Sustainable Elimination of
Iodine Deficiency (Disorders):
Perspective for
Central & Eastern Europe and Central
Asia on
“Realizing USI”
ARNOLD TIMMER,
UNICEF REGIONAL OFFICE
April 2004
Realizing USI
Phases:
1. Building commitment among partners,
creating alliances, USI legislation
development
2. Increasing iodized salt supply
(production/import) and supporting
activities
3. Fine-tuning of the programme, assessing
impact, focus on sustainability
Iodized Salt:
From the
Law to the Table
Government Legislation
Enforcement of Laws
Production of IS
The Black
Market
Uniodized
Salt
The Market
The Household
Adequate iodine nutrition
Programme Cycle
ASSESSMENT
of the problem & means
for resolution
ACTION
ANALYSIS
Based on the analysis &
available resources
of the cause of the
problem
Action Components
Communication and
Advocacy
Interventions
Monitoring and
Evaluation
Management, Training, Technical support, Capacity
development
The Main Components of a
National Iodine Nutrition
Programme
Communications
IDD
• High-level Advocacy
• Mobilization
• Consumer Education
Salt Iodization
• Production & Quality Assurance
Monitoring
• Packaging & labeling
• Legislation/Regulation • Marketing
• Standards & Inspection • Retailing
• Manufacturing Practice • Pricing
• Impact Assessments
• Reporting
Slide courtesy of Emory University
Production
Policy
Universal Salt
Iodization
Impact
Role of Communication
• Difficult to convince behavior
• Different scenarios:
– legislation (+)
– legislation (+)
– legislation (-)
enforcement (+)
enforcement (-)
enforcement (-)
• Purpose short term is to increase immediate
use:
– Mass media campaign
– Package and shops
• Purpose long term is to sustain basic level of
awareness:
– Curriculum in schools
– Package
Iodized Salt:
From the
Law to the Table
Government Legislation
Enforcement of Laws
Production of IS
The Black
Market
Uniodized
Salt
The Market
Supportive Environment
•Advocacy for USI legislation
Creation of IDD coalitions and
monitoring bodies
Engagement of IS producers in
advocacy and IS agenda
Increasing ImmediateUse
IS marketing to consumers
Branding and packaging with IS
producers
Point of sale promotion
Ensuring Sustained Use
IS promotion by medical
professionals
IDD education and IS promotion
in schools and civil society groups
Engaging private sector salt
production in marketing
The Household
Adequate iodine nutrition
Production/Importation
Quality assurance
Packaging/labeling
Legislation/Regulation
Price
Monitoring
Awareness
Logo/
product recognition
Behavior change
Coverage
Ensuring
Adequate
Supply
Program Management
Policy/Advocacy
Ensuring
Awareness and
Use
Universal Salt
Iodization
Impact
Assessment