IODINE DEFICIENCY CONTROL PROGRAMME-INDIA

1. DR.MAHESWARI JAIKUMAR

2. NATIONAL GOITER
CONTROL
PROGRAMME IN
INDIA
DR. MAHESWARI JAIKUMAR

4. IODINE DEFICIENCY
DISORDER

5. • Iodine is required for the synthesis
of the thyroid hormones, thyroxine
(T4) and tri iodothyronine (T3) and
essential for the normal growth and
development and well being of all
humans.

6. • It is a micronutrient and normally
required around 100-150 micro
gram for normal growth and
development. Deficiency of iodine
may cause following disoders:

7. • Goiter
• Subnormal intelligence
• Neuromuscular weakness
• Endemic cretinism
• Still birth

8. • Hypothyroidism
• Defect in vision, hearing, and
speech
• Spasticity
• Intrauterine death
• Mental retardation

9. SIGNS AND SYMPTOMS
• Nervousness
• Anxiety
• Increased perspiration
• Heat intolerance
• Hyperactivity
• Palpitations

13. BURDEN OF DISEASE
• It is estimated that more than 71
million persons are suffering
from goiter and other iodine
deficiency disorders like mental
retardation, deaf, mutism,
squint, and neuromotor defects.

14. • 200 million people at risk of IDD
• That not even a single State/UT
is free from the problem of
Iodine Deficiency Disorders.

15. NATIONAL GOITER
CONTROL PROGRAMME.
• India has launched 100% centrally
sponsored the National Goiter
Control Programme.

18. OBJECTIVES
1.Initial survey to identify
magnitude of problem in the
country
2.Production and supply of iodized
salt to the endemic regions

19. 3. Health Education & Publicity
4. To undertake monitoring of the
quality of iodized salt assessing
urinary iodine excretion pattern and
monitoring of Iodine Deficiency
disorder

20. 5. Re-survey in goiter endemic
regions after five years continuous
supply of iodized salt to assess the
impact of the control programme.
The result of re-survey in some
areas has revealed that the
prevalence of goiter has not been
controlled as desired.

21. NATIONAL GOITRE CONTROL
PROGRAMME(NGCP) 1962 .
• OBJECTIVES:
• conduction of surveys to assess the
magnitude of Iodine Deficiency
Disorders
• the provision of iodated salt in place
of common salt.

22. GOITRE CONTROL
PROGRAMME IN 1980
• Assess reasons for failure of control
programmes so far
• Identify newly emerging dimensions of
this problem and
• Set out practical recommendations for
future action, based on detailed
• Consideration of causes of earlier
failures.

23. • Opening up iodization of salt to
private sector to ensure adequate
• Production to meet national needs
• Ensuring quality control at
production site
• Packing salt in poly packs to reduce
iodine loss during transport and
storage

24. • Testing iodine content of salt at
consumer level
• Improving awareness about the
need to consume only iodised
salt

25. RESULTS
1. Universal iodization of salt has not
been achieved even after a decade
has passed, when the target was set
to be achieved
2. More strengthening of transportation
of iodized salt by Railways and roads
is needed. Monitoring during
transportation is usually not done
regularly.

26. 3. Boosting up of political and
bureaucratic commitment is
required as the problem of visible
goiter has been reduced.
4. There is a difference in guidelines
for assessment of IDD issued by
Indian Government and
international organisations

28. • In 1992, the National Goiter Control
Programme (NGCP) was renamed as
National Iodine Deficiency Disorder
Control Programme(NIDDCP).

29. THE NATIONAL IODINE
DEFICIENCY DISORDER CONTROL
PROGRAMME(NIDDCP) 1992
• AIM:
• To reduce the incidence of IDD
• To less than 10 % among adults

30. • To less than 5 % among children 10
to 14 yrs
• To zero % of cretins among the
newborns by the year 2000

31. OBJECTIVES
• To assess the magnitude of the IDD
problem in the country
• To assess the impact of control
measures after every 5 years

32. • To monitor the quality of iodised
salt available to consumers and
estimate their urinary iodine
excretion pattern
• To conduct IEC campaigns for
promoting community participation
in the implementation of the
program

33. POLICY
• Central Council of Health
decided to iodize the entire
edible salt in 1992.
• To date annual production of
iodated salt is 42 lakh tones

34. ACHIEVEMENTS
1. The policy of iodized salt production
has been liberalized to private sector.
2. 790 private manufacturers have been
by the Salt Commissioner to have
annual production of 112 lakh tones
for direct human consumption.

