Universal Salt Iodization and Vitamin-A Supplementation

Universal Salt Iodization (USI) Goal in Bihar

Background

Of all micronutrients, Iodine deficiency is the leading cause of mental retardation worldwide. Children born and living in Iodine-deficient areas have an average intelligence quotient (IQ) of 13.5 points lower as compared to children born in iodine-sufficient areas. It is a significant public health problem, with 13 million children born each year unprotected from brain damage caused by Iodine deficiency. Hence sustainable elimination of Iodine deficiency disorders (IDD) in intricately linked with achievement of the Millennium Development Goals (MDGs). Globally 1.88 billion people are at risk of IDD due to insufficient iodine intake.

Universal Salt Iodization (USI) and Iodine supplementations are highly effective strategies for preventing and controlling iodine deficiency. United Nations General Assembly at a special session at New York in 2002 reviewed progress towards USI and set the target for elimination of IDD.

In Coverage Evaluation Survey reports (2009), approximately 71% of households in India were consuming salt with adequate levels of Iodine i.e. ≥15 ppm; however, nearly 250 million Indians, including 8 million children born annually, still remain susceptible to IDD. Bihar being a backward state with high illiteracy and poverty level has an inherent problem of poor salt iodization. Though the general awareness regarding salt iodization is high in the state, the actual consumption is not upto the desired level due to lack of mechanisms to ensure availability. Moreover, there was no functioning State Lab in Bihar.

History

The initiative: In the second meeting of the State USI Coalition, held on 5th November 2014, under the chairmanship of the Executive Director, State Health Society Bihar, decision to establish a lab for salt testing at Patna Medical College in Bihar, on the same lines as is being done in Uttar Pradesh was taken. Dr Rashmi Singh, Professor and Head, and Dr Ranjeet Kumar Sinha, Assistant Professor from the Department of Community Medicine, Patna Medical College participated in the meeting and agreed to take up the responsibility.

Exposure Visit: For compliance to this decision, it was also decided to organize an exposure visit to BRD Medical College, Gorakhpur, Uttar Pradesh, where such a lab is functioning for some time get hands-on experience. Accordingly a visit to the said Medical College was undertaken by all stakeholders on 29^th, 30^th & 31^st January, 2015. The following were the team members:

Department of Community Medicine, PMCH

1. Dr Rajesh Ranjan Sinha (Assistant Professor)
2. Dr Ajay Krishna (Assistant Professor)
3. Dr Bipin Kumar (Tutor)
4. Dr Alok Kumar (Junior Resident)

Iodine Namak Aapurtikarta Kalyan Sangh (NGO)

• Mr RK Mishra

United Nations Children's Fund

1. Dr Shivani Dar
2. Mr Nishant Kumar
3. Mr Rajendra Prasad
4. Mr Parvez Azam

The cooperation of the Principal and faculty members of BRD Medical College, Gorakhpur and UNICEF team from Uttar Pradesh is duly acknowledged.

Inauguration of the State Salt Testing Laboratory, 25 March 2015

The state salt-testing laboratory was inaugurated on 25th March 2015 by Prof Dr SN Sinha, the Principal of Patna Medical College. The event was attended by Dr MK Sinha of SHS Bihar and personnel from UNICEF. A workshop was held on the same day to plan the future of the salt lab.

State Level Workshop, 25 March 2015

The session was inaugurated by Mr Anand Kishore, IAS, Joint Secretary of health, Government of Bihar. He released the two books of reports of preliminary enquiries conducted by the department into the status of micronutrient programme in Bihar.

Apart from Iodine Deficiency Disorders, this workshop also focused on issues related to Vitamin A deficiency and Iron deficiency among the people, particularly children, of the state. The workshop included interactive lectures and panel discussions to elaborate on the role of micronutrients in growth and development, and public health problems and challenges related to the same.

Books

The two books released are entitled

• Sustainable Progress towards achieving the USI Goal in Bihar (later reprinted as a handbook/manual for training of various stakeholders to achieve the USI goal)
• Vitamin A Prophylaxis Programme in Bihar

Testing of Salt Samples

In Phase I, it was decided to test salt samples from 2 districts - Vaishali and Patna - collected from four categories of sites:

• Salt unloading stations i.e. railway rake points
• Salt traders i.e. Wholesalers
• Retailers i.e. Shops
• Consumers i.e. households, and hotels/restaurants

Iodine Deficiency Disorders' Survey

Iodine Global Network IDD Newsletter Aug 2017

Our efforts featured as an international success in the August 2017 newsletter issued by the Iodine Global Network (Volume 45, Number 3, Page 10-11) based on the improvement documented by NFHS-4 data. Click the links below to:

• Visit newsletter webpage
• Download newsletter (PDF)
• Read the article (PDF)

Vitamin A Supplementation (VAS) Programme in Bihar

VAS Surveillance Preparedness Workshop for District Immunization Officers

State Level Training Workshop on VAS round 2