|
|
Status
Report on National Iodine
Deficiency Disorders Control Programme in Southern States
Continued ….
NATIONAL
IODINE DEFFICIENCY DISORDERS CONTROL PROGRAMME
ORISSA
CENSUS OF INDIA 2001
PROVISIONAL POPULATION TOTALS
ORISSA
FIGURES AT A GLANCE
Number of districts 30
Area(In Sq.Kms) 1,55,707
TotalPopulation Persons 3,67,06,9
Males 1,86,12,340
Females 1,80,94,580
Decadal Population
Growth 1991-2001 Absolute 50,47,184
Percentage (+)15.94
Population Density
(perSq.Km) 236
Sex Ratio
(Females per1000 Males)
0-6 Population Absolute
Percentage
to
total
Population
Persons
51,80,551 14.11
Males 26,56,046 14.24
Females 25,24,505 13.95
Literacy Absolute
Rate(Excluding
0-6
Population)
Persons 2,00,53,785 63.61
Males
1,21,18,256 75.95
Females 79,35,529 50.97
IDD PREVALENCE IN ORISSA
|
Surveyed 6 districts |
Prevalence Rate |
|
1. Puri |
19.34% |
|
2. Sundargarh |
33.50% |
|
3. |
21.61% |
|
4. Keonjhar |
14.90% |
|
5.Nuapada |
14.40% |
|
6. Baragarh |
10.8% |
SALT PRODUCTION IN ORISSA
Total
Requirement :
3Lakh tons
Production
Capacity :
76,000 tons
Actual
Production : 40,000tons
Orissa
largely dependent on other States for its salt requirement
IMPORT OF SALT FROM
OTHER STATES:-
Chennai:- 1,09,400tons
Gujurat:- 69,600tons
Rajastan:- 34,800 tons
Kolkata:- 12,900
tons
---------------------------------------------------
TOTAL:- 2,26,700
tons
CONSTRAINTS FACED IN THE STATE:-
1.Lack of
knowledge in the most of the areas of the State on the benefit of Iodised Salt.
2. Iodised
Salt production quite less in
comparison to the requirement .
3.
Comparative higher production cost due to:-
a.
Transportation problem from the manufacturing unit.
b. Higher electricity charge.
c. Less density of Seawater.
d. Unlike other State salt is not manufacture
by boring the soil.
4.
Insufficient & out of order machineries
for iodisation.
5. Non-
availability of potassium iodate.
6. Partial
ban on non- iodise salt in the neighboring State. As a result
non-iodised salt are sold in the cheaper rate
in the State.
7. Huge
amount of non- iodised salt left in the salt manufacturing unit.
IDD
CELL IN STATE HEALTH DIRECTORATE:-
The National
Iodine Deficiency Disorders
Control Programme started in our
State since Dec'1989 & it is a 100%
centrally sponsored scheme.
An I.D.D.
Control Cell is functioning in the Health
Directorate, Orissa with the following Staffs:-
1.Technical
Officer (I.D.D.) - 1(One)
2.
Statistical Assistant - 1(One)
3.
L.D.C./Typist (Jr.Asst,) - 1(One)
OBJECTIVE:-
- Assess
magnitude & distribution of IDD prevalence.
- identify
high-risk population.
- Evaluation
of Control Programme.
- Monitoring
progress to wards achieving long-range goals & to create
awareness among the
people through IEC
activities regarding use and
benefit of iodised salt.
MAGNITUDE
OF THE PROBLEM:-
Sample
surveys conducted in 6 districts.
In all districts surveyed, IDD is a major public
Health problem total goiter rate more than 10% against cut off 5% proposed
by WHO.
Both
Coastal & Hill areas have more prevalence rate.
WHO
ARE MOST AFFECTED:-
√
Live in rural areas
√
Have lower standard of living.
√ Are from SC,ST and OBC
Therefore, iodine deficiency can perpetuate the
cycle of
under development and poverty.
8. In
adequate fund released from Central Govt. of implementation of the programme.
9.
Non-functioning of IDD Monitoring Laboratory in full swing.
SUGGESTION FOR EFFECTIVE IMPLEMENTATION OF NIDDCP IN THE STATE:-
1. More Salt Production Unit.
2. IEC activities through out the State to
educate the people & increase the
awareness.
3. Free supply of iodisation machineries &
potassium iodate to the salt farmers.
4. Separate IDD Monitoring Laboratory.
5. Checking of entry of non-iodised salt
from the
neighboring State.
6. Action plan for disposal of huge stock of
non-iodised salt in the manufacturing unit.
7. Incentive to the salt farmers to increase
the production of iodised salt.
KERALA
Introduction
As part
of implementation of NIDDCP
Goitre Control Cell
was established in October 1988 which became fully
functional by 1990.
The
activities under NIDDCP include:
Goitre
prevalence surveys.
IEC-
Awareness generation in various sectors and community.Setting up of laboratory for analysis of salt samples
and urine iodine content.
Goitre Cell
consists of a
Technical Officer, Statistical Assistant Clerk cum Typist,
Laboratory Technician and Laboratory
Assistant.
In Kerala
Goitre prevalence surveys were conducted
in all 14 districts
up to 1994 which revealed endemicity in 11 districts. The survey was restarted in 1998.
Activities.
IEC
One day
awareness workshop on Iodine
Deficiency Disorder was conducted
for the MSS (
Mahila Swasth Sangh)
convenors of Trichur, Pathanamthitta, Kollam, Malappuram, Alapuzha, Wayanad, Ernakulam and
Idukki Districts on 14-10-98. The
programme was funded by UNICEF
and organized by IDD Cell DHS
One day
awareness workshop on Iodine Deficiency
Disorders was conducted for
Anganwadi workers of
Pathanamthitta, Kollam,
Malappuram, Alapuzha, Wayanad, Ernakulam and Idukki Districts on 14-10-98. The programme was
funded by UNICEF and organized by IDD Cell DHS
One day
awareness workshop on Iodine Deficiency
Disorders was conducted for
Anganwadi workers of
Pathanamthitta, Thiruvananthapuram,
Kollam,Alappuzha, Ernakulam, Kottayam
and Palakkadu Districts on 22-3-99. This programme was also funded by
UNICEF and organized
by the State
IDD Cell DHS Thiruvananthapuram.
The State
level Global IDD Day was observed at Kozhikode District on
During the
year 1999 and 2000, celebrated
" Global IDD "
on October 21st 11
districts were selected
for this i.e., Thiruvananthapuram,Kollam, Kottayam,
Idukki, Pathanamthitta,
Thirussur, Malappuram, Kozhikkod, Kannur, Kasaragod and Wayanad. 10
numbers of one day lecture
discussion classes for the High School students were conducted in each
district. For this,10 different Primary Health Centers in each
district were selected. The Medical Officers in the Primary Health
Centers conducted a lecture discussion class for a selected number
of students in a high
school under this Primary Health
Center, highlighting the Iodine Deficiency Disorders and the need for
the use of Iodised Salt for better
health.Printed materials on IDD
also supplied
to the participants.
In addition, 10
group discussions were also
conducted in each district for mothers
of Anganwadi Children by
Junior Public Health Nurse. They
also
supplied Iodised
Salt for mothers who attended
the discussion classes.
Distributed IEC
materials such as "20 Questions
on IDD" ,IDD Booklets
for School Children and Booklet on IDD for Teachers
( Produce, Procure, Stock
and sell only Iodised Salt ) to all
districts in Kerala. Distributed cassettes on
Iodine Deficiency Disorders "
Every Hour Cost"
in Malayalam version
to all districts, which was
supplied by UNICEF.
One talk
in Malayalam on IDD was telecast by AIR on 17.2.2000.
On October 21 st, 2001 conducted one quiz
programme for 40 girl students from
different schools at Ernakulam.
2001-2002:- District level
Health Education Camp
and Demonstration of Salt Testing
Kit, quiz competition for school children in
all districts were
conducted on October
21st. Supplied stickers on
IDD, posters, booklets
etc.,in all districts.
Goitre
Surveys:- Under this programme,
we conducted Goitre survey in
districts to find out the
prevalence of Goitre among
high school children. During 1999-2000, 4 districts were selected for the survey i.e. Thiruvananthappuram,
Kottayam, Idukki & Thrissur. During 2000-01,2 districts were selected i.e.
Kollam & Kannur and during 2001-02 four districts were selected Alappuzha,
Palakkadu, Kozhikkodu and Pathanamthitta.
The report
is as follows,
|
Grade. District |
0 Grade* (%) |
GradeI* (%) |
Grade II*
(%) |
|
Thiruvananthapuram |
78 |
15 |
07 |
|
Kottayam |
62 |
31 |
07 |
|
Idukki |
83 |
15 |
02 |
|
Trissur |
78 |
14 |
08 |
|
Kannur |
81 |
15 |
04 |
|
Kollam |
83.3 |
15.4 |
1.3 |
|
Alappuzha |
90.38 |
7.97 |
1.65 |
|
Palakkadu |
91.06 |
0.01 |
0.93 |
|
Kozhikkodu |
64.53 |
34.13 |
1.34 |
|
Pathanamthitta |
90.02
|
9.28 |
0.07 |
During 2002-02,
4 districts are
selected for survey
viz., Kasaragod, Wayanadu, Malappuram and Ernakulam.
Salt
Sample Analysis.
Establishment
of State level IDD laboratory was completed in July 2000. Before
that only qualitative analysis of salt
was being done by
field workers. Government Analytical
Laboratory was analysing a few
samples of salt through titration. The
available results are as in the table below:-
Pattern of
Iodine Content of Salt samples
available in the
households
of different districts (Jan. to May 1999)
|
Name of the
District |
%of alts in different Iodine
oncentration(as ppm) ---------------------------- Nil/<2ppm |
---------------------------- 2-15ppm |
---------------------------- >15ppm |
|
Trivandrum Kollam Pathananthitta Alappuzha Kottayam Idukky Ernakulam Thrissur Palakkad Malappuram Wayanad Kannur Kasaragod |
26.7 23.0 1.5 29.0 23.8 28.5 21.5 31.6 45.7 54.5 54.2 50.8 50.0 23.6 |
28.3 22.6 19.8 19.2 21.5 20.5 24.0 23.0 26.3 20.8 21.6 25.6 20.7 20.3 |
45.0 54.4 79.7 51.8 54.6 51.0 54.5 45.4 28.0 24.7 24.0 23.6 19.0 29.5 |
Once the
state level IDD laboratory became
operational salt samples analysis
was undertaken by the laboratory. The laboratory continues to perform analysis of iodine content of salt
sample
collected from various house holds and shops .The results
from August 2000 to October 2001
are as follows:-
|
District |
Iodine Deficient salt (<15ppm or Nil) |
Iodised Salt (>15ppm) |
