National Iodine Deficiency Disease Control Programme
Iodine is an essential micronutrient required for normal body growth and mental development and an essential element for human survival. Hence Iodine Deficiency Disorder (IDD) has been identified all over the world as a serious threat. In our country, it is estimated that more than 200 million people are at the risk of IDD, while the number of persons suffering from goiter and other iodine deficiency disorder is above 71 million (Govt. of India's guideline for NIDDCP). The main factor responsible for the development of IDD is low dietary supply of iodine in the natural foods. All crops grown on soils that are iodine deficient will be iodine deficient. Iodine deficiency is therefore a deficiency which can affect rich and poors alike, because it depends on the geophysical properties of the land. However consumption of iodized salt can prevent the occurrence of IDD. After successful trial of iodized salt in Kangara valley, Himachal Pradesh in 1962, the Government of India launched a fully centrally sponsored National Goiter Control Programme (NGCP). The main focus was on provision of iodated salt and to identify the endemic areas. The nomenclature of the NGCP was redesigned in 1992 as National Iodine Deficiency Disorder Control Programme (NIDDCP) to emphasize on the wider implication of iodine deficiency.
Affects of IDD:
Iodine deficiency may not result in Goitre but it might result in physical and mental retardation. It affects people of all ages, sexes and different socio economic status. It could also result in still birth, abortion, deaf-mutism, dwarfism, squint, cretinism, goiter of all ages, neuromotor defects, etc (Govt. of India's guideline for NIDDCP).
About the Project:
The National Iodine Deficiency Disorders Control Programme (NIDDCP) is implemented in order to prevent, control and eliminate these disorders and to provide assistance to the States for Setting up IDD Cell and IDD monitoring laboratories for ensuring quality control of iodated salt and for monitoring urinary iodine excretion. Survey of goitre and health education activities is also conducted through the Programme.
- Survey to assess the magnitude of the iodine Deficiency Disorders
- Supply to iodated salt in place in place of common salt
- Resurvey after every five years to assess the extent of Iodine Deficiency Disorders and the impact of iodated salt.
- Laboratory monitoring of iodated salt and urinary iodine excretion.
Along with the above mentioned objectives, the NIDDCP in Assam also works to achieve the following objectives
- Universal Salt Iodization in Assam
- Improvement of awareness about iodized salt among all the group of population
- To sustain IDD elimination in all districts through USI strategy.
- To bring awareness among the people with special reference to the Tea garden people regarding the IDD and increase the consumption of iodized salt among them.
- To encourage the supply of iodized salt through targeted PDS so as to cover BPL families.
To increase consumption and preservation of iodized salt through the involvement of media and NGO's to create awareness among the population, Institute like hotels, prisons, and other institutional facilities, professional bodies and persons concerned with different ICDS programmes like SNP, School Mid Day Meal programme etc.
Expected outcome of The Programme
- 100% consumption of iodized salt.
- Reduce rate of Goitre & other Deficiency Disorder related to Iodine.
- Monitoring of Salt should be improved.
In Assam the NIDDCP is looked after by the Directorate of Health Services with the support of Government of India. Director of Health Services is overall responsible for the Programme in the State. However it is the Program Officer (NIDDCP) who supervises the project. Under the Programme Officer is the Technical Officer and then comes the Lab technicians to support the working of the programme. Since there is no administration structure separately meant for this programme, hence intersectoral support is taken so that the programme is implemented at the grass root level.
Since the NIDDCP in Assam is planned to cover the entire state, hence a wide extensive approach is adopted for the project. The project has therefore covered a majority area in a phased manner. There is no revisiting or re-survey of the villages once visited by the workers. This is done only after completion of the entire state in the first stage.
Monitoring and Information System
Monitoring Team is constituted to monitor the overall activities of NIDDCP especially the activities & Iodine Content of salt in Wholesaler, Retailer & Consumer Level. IDD Salt monitoring team consists of Programme Officer, Technical officer of NIDDCP, Food Inspectors etc. Food Inspectors collect the salt from Wholesaler, Retailer & Consumer Level and send the salt samples to State IDD monitoring lab. for analysis of salt. Food inspector also tests the salt by spot salt testing kits and sends the report to Directorate of Health Services. The Technical Officer compile the report and send to IDD cell, Govt. of India. Programme Officer, Technical officer, Lab Technicians of NIDDCP also collect the salt samples from Whole seller, Retailer & Consumer Level and analysis the salt samples in state IDD monitoring lab. Salt samples are analyzed by Lab technicians of IDD monitoring lab.
