Team L&M
Iodine is a vital micronutrient needed regularly in small quantity for optimal mental and physical development in human beings. Deficiency of iodine can result in a range of disabilities and disorders such as goitre, hypothyroidism, cretinism, abortion, still-birth, mental retardation and psychomotor defects. Children born in iodine deficient areas may have up to 13.5 IQ points less than those born in iodine sufficient areas.
A majority of these consequences are invisible and irreversible but can be prevented. Fortifying cooking salt with iodine is the easiest and most cost-effective way to address this problem. According to WHO guidelines, daily iodine intake of 150μg is required to prevent iodine deficiency disorders which can be achieved if household salt contains a minimum of 15 ppm of iodine.
To estimate the iodine status of the population and assess the extent to which Indian households have access to adequately iodised salt, a global nutrition organisation, Nutrition International, conducted a countrywide study, India Iodine Survey 2018-19. Conducted in collaboration with the All India Institute of Medical Sciences (AIIMS) New Delhi, Association for Indian Coalition for the Control of Iodine Deficiency Disorders (ICCIDD) and Kantar, the survey has shown that 76.3% of Indian households consumed adequately iodised salt which means salt with more than or equal to 15 parts per million (ppm) of iodine.
The results signify the progress made by India towards Universal Salt Iodisation (USI) which has a target of reaching 90% of the population with adequately iodised salt. The results also convey the need to step up the efforts to ensure all households consume adequately iodised salt while sustaining the gains achieved over years to protect everyone from the risk of Iodine Deficiency Disorders.
The survey, carried out with the support of the Government of Canada through Global Affairs Canada, was conducted across all 29 states and seven Union Territories and included a total of 21,406 households. Frontrunner states with more than 99% of households having access to adequately iodised salt were Jammu & Kashmir, Manipur, Mizoram and Nagaland. In addition, the survey revealed that 13 out of 36 states have already achieved Universal Salt Iodization (USI) with more than 90% of their households having access to adequately iodized salt.
The survey tested the iodine content in samples of cooking salt from households to estimate the coverage of the use of adequately iodised salt. In addition, the survey also studied the urinary iodine concentration in samples from pregnant women, lactating women and non-pregnant non-lactating women of reproductive age (15 to 49 years) to estimate the iodine status among them. Notably, the median Urinary Iodine Concentration (µg/L) among these three categories of women was found to be adequate as per WHO guidelines.
KEY FINDINGS
A total of 55% of those surveyed had heard about iodised salt and 61.4 % mentioned prevention of goitre as the primary benefit of consuming iodised salt.
Awareness about iodised salt was 62.2% in urban areas and 50.5% in rural areas.
Around 56% of consumer identified iodised salt at the time of purchase from the use of the word ‘iodised’ printed on the packet. Around 21% relied on information from the shopkeeper for their purchase.
Among those who had heard of iodised salt, around 74% mentioned radio and television as their main source of information.
Around 82% of households used refined salt, whereas 12.7% used crystal salt and 5.3% used crushed salt. Around 83% of refined salt samples were adequately iodised whereas only 49.7% and 42.5% of crushed and crystal salt samples were found to be adequately iodised.
In urban India, 47.8% bought salt based on the brand where as in rural India most purchases (41.2%) were made on the basis of price of salt.
Based on the findings of India Iodine Survey 2018-19, the experts present at the dissemination urged the government to develop a more contextual and state specific approach to improve coverage of iodised salt with greater focus on enforcement and monitoring. Along with generating more awareness about consumption of adequately iodised salt, the survey also portrays a need to promote production and supply of adequately iodised salt, in order to reach the last mile in the march towards universal salt iodisation in the country.
