RESUMO
Objectives: India was one of the first countries to introduce salt iodization. This presentation reviews the national efforts towards universal salt iodization (USI) in India, documents achievements and progress, and highlights key challenges in programme implementation. Methods: The Salt Department of the Government of India and its development partners have made concerted efforts to improve availability, access and use of adequately iodized salt. Results: National and state level advocacy meetings were carried out to ensure high political commitment and prioritization of the USI programme. The National Coalition for Sustained Iodine Intake was launched to improve the overall programme management and coordination. The technical capacity of salt producers was enhanced and salt wholesalers and retailers were mapped, sensitized and equipped with tools and skills to procure only adequately iodized salt. A state-of-the-art management information system was launched to improve the efficiency in monitoring the flow of iodized salt. In addition, awareness and communication activities were scaled up to generate demand for iodized salt. As a result, the national household coverage of adequately iodized salt increased from 51% in 2005 to 71% in 2009. However, data indicate a clear urban-rural and rich-poor differential, leaving some of the most disadvantaged populations vulnerable to iodine deficiency. Conclusions: An evidence-based, well-defined strategy will be necessary to reach the last 30% of households, which are are likely to be least accessible and most socio-economically vulnerable. Both national and state level policies should mainstream the use of adequately iodized salt in feeding programmes for the benefit of all.
RESUMO
Objectives: Showcasing Soybean oil fortification with Vitamin A and D as a demonstration project in Madhya Pradesh (MP), a state with worst nutritional indicators in India. Methods: A program cycle approach was followed for selection of state, fortifiable vehicle, micronutrient and delivery channel. Results: Soyabean oil was identified as a fortifiable vehicle as MP is soybean oil producing state with 94% household penetration and Industry having necessary infrastructure. Knowledge on fortification process and lack of awareness among consumers/ key stakeholders (KS) were the gap areas. Soybean oil fortification was launched by 12 millers in June in the open market with technical and part financial support from GAIN. With four months of launch, 4 new partners have joined in, increased investment from Industry partners on communication, capacity building was observed. 73% of the branded oil is being fortified and 18.4 million consumers are being reached monthly. 16-20% growth in fortified oil sales was observed. Soyabean oil fortification was found to be cost effective (Vitamin A and D premix: Sale price of oil = 1/1000). Social marketing campaign is creating demand. Advocacy efforts led to state food fortification alliance formation which is advocating for mandatory fortification of oil and usage of proven interventions in public funded programs. The reason for quick scale up is capacity building of industry, KS analysis and management, usage of pretested marketing campaigning, fortification logo, advocacy and monitoring plan. Conclusions: Soya bean oil fortfication was found to be a viable complementary strategy to address vitamin A and D deficiency.