![Page 1: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/1.jpg)
DR.MAHESWARI JAIKUMAR
![Page 2: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/2.jpg)
NATIONAL GOITER CONTROL
PROGRAMME IN INDIA
DR. MAHESWARI JAIKUMAR
![Page 3: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/3.jpg)
![Page 4: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/4.jpg)
IODINE DEFICIENCY DISORDER
![Page 5: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/5.jpg)
• Iodine is required for the synthesis of the thyroid hormones, thyroxine (T4) and triiodothyronine (T3) and essential for the normal growth and development and well being of all humans.
![Page 6: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/6.jpg)
• It is a micronutrient and normally required around 100-150 microgram for normal growth and development. Deficiency of iodine may cause following disoders:
![Page 7: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/7.jpg)
• Goiter• Subnormal intelligence• Neuromuscular weakness• Endemic cretinism• Still birth
![Page 8: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/8.jpg)
• Hypothyroidism• Defect in vision, hearing, and
speech• Spasticity • Intrauterine death• Mental retardation
![Page 9: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/9.jpg)
SIGNS AND SYMPTOMS• Nervousness• Anxiety• Increased perspiration• Heat intolerance• Hyperactivity• Palpitations
![Page 10: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/10.jpg)
![Page 11: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/11.jpg)
![Page 12: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/12.jpg)
![Page 13: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/13.jpg)
BURDEN OF DISEASE• It is estimated that more than 71
million persons are suffering from goiter and other iodine deficiency disorders like mental retardation, deaf mutism, squint, and neuromotor defects.
![Page 14: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/14.jpg)
• 200 million people at risk of IDD
• That not even a single State/UT is free from the problem of Iodine Deficiency Disorders.
![Page 15: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/15.jpg)
NATIONAL GOITER CONTROL PROGRAMME.
• India has launched 100% centrally sponsored the National Goiter Control Programme.
![Page 16: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/16.jpg)
![Page 17: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/17.jpg)
![Page 18: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/18.jpg)
OBJECTIVES1.Initial survey to identify
magnitude of problem in the country
2.Production and supply of iodized salt to the endemic regions
![Page 19: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/19.jpg)
3. Health Education & Publicity
4. To undertake monitoring of the quality of iodized salt assessing urinary iodine excretion pattern and monitoring of Iodine Deficiency disorder
![Page 20: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/20.jpg)
5. Re-survey in goiter endemic regions after five years continuous supply of iodized salt to assess the impact of the control programme.
The result of re-survey in some areas has revealed that the prevalence of goiter has not been controlled as desired.
![Page 21: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/21.jpg)
NATIONAL GOITRE CONTROL PROGRAMME(NGCP) 1962 .
• OBJECTIVES:• conduction of surveys to assess the
magnitude of Iodine Deficiency Disorders • the provision of iodated salt in place
of common salt.
![Page 22: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/22.jpg)
GOITRE CONTROL PROGRAMME IN 1980
• assess reasons for failure of control programmes so far
• identify newly emerging dimensions of this problem and
• set out practical recommendations for future action, based on detailed
• consideration of causes of earlier failures.
![Page 23: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/23.jpg)
• opening up iodization of salt to private sector to ensure adequate • production to meet national needs
• ensuring quality control at production site • packing salt in poly packs to reduce
iodine loss during transport and
![Page 24: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/24.jpg)
• storage • testing iodine content of salt at
consumer level • improving awareness about the
need to consume only iodised salt
![Page 25: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/25.jpg)
RESULTS1. Universal iodization of salt has not
been achieved even after a decade has passed away when the target was set to be achieved
2. More strengthening of transportation of iodized salt by Railways and roads is needed. Monitoring during transportation is usually not done regularly.
![Page 26: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/26.jpg)
3. Boosting up of political and bureaucratic commitment is required as the problem of visible goiter has been reduced.
4. There is a difference in guidelines for assessment of IDD issued by Indian Government and international organisations
![Page 27: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/27.jpg)
![Page 28: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/28.jpg)
• In 1992, the National Goiter Control Programme (NGCP) was renamed as National Iodine Deficiency Disorder Control Programme(NIDDCP).
![Page 29: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/29.jpg)
THE NATIONAL IODINE DEFICIENCY DISORDER CONTROL
PROGRAMME(NIDDCP) 1992
• AIM:
• To reduce the incidence of IDD
• To less than 10 % among adults
![Page 30: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/30.jpg)
• To less than 5 % among children 10 to 14 yrs
• To zero % of cretins among the newborns by the year 2000
![Page 31: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/31.jpg)
OBJECTIVES• To assess the magnitude of the IDD
problem in the country
• To assess the impact of control measures after every 5 years
![Page 32: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/32.jpg)
• To monitor the quality of iodised salt available to consumers and estimate their urinary iodine excretion pattern
• To conduct IEC campaigns for promoting community participation in the implementation of the program
![Page 33: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/33.jpg)
POLICY • Central Council of Health
decided to iodize the entire edible salt in 1992.
