ABSTRACT
Objectives: The state of Andhra Pradesh (AP) is home to a substantial proportion of India's poor with 51% of the state's population living below the national poverty line. In 2009, access to adequately iodized salt in AP was nearly 90% among the richest households, but 44% among the poorest. This presentation documents the large scale effort made by the state government to improve access to adequately iodized salt by the poorest households. Methods: AP's situation led UNICEF and other partners to request that the state government accelerate efforts to make iodized salt available to the poorest households - and potentially the most vulnerable to iodine deficiency - through the Public Distribution System (PDS), India's food security safety-net for the poor. Results: Subsequently, in 2012 the state government made a decision to ensure the distribution of iodized salt through the PDS as part of a ration comprising nine subsidized food items. The ration - referred to as Amma Hastham (i.e. mother's hand) - is sold through a network of 44,000 PDS' fair price shops. It comprises wheat flour, whole wheat grains, lentils, sugar, oil, tamarind, turmeric, chili powder and iodized salt. Iodized salt is made available at subsidized cost of INR5 (USD 0.016) per kg per month. Conclusions: Currently 23.2 million families with an average size of 5 members are benefitting from this initiative, launched by the State Chief Minister with extensive media coverage for public sensitization and demand generation. Efforts are underway to ensure proper monitoring of the quality of salt and its iodine content.