NATIONAL IODINE DEFICIENCY DISEASE CONTROL PROGRAMME
Introduction:-
A 100% CSS Programme launched in 1962 as National Goiter Control Programme Renamed as National Iodine Deficiency Disorder Control Programme in 1992 to cover the wide spectrum of disorders. The Iodine Deficiency Disorder Control programme was launched in the year 1984 in the State as it was decided as a National policy to fortify all edible salt in a phased manner. The sale of Non iodised salt was banned in the State of Sikkim under the provision of Food Adulteration Act 37, of 1954 and implemented since September 1985 with the following objectives:-
- To supply iodated salt in place of common salt
- Laboratory monitoring and iodated salt and urinary iodine excretion.
- Health Education.
- Surveys & Resurveys to assess the magnitude and extent of IDDs and
impact of use of iodated salt.
The goal is to reduce the prevalence of IDD to <5% by 2017 in the entire
Country.
A. Implementation mechanism and activities:
The different components of the NIDDCP for implementation activities are IDD control Cell, IDD Monitoring Laboratory, Publicity & Health Education and Surveys & Resurveys.
1. IDD Control cell:
The IDD Control Cell based at the Head Quarter is created for proper implementation and effective monitoring of the programme. All the sanctioned posts of Technical Officer, Statistical Assistant and LDC are filled at present. At the districts the implementation activities are carried out by the CMO who are the Nodal Officer for the programme. Apart from conducting IDD survey it is also imparting trainings to all the health functionaries including AWW, ASHA and Salt retailers.
2. IDD Monitoring Laboratory:
The IDD monitoring laboratory is established at STNM Hospital, Gangtok. Earlier it was functioning with the food testing centre however a well functional IDD laboratory has been established in the STNM complex in 2008-09.
A regular monitoring and evaluation of iodated salt sample at both consumers and retailer’s level is being carried out to monitor the quality of the iodized salt.
A minimum of fifty salt samples from each district is being collected and analyzed monthly as per the GoI Policy Guidelines 2006.
Estimation has also been taken up in this laboratory since Nov 2009. A total of 25 samples each district is being collected and analyzed and reports are forwarded to GOI on monthly as per the GoI guidelines.
Salt testing with Spot Test Kit (STK) by ASHA during VHN Days is being continued since 2009-10.A total of 20 samples are being tested by ASHA with STK during VHN Days. Reports are being forwarded to IDD Cell through DRCHO/DPM which is further forwarded to GoI on quarterly basis.
3. Publicity and health education:
Publicity and health education is being carried out with an objective to generate awareness among general population regarding consequences of iodine deficiency disorders and to educate the general masses on improving storage of iodized salt and to promote the consumption of iodated salt.
A week long Global IDD Prevention Day starting on 21st October is celebrated every year. This day is celebrated to create awareness about the importance of regular consumption of iodized salt in prevention of Iodine Deficiency Disorders. In addition to Global IDD Prevention Day Celebration, Orientation Training Camp Programme is conducted for all the health functionaries including AWW, ASHA and Salt retailers.
4. Surveys and resurveys:
The surveys are conducted for assessing the magnitude of Goiter and other Iodine Deficiency Disorders. It is conducted as per the guidelines of Government of India. The resurvey is carried out every five years to assess IDD and to assess impact of use iodated salt.
The last survey was conducted in the year 2006-07 where in the prevalence of goiter was found to be 14.17% and the resurvey was carried out during 2009-10 in all the four districts, Where in the prevalence of goiter is found to be 13.37. Resurvey was conducted in the north district in the year 2011-2012, south and east district in the year 2012-13 and west in the year 2013-14 wherein the prevalence was found to be 2.33%, 6.1%, 4.9%, and 8.8% respectively. Survey of each district is being carried out this year to check the state prevalence. However the state as a whole is still endemic for IDD as a district is said to be endemic if the goiter rate is above 5% in children of age group 6 to 12 years surveyed.