• To date annual production of iodated salt is 42 lakh tones
![Page 34: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/34.jpg)
ACHIEVEMENTS 1.The policy of iodized salt production
has been liberalized to private sector.790 private manufacturers have been licensed by the Salt Commissioner to have annual production of 112 lakh tones for direct human consumption.
![Page 35: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/35.jpg)
2.The annual production of iodized
salt has been raised from 7 lakh tones (1985-86) to 42 lakh tones in 1997-98. This is expected further to raise to 50 lakh tones in near future.
![Page 36: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/36.jpg)
3. The Salt Commissioner in consultation with the Ministry of Railways arranges for the transportation of iodized salt from the production centers to the consuming states under priority category “B” a priority second to that of defense.
![Page 37: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/37.jpg)
4.To ensure use of only iodized salt (w.e.f 27 May 1998) & the sale of non iodized salt was banned under Prevention of Food Adulteration Act, 1954 except in kerala.
![Page 38: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/38.jpg)
• For effective monitoring & proper implementation of NIDDCP all the states & UTs have been advised to establish IDD Control Cell in the State Health Directorate & Central Govt provides cash grants for this purpose.
![Page 39: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/39.jpg)
• A National Reference Laboratory for monitoring of IDD has been set up at the Bio chemistry division of National Institute of Communicable Diseases, Delhi for training medical & para medical personnel & monitoring the iodine content of salt & urine.
![Page 40: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/40.jpg)
• For ensuring the quality control of iodized salt at consumption level, testing kits for on the spot qualitative testing have been developed & were distributed to all Dt Health Officers in endemic states for awareness.
![Page 41: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/41.jpg)
• Cash grants are provided by the Central Govt for conducting surveys/ re surveys of IDD; Health Education & Publicity Campaign to promote the consumption of iodized salt
![Page 42: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/42.jpg)
• The standards for iodized salt have been laid down under PFA Act, 1954. These stipulate that iodine content of salt at the production & consumption level should be at least 30 & 15 ppm respectively.
![Page 43: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/43.jpg)
INFORMATION, EDUCATION AND COMMUNICATION
![Page 44: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/44.jpg)
BLOCK LEVEL
• BEE /HE / Supervisor & NGO / Teachers
![Page 45: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/45.jpg)
VILLAGE LEVEL• Training of ASHA/ANM/PRI/AWW/NGO
& village health & sanitation committee.
• One Monthly Health Day – IEC/ Demo.
• Village Health & Nutrition Day-1 session/month at AWC –(B compl feeding with iodized salt)
![Page 46: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/46.jpg)
• Immunization& ANC-display of posters, distribution of leaflets, salt demo as focus area under NRHM.
• Postering & wall painting with key messages.
• Advocacy with press/mass media/ TV/ salt traders.
• School Health Activities –lecture & demo on salt to students involving them
![Page 47: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/47.jpg)
• Goiter survey & monitoring of iodization of plants.
• IDD spot has been telecast on Doordarshan (National Network).
![Page 48: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/48.jpg)
REVIEW• In 1997, all State Governments
banned the sale of salt other than iodated salt.
• advised to include iodated salt under Public Distribution System (PDS).
![Page 49: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/49.jpg)
• The Salt Commissioner has advised to install iodization plant in consuming areas and to improve packaging of iodated salt to prevent iodine loss during transit.
![Page 50: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/50.jpg)
MONITORING & EVALUATION
MONITORING IS DONE THROUGH THREE
METHODS:
1.Field Salt Testing Method
2. Laboratory.
3.Questionnairre
![Page 51: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/51.jpg)
ADMINISTRATIVE SET UP
1. Salt commissioner, Central Office of Government of India, supervises the universal iodization and issues licenses to salt manufacturers.
2. A National Reference Laboratory for monitoring IDD
![Page 52: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/52.jpg)
• Through 100 IDD control cells and IDD monitoring laboratories.
![Page 53: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/53.jpg)
9th FIVE YEAR PLAN PROPOSAL
• Proposed to strengthen IDD Monitoring by setting up 90 IDD monitoring laboratories
• IDD monitoring at the district level is by regular checking of iodated salt as well as urinary iodine excretion.
![Page 54: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/54.jpg)
• The goal is to bring down the incidence of IDD below 10 per cent in endemic districts by 2000 A.D.
![Page 55: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/55.jpg)
OBJECTIVES1.Initial survey to identify
magnitude of problem in the country
2.Production and supply of iodized salt to the endemic regions
![Page 56: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/56.jpg)
3. Health Education & Publicity
4. To undertake monitoring of the quality of iodized salt assessing urinary iodine excretion pattern and monitoring of Iodine Deficiency disorder
![Page 57: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/57.jpg)
5. Re-survey in goiter endemic regions after five years continuous supply of iodized salt to assess the impact of the control programme.
The result of re-survey in some areas has revealed that the prevalence of goiter has not been controlled as desired.
![Page 58: Iodine Deficiency Disorder Control Programme in India](https://reader036.vdocuments.mx/reader036/viewer/2022081413/546d4bafaf7959693c8b5903/html5/thumbnails/58.jpg)