Monitoring of Salt tests is done through two methods:
Iodine content of salt should be more than 15ppm at consumer level and more than 30ppm at manufacturing level.
Field Salt Testing Method
This is carried out through testing kits which gives results on spot .This is a qualitative method of iodized salt testing. The kits will be distributed to all the districts health authority, ANM's, Food Inspectors do the analysis and the report will come to the Directorate of Health Services. Field salt testing Kits also used by School Student & Teacher to find out the Iodine Content of Salt and latter they send the report to IDD Cell of Directorate of Health Services.
Laboratory Method of Salt Testing
This method involves the salt test by Titration methods. The salt testing will be carried in the monitoring laboratory of the Directorate campus and in the Public health laboratories, Assam. For this testing process salts are collected by the Food Inspectors of the Districts and some time officials of the IDD cell.
Data collection and reporting system has been formulated which are updated regularly.
Activities from March 2013 to December 2015
- State level awareness meeting was conducted for MNGO's of all the districts of Assam on May 2013.
- State level awareness meeting was conducted for Nursing staff of ANM training centre of Assam on the month of June 2013.
- State level awareness meeting for Faculty's of Districts Institute of Education and Training was conducted on July 2013.
- State level awareness meeting was conducted for PRI Member's of Zilla Parishad of all districts of Assam on the month of August 2013.
- State, District level & Block level USI drive was conducted through MPW's in fourteen nos. of endemic districts.
- Celebration of Global IDD Day at state level & District level on 2013.
- Goitre Survey was conducted in 5 nos. of districts.
- State level & Block level awareness programme was conducted with NGO's of Kamrup(R) &Kamrup(M) Districts on July' 2014.
- State level & Districts level awareness programme was conducted with Song & Drama Division, Ministry of Information & Broadcasting on July' 2014.State level Training Cum Awareness Porgramme was conducted for CDPO's & Extension Officers (W&CD) on July' 2014.
- Goitre survey in 9 nos. of Districts namely: Morigaon, Darrang, DimaHasao, Karbi-Anglong&Kamrup(R), Lakhimpur, Cachar, Karimganj&Hailakandi.
- Awareness conducted in 14 nos. of endemic districts through MPW's for the year 2014.
- State level meeting conducted with the NGO's, on 11th of July' 2014 followed by district level meeting & filed programme by the NGO's.
- State level meeting conducted with the Song & Drama Division on 17th July' 2014 followed by field programme by the troupes of Song & Drama at different district.
- State level training programme conducted for the CDPO & EO(P&RD) on 30th July' 2014.
- State level awareness programme for school teachers on 12th September' 2014.
- State coalition committee was formed and meeting held on 17th September' 2014 which was Chaired by Principal Secretary, Health & F.W. Government of Assam.
- Celebration of Global IDD Prevention Day on 14th November' 2014 state level as well as district level.
- All Assam basis essay completion was organized on occasion of Global IDD Prevention Day 2014.
- Display of hoarding at the civil hospitals of 12 nos. of districts of Assam.
- Celebration of Global IDD Day in the state level as well as district level for the year 2014.
- State level awareness meeting was conducted on 8th April' 2015 by involving officials of intersectoral department like Health & F.W., Education, Railway, Food, Civil Supply & Consumer Affairs, Salt Traders & NGO's etc.
- USI programme through MPW in 14 endemic districts for the year 2015.
- 3,79,606 nos. of salt samples are tested on 2014-2015. Where 12.13% found Non Adequately Iodized and 87.87% found Adequately Iodized.
Iodine Deficiency Disorders are becoming a public health problem in India and many others countries. IDD effects all sections of the population from fatal stage to old age. The State IDD cell is continuing its effort with various activities to combat the problems of IDD. But the peoples should be conscious to solve the problem related to IDD and should take accurate measures to eliminate the IDD problem for success and sustainable achievement of the programme.