India Iodine Survey 2018-19: 76.3% of Indian households consume adequately iodized salt

Nutrition International and partners disseminate results of India Iodine Survey 2018-19 which convey need to sustain and step up efforts to achieve Universal Salt Iodisation (USI)

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The survey results were released by Dr Vinod Paul, Member (Health and Nutrition), NITI Aayog, Government of India along with Dr Chandrakant S. Pandav, President, Association for Indian Coalition for Control of Iodine Deficiency Disorders & Former Professor & Head, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Nutrition International Regional Director, Asia, Andrew O’Connell and Mini Varghese, Acting India Country Director, Nutrition International.

New Delhi: Nutrition International, a global nutrition organisation, conducted a country-wide study – INDIA IODINE SURVEY 2018-19 to estimate the iodine status of the population and assess the extent to which Indian households have access to adequately iodised salt.

The survey 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, has shown that 76.3% of Indian households consumed adequately iodized 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 Iodization (USI) which has a target of reaching 90% of the population with adequately iodized salt. The results also convey the need to step up the efforts to ensure all households consume adequately iodized salt while sustaining the gains achieved over years to protect everyone from the risk of Iodine Deficiency Disorders.

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.

Dr Vinod Paul, Member (Health and Nutrition), NITI Aayog, Government of India said, “India Iodine Survey, 2018-19 comes at a crucial time when the entire country is celebrating Poshan Maah. The results show that industry regulators, state and central government and other stakeholders have played a critical role in the success so far. It is now time for us to step up our efforts to achieve full USI by 2022. The survey is a very good effort to scientifically estimate the progress so far and we need to accelerate progress in states that are facing challenges. I would be happy to organize a meeting of the stakeholders and states at the NITI Aayog to take this discussion forward and devise a strategy to achieve USI by 2022.”

The survey, carried out with the support of the Government of Canada through Global Affairs Canada, was conducted across all 29 states and 7 Union Territories and included a total of 21,406 households. Front-runner states with more than 99% of households having access to adequately iodized 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.

Andrew O Connell, Nutrition International’s Regional Director, Asia, said, “For more than 20 years Nutrition International has been working with the Government of India and partners to eliminate iodine deficiency disorders and we are proud of the progress we have collectively made to reduce the risk of iodine deficiency disorders across the country. We are confident that the results from the India Iodine Survey 2018-19 will guide policy decision and interventions needed to sustain the progress and step up efforts to reach Universal Salt Iodization.”

The survey tested the iodine content in samples of cooking salt from households to estimate the coverage of the use of adequately iodized 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:

  1. 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.

  2. Awareness about iodised salt was 62.2% in urban areas and 50.5% in rural areas.

  3. Around 56% of consumer identified iodized salt at the time of purchase from the use of the word `iodized’ printed on the packet. Around 21% relied on information from the shopkeeper for their purchase.

  4.  Among those who had heard of iodized salt, around 74% mentioned radio and television as their main source of information.

  5. 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 iodized whereas only 49.7% and 42.5% of crushed and crystal salt samples were found to be adequately iodized.

  6. In urban India, 47.8% bought salt based on the brand whereas 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 iodized salt with greater focus on enforcement and monitoring. Along with generating more awareness about consumption of adequately iodized salt, the survey also portrays a need to promote production and supply of adequately iodized salt, in order to reach the last mile in the march towards universal salt iodization in the country.

The dissemination was attended by over 100 participants from the Ministry of Health and Family Welfare, NITI Aayog, Food and Drugs Control Administration, Iodine Deficiency Disorders (IDD) Cell, salt processors, development partners, doctors, academicians from leading research organizations and media.