35. 2. The annual production of iodized
salt has been raised from 7 lakh
tones (1985-86) to 42 lakh tones
in 1997-98. This is expected
further to raise to 50 lakh tones
in near future.

36. 3. The Salt Commissioner in consultation
with the Ministry of Railways
arranges for the transportation of
iodized salt ………
……from the production centers to
the consuming states under priority
category “B” a priority second to
that of defense.

37. 4. To ensure use of only iodized salt
(w.e.f 27 May 1998) & the sale of
non iodized salt was banned
under Prevention of Food
Adulteration Act, 1954 except in
kerala.

38. • For effective monitoring & proper
implementation of NIDDCP all the states
& UTs have been advised to establish
IDD Control Cell in the State Health
Directorate & Central Govt provides
cash grants for this purpose.

39. • A National Reference Laboratory for
monitoring of IDD has been set up at
the Bio chemistry division of National
Institute of Communicable Diseases,
Delhi for training medical & para
medical personnel & monitoring the
iodine content of salt & urine.

40. • For ensuring the quality control of
iodized salt at consumption level,
testing kits for on the spot
qualitative testing have been
developed & were distributed to all
Dt Health Officers in endemic states
for awareness.

41. • Cash grants are provided by the Central
Govt for conducting surveys/ re surveys
of IDD; Health Education & Publicity
Campaign to promote the consumption
of iodized salt

42. • The standards for iodized salt have been
laid down under PFA Act, 1954. These
stipulate that iodine content of salt at
the production & consumption level
should be at least 30 & 15 ppm
respectively.

43. INFORMATION, EDUCATION
AND COMMUNICATION

44. BLOCK LEVEL
• BEE /HE / Supervisor & NGO /
Teachers

45. VILLAGE LEVEL
• Training of ASHA/ANM/PRI/AWW/NGO
& village health & sanitation committee.
• One Monthly Health Day – IEC/ Demo.
• Village Health & Nutrition Day-1
session/month at AWC –(B compl
feeding with iodized salt)

46. • Immunization& ANC-display of posters,
distribution of leaflets, salt demo as
focus area under NRHM.
• Postering & wall painting with key
messages.
• Advocacy with press/mass media/ TV/
salt traders.
• School Health Activities –lecture &
demo on salt to students involving them

47. • Goiter survey & monitoring of
iodization of plants.
• IDD spot has been telecast on
Doordarshan (National Network).

48. REVIEW
• In 1997, all State Governments
banned the sale of salt other than
iodated salt.
• advised to include iodated salt
under Public Distribution System
(PDS).

49. • The Salt Commissioner has advised
to install iodization plant in
consuming areas and to improve
packaging of iodated salt to prevent
iodine loss during transit.

50. MONITORING & EVALUATION
MONITORING IS DONE THROUGH THREE
METHODS:
1.Field Salt Testing Method
2. Laboratory.
3.Questionnaire

51. ADMINISTRATIVE SET UP
1. Salt commissioner, Central Office of
Government of India, supervises the
universal iodization and issues
licenses to salt manufacturers.
2. A National Reference Laboratory for
monitoring IDD

52. • Through 100 IDD control cells
and IDD monitoring laboratories.

53. 9th FIVE YEAR PLAN PROPOSAL
• Proposed to strengthen IDD
Monitoring by setting up 90 IDD
monitoring laboratories
• IDD monitoring at the district level is
by regular checking of iodated salt
as well as urinary iodine excretion.

54. • The goal is to bring down the
incidence of IDD below 10 per
cent in endemic districts by 2000
A.D.

55. OBJECTIVES
1. Initial survey to identify
magnitude of problem in the
country
2. Production and supply of iodized
salt to the endemic regions

56. 3. Health Education & Publicity
4. To undertake monitoring of the
quality of iodized salt assessing
urinary iodine excretion pattern
and monitoring of Iodine
Deficiency disorder

57. 5. Re-survey in goiter endemic regions
after five years continuous supply
of iodized salt to assess the impact
of the control programme.
The result of re-survey in some
areas has revealed that the
prevalence of goiter has not
been controlled as desired.