Strategy of National Iodine Deficiency Disorders Control
Intervention strategies in prevention and control of IDD
Method for iodine supplementation and associated difficulties

• Iodized salt.
• Iodized salt by injection.
• Iodized oil by mouth.

Of the above mentioned methods, iodination of salt of a proven intervention, salt being a common food item used by a vast majority of population. Therefore, to ensure success of a national iodine deficiency disorders programme, it is mandatory to check that the salt being used by humans is adequately iodized.

1. The highly volatile nature of iodine in all forms, potassium iodide ( ki) being the most volatile and potassium iodate ( KIO3) the least, makes production and quality assurance of iodinated salt quite difficult.
2. The problem may be compounded due to fragile distribution network and faulty preservation system, e.g. salt may be left uncovered or exposed to heat. Addition of salt after cooking to reduce loss of iodine is advocated.
3. The last but not the least difficult task is to ensure actual consumption of salt. Though the addition of iodine makes no differences in the taste of the salt, but the introduction of a new variety of salt, where a familiar one is already available, is likely to be resisted. Thus it is quality important to create a high demand and preference for iodized salt to be used in households.

Steps towards prevention of IDD
In order to make the national programme of IDD elimination possible, it is important to take up effective steps in the following directions

1. Advocacy efforts create awareness – The impact of iodine deficiency on the next generation and its potential economic impact need to be highlighted.
2. Education of the masses through IEC materials will assure a demand for iodized salt.
3. Formulation of legalization that only salt with specific iodine content should be produced or imported, guarantees that only iodized salt is available in the market.
4. Quality assurance procedures should be opted for production, distribution and marketing of salt.
5. A strategy needs top be established to verify the extent and nature of the IDD problem.

Activities
District level
Guidance to medical officer, team at district training Centre and review in monthly meeting about spot testing of salt sample and Collection of Urine Sample.

Divisional level
Dy. Director of Health Services (IDD) is responsible for the implementation of National Iodine Deficiency Disorders Control Programme by CME about IDD, functional status of various district Public Health Lab and Regional Public Health Lab, Co-ordination in various sectors like Food and Drug Administration (FDA), Civil Supplies Department, Tribal Development Department, ICDS wing of Women & Child Department, Workshop in various medical collages involvement of Municipal Corporation.

Services to Common People
The anganwadi workers. MPW’s at PHC, ANM’s at Sub–centre can have Spot – testing of salt and also estimation of Iodine content salt in Public Health Laboratories can be done free of charge for a common man directly or through health workers.

Urinary Iodine estimation is done at Aurangabad, Nasik, Nagpur, Pune regional public health laboratories at no charges.

Medical Officer at PHC, Sub–district hospital, Rural Hospital, examines for the diagnosis of goitre in out patient department and treatment can be obtained free of charge.