National Iodine Deficiency Disorders Control Programme

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National Iodine Deficiency Disorders Control
Programme
Dr. Subhash Pandey State Nodal
Officer Directorate of Health Family Welfare,
Chhattisgarh, Raipur.
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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
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Part -A About National Iodine Deficiency
Disorders Control Program
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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
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• OBJECTIVES
• Surveys to assess the magnitude of the Iodine
  Deficiency Disorders
• Supply of Iodated salt in place of common salt.
• Re-survey after every 5 years to assess the
  extent of Iodine Deficiency Disorders and the
  impact of iodated salt.
• Laboratory Monitoring of Iodated Salt and Urinary
  Iodine Excretion
• Health Education Publicity

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Spectrum of Iodine Deficiency Disorders Foetus
1. Abortions 2. Still Births 3.
Congenital Anomalies 4. Increased PNMR 5.
Neurological Cretinism 6. Myxedematotous
Cretinism
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Spectrum of Iodine Deficiency Disorders Neonate
Neonatal Goitre Neonatal Hypothyroidism Chil
d Adolescent Juvenile Hypothyroidism Im
paired Mental Function Retarded Physical
development Adult Goitre with its
complication Hypothyroidism Impaired
Mental Function
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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

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Brain Cell Growth
Iodine Sufficiency
Iodine Deficiency
Iodine Deficiency is the single most common
cause of preventable mental retardation
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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
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IDD The Hourglass

• Iodine Deficiency Goitre
• Visible Swelling
• No Pain Not a cause of
• Mortality Cosmetic problem
• Cretinism rare

Historic View
Mental Physical growth Loss of
Energy-hypothyroidism Learning Disability,
Poor Motivation Child Development and Child
Survival Human Resource Development
Current View
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IDD Prevalence Indicators and Criteria for
classifying IDD as significant public health
problem
Indicator Mild Moderate Severe
Goitre Grade gt0 5-19.9 20-29.9 gt30
Urine Iodine Excretion (Microgram/L) 50-99 20-49 lt20
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Part -B

• Facts about Iodine Iodized Salt

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What is Iodine?

• Iodine is an essential micronutrient supporting
  some of the most vital functions of the human
  body.

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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.

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How much Iodine does a person normally need?

• The average daily adult requirement is 150
  micrograms
• Average lifetimes requirement of an individual
  less than a teaspoonful.

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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.

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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.

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Part - C

• Chhattisgarh State at a Glance

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• 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 (n29,539)

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Prevalence of IDD and status of NIDDCP in
Chhattisgarh Table showing the number of
districts surveyed found endemic
State No. of Districts Surveyed No. of Districts Found Endemic IDD LAB
Chhattisgarh 2 (Sargujja, Jashpur) 2 No
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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)

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Status of NIDDCP implementation in Chhattisgarh

1. Mass awareness about Iodine Deficiency disorders
   among community have been generated using print,
   folk and electronic media , through NGOs and
   public awareness campaigns.
2. The State Nodal officer for NIDDCP, Dr. Subhash
   Pandey has been regularly attending discussions
   on Doordarshan on the importance of iodine and
   related disorders.

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Status of NIDDCP in Chhattisgarh State

• 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.
• 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, PRD)

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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.

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NIDDCP Budgetary Provisions under NRHM
Activity Proposed Amount Proposed Amount Approved 2009-10 Remarks
1 Establishment of IDD Control Cell 4.50 6.00 The State Govt. may modify the PIP as per allocation.
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 The State Govt. may modify the PIP as per allocation.
4 IDD Surveys 1.50 2.50 The State Govt. may modify the PIP as per allocation.
Total 11.50 18.00 The State Govt. may modify the PIP as per allocation.
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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.

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Innovative activities in the state

• The following has been the distribution details
  of Iodized salt (Amrit Namak) in the state
• 2003-04 1889.00 MT
• 2004-05 30916.14 MT
• 2005-06 46909.00 MT
• 2006-07 53823.00 MT
• 2007-08 64047.00 MT
• 2008-09 58743.54 MT
• 2009-10 55753.78 MT (till Oct 09)

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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

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