Prevalence of IDD in Sikkim since 1982 to 2014-15.
| Year of Survey | Goiter (%) | Cretinism (%) |
|---|---|---|
| 1982 (ICMR) | 56.6 | - |
| 1989-91 | 54.03 | 3.46 |
| 1998-99 | 16.08 | 1.8 |
| 2006-07 | 14.17 |
|
| 2009-10 | 13.37 | |
| 2011-12 | 2.33% (North district) | |
| 2012-13 | 6.1%and 4.9%(south and east) | |
| 2014-15 | 8.8%(west district) | |
| 2015-16 | Survey is being conducted |
B. Physical Achievements:
2014-15 Percentages of households consuming adequately iodized salt as per salt sample analysis report from the Monitoring Laboratories for the last five years.
|
|
|
| |
|---|---|---|---|---|
| >15 ppm | <15 ppm | |||
| 2007- 08 | 2205 | 225 | 2430 | 90.70 |
| 2008- 09 | 2233 | 167 | 2400 | 93.00 |
| 2009- 10 | 1824 | 76 | 1900 | 96.00 |
| 2010- 11 | 2350 | 50 | 2400 | 97.70 |
| 2011-12 | 2335 | 15 | 2350 | 99.36 |
| 2012-13 | 2366 | 34 | 2400 | 98.58 |
| 2013-14 | 2386 | 14 | 2400 | 99.41 |
| 2014-15 | 2396 | 04 | 2400 | 99.83 |
| 2015-16 | 2382 | 18 | 2400 | 99.25 |
2. Salt Sample analysis report for Consumers and Retailers for 2015-16
|
|
|
|
| ||
|---|---|---|---|---|---|---|
|
| |||||
| >15 ppm | <15 ppm | >15 ppm | <15 ppm | |||
| April 15 | 158 | 02 | 160 | 40 | - | 40 |
| May 15 | 160 | - | 160 | 40 | - | 40 |
| June 15 | 158 | 02 | 160 | 40 | - | 40 |
| July 15 | 160 | - | 160 | 40 | - | 40 |
| August 15 | 160 | - | 160 | 40 | - | 40 |
| September 15 | 155 | 05 | 160 | 40 | - | 40 |
| October 15 | 159 | 01 | 160 | 40 | - | 40 |
| Nov-Dec15 | 316 | 04 | 160 | 80 | - | 80 |
| January 16 | 157 | 03 | 160 | 40 | - | 40 |
| February 16 | 160 | - | 160 | 40 | - | 40 |
| March 16 | 159 | 01 | 160 | 40 | - | 40 |
| Total | 1902 | 18 | 1920 | 480 | 480 |
3. District Wise break up of Salt Sample Analysis report 2015-2016
Year | Consumers | Total | Retailer | |||
|---|---|---|---|---|---|---|
| >15 ppm | <15 ppm | >15 ppm | <15 ppm | Total | ||
| EAST | 479 | 01 | 480 | 120 | 00 | 600 |
| NORTH | 480 | 00 | 480 | 120 | 00 | 600 |
| SOUTH | 477 | 03 | 480 | 120 | 00 | 600 |
| WEST | 466 | 14 | 480 | 120 | 00 | 600 |
| TOTAL | 1902 | 18 | 1920 | 480 | 00 | 2400 |
5. Details of UIE estimation report for 2015-16
| Median Value µ/L | 2015-16 |
|---|---|
| <20 | 00 |
| 20-49 | 00 |
| 50-99 | 09 |
| 100-199 | 47 |
| 200-299 | 217 |
| >= 300 | 927 |
| Total | 1200 |
6. Publicity and Health education
A: Global IDD Prevention day celebration
Global IDD Prevention day is celebrated for awareness generations in the State on 21st October every year…
7. Financial Progress for last five years
| Year | 1st Qtr | 2nd Qtr | 3rd Qtr | 4th Qtr | Total expenditure | Fund released from GOI | Total fund | Balance |
|---|---|---|---|---|---|---|---|---|
| 2010-11 | 3.25 | 2.96 | 8.41 | 6.79 | 21.41 | 34.53 | 35.39 | 13.98 |
| 2011-12 | 3.60 | 14.19 | 2.57 | 7.39 | 27.75 | 20.87 | 34.85 | 7.10 |
| 2012-13 | 3.46 | 3.79 | 12.80 | 6.07 | 26.12 | 21.96 | 29.06 | 2.94 |
| 2013-14 | 4.08 | 3.64 | 12.55 | 16.65 | 36.92 | 43.37 | 46.31 | 9.39 |
| 2014-15 | 4.41 | 3.49 | 3.93 | 22.62 | 34.45 | 33.75 | 43.14 | 8.69 |
| 2015-16 | 4.95 | 4.16 | 3.80 | 2.72 | 15.63 | 36.00 | 44.69 | 29.06 |
Future strategies
- Set up IDD laboratory in all the districts with man power for smooth implementation of programme.
- Fund should be routed through RTGS as it is hampering the smooth functioning of the programme.