National Iodine Deficiency Disorders Control Programme Dr. Subhash Pandey State Nodal Officer...
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Transcript of National Iodine Deficiency Disorders Control Programme Dr. Subhash Pandey State Nodal Officer...
National Iodine Deficiency Disorders Control Programme
Dr. Subhash Pandey
State Nodal Officer
Directorate of Health & Family Welfare, Chhattisgarh, Raipur.
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
Part -A
About National Iodine Deficiency Disorders Control Program
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
OBJECTIVES
1. Surveys to assess the magnitude of the Iodine Deficiency Disorders
2. Supply of Iodated salt in place of common salt.
3. Re-survey after every 5 years to assess the extent of Iodine Deficiency Disorders and the impact of iodated salt.
4. Laboratory Monitoring of Iodated Salt and Urinary Iodine Excretion
5. Health Education & Publicity
Spectrum of Iodine Deficiency Disorders
Foetus: 1. Abortions2. Still Births3. Congenital Anomalies4. Increased PNMR5. Neurological Cretinism 6. Myxedematotous Cretinism
Spectrum of Iodine Deficiency Disorders
Neonate: Neonatal GoitreNeonatal Hypothyroidism
Child & Adolescent:Juvenile HypothyroidismImpaired Mental Function
Retarded Physical development
Adult: Goitre with its complicationHypothyroidismImpaired Mental Function
Effect on people : HUMANS Health & Socioeconomic impact
Effect on animals : LIVESTOCK Clinical & Reproductive disorders,decreased productivity
Low Availabilityof iodine : PLANTS Iodine poor feeds &
fodders
Soil Erosion : WATER, SOIL Environmental iodine deficiency
Iodine Deficiency – A Disease of The Soil
Brain Cell Growth
Iodine Deficiency Iodine Sufficiency
Iodine Deficiency is the single most
common cause of preventable mental retardation
School age children living in
iodine deficient environment
on an average, have
13 I.Q. points
less than those living in
iodine sufficient environments
Iodine Deficiency & Learning Abilities
Iodine Deficiency = Goitre = Visible Swelling
No Pain = Not a cause of Mortality = Cosmetic problem
Cretinism rare
IDD – The Hourglass
Historic View
Current View
Mental & Physical growth
Loss of Energy-hypothyroidism
Learning Disability, Poor Motivation
Child Development and Child Survival
Human Resource Development
IDD Prevalence Indicators and Criteria for classifying IDD as
significant public health problem
Indicator Mild Moderate Severe
Goitre Grade >0
5-19.9% 20-29.9% >30%
Urine Iodine Excretion (Microgram/L)
50-99 20-49 <20
Part -B
Facts about Iodine & Iodized Salt
What is Iodine?
Iodine is an essential micronutrient supporting some of the most vital functions of the human body.
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.
How much Iodine does a person normally need?
The average daily adult requirement is 150 micrograms
Average lifetime’s requirement of an individual less than a teaspoonful.
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.
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.
Part - C
Chhattisgarh State at a Glance
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 (n=29,539)
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
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)
Status of NIDDCP implementation in Chhattisgarh
a. Mass awareness about Iodine Deficiency disorders among community have been generated using print, folk and electronic media , through NGOs and public awareness campaigns.
b. The State Nodal officer for NIDDCP, Dr. Subhash Pandey has been regularly attending discussions on Doordarshan on the importance of iodine and related disorders.
c. 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.
d. 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, P&RD)
Status of NIDDCP in Chhattisgarh State
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 alsoduring 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.
NIDDCP – Budgetary Provisionsunder 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
3 Health Education and Publicity.
3.00 6.00
4 IDD Surveys 1.50 2.50
Total 11.50 18.00
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.
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)
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