iodine poor feeds &
fodders
Soil Erosion
: WATER, SOIL Environmental iodine
deficiency
Brain Cell Growth
Iodine Deficiency
Iodine Sufficiency
Iodine Deficiency is the single most
common cause of preventable mental retardation
Iodine Deficiency & Learning
Abilities
School age children living in
iodine deficient environment
on an average, have
13 I.Q. points
less than those living in
iodine sufficient environments
IDD – The Hourglass
Historic
View
Iodine Deficiency = Goitre =
Visible Swelling
No Pain = Not a cause of
Mortality = Cosmetic problem
Cretinism rare
Mental & Physical growth
Current
View
Loss of Energy-hypothyroidism
Learning Disability, Poor Motivation
Child Development and Child Survival
Human Resource Development
IDD Prevalence Indicators and
Criteria for classifying IDD as
significant public health problem
Indicator
Mild
Moderate
Severe
Goitre Grade
>0
5-19.9%
20-29.9%
>30%
20-49
<20
Urine Iodine
50-99
Excretion
(Microgram/L)
Part -B
Facts about Iodine & Iodized Salt
What is Iodine?
Iodine is an essential micronutrient supporting
some of the most vital functions of the human
body.
What is Iodated Salt?
• Iodated salt is common salt containing minute
quantities of an iodine compound
• Iodated salt looks, tastes and smells exactly like
ordinary salt.
• The Govt. of India has issued notification banning
the salt of non iodized salt for direct human
consumption with effect from 17th May, 2006.
How much Iodine does a person
normally need?
The average daily adult requirement is 150
micrograms
Average lifetime’s requirement of an individual
less than a teaspoonful.
From where do we normally get
Iodine?
• Present in its natural state in the soil and in water.
• Normal requirement comes from crops grown on
iodine-rich soil.
• When the soil lacks iodine, crops grown on that
soil are deficient in this essential micronutrient.
• People who live on iodine-deficient land and eat
its crops regularly, do not get their daily
requirement of this essential element.
How do we know if salt contains
Iodine?
A low cost testing kit is available which allows to
test for the iodine content of the salt on the spot.
Part - C
Chhattisgarh State at a Glance
Iodine consumption
NFHS III :
• Adequate iodine in salt: 55% households
• Inadequate iodine in salt: 24% households
• No iodine in salt: 21% households
SSM Oct 2008:
• Salt tested for iodine content was found
satisfactory in 97% samples (n=29,539)
Prevalence of IDD and status of
NIDDCP in Chhattisgarh : Table
showing the number of districts
surveyed & found endemic
State
Chhattisgarh
No. of Districts
Surveyed
2
(Sargujja, Jashpur)
No. of Districts
Found Endemic
2
IDD LAB
No
Status of Iodine Deficiency Survey in
Sarguja District
42% School Age Children (6-12 years) of Sarguja
district had Urinary Iodine Excretion below 99
micrograms/L
(Source: National Institute of Nutrition, ICMR,
2003)
Status of NIDDCP
implementation in Chhattisgarh
a. Mass awareness about Iodine Deficiency
disorders among community have been generated
using print, folk and electronic media , through
NGOs and public awareness campaigns.
b. The State Nodal officer for NIDDCP, Dr.
Subhash Pandey has been regularly attending
discussions on Doordarshan on the importance of
iodine and related disorders.
Status of NIDDCP in
Chhattisgarh State
c. Mass Public awareness to use Iodized salt
through demonstration by salt testing kits was
telecast in the months of Oct’ 08 & Oct’ 09 four
times in Kalyani Programme of Doordarshan.
d. The 21st of October is celebrated as “Global
Iodine Deficiency Disorder (IDD) Prevention
Day ” every year and marked by educational
workshops, seminars and attended by several line
departments like (DWCD, Food and Civil
Supplies, P&RD)
Special Campaign in the Month of
October since 2006- SSM
• During the October round of SSM every year, Salt
Testing Kits are used testing salt for its iodine
content at the vaccination session sites and also
during House hold surveys.
• Visits are made by the LHV or ANM to the
households of few pregnant women and there
cooking salt is tested for its iodine content.
• 10,000 such salt testing kits are distributed to all
sub centers, PHCs, CHCs and Urban areas.
NIDDCP – Budgetary Provisions
under NRHM
Activity Proposed
Amount
Proposed
Amount
Approved
2009-10
Remarks
1
Establishment of IDD
Control Cell
4.50
6.00
2
Establishment of IDD
Monitoring Lab.
2.50
3.50
The State Govt.
may modify the
PIP as per
allocation.
3
Health Education and
Publicity.
3.00
6.00
4
IDD Surveys
1.50
2.50
Total
11.50
18.00
Innovative activities in the state
• Iodized salt is distributed by Deptt. Of State Civil
Supplies through PDS
• Total Iodized salt distributed per month is 7500
Metric ton
• 37 lacs poor families are benefited by providing
Iodized salt (Amrit Namak), free of cost.
• Iodine content of salt "Amrit" is 30 P.P.M., is of
ISI standard and has PFA specifications.
• Special Iodized salt for above poverty line
families is Mahamaya Salt is also supplied by
State Civil Supplies Deptt.
Innovative activities in the state
• The following has been the distribution details of
Iodized salt (Amrit Namak) in the state:
–
–
–
–
–
–
–
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
2009-10
1889.00 MT
30916.14 MT
46909.00 MT
53823.00 MT
64047.00 MT
58743.54 MT
55753.78 MT (till Oct 09)
Activities Undertaken
• One trained Laboratory Technician is working at
the District Hospital Raipur for investigations
related to estimation of iodine content.
• Budgetary provisions under the NIDDCP for
SC/ST is allocated for IEC activities, medicines
and others supplies.
• Under this scheme, Rs.1.27 lakhs for IEC
activities and Rs. 2.20 lakhs for procuring
medicines in year 2009-10 have been distributed
to all districts.
• In Year 2009-10 each district was given Rs.
8000/- from the state budget to perform similar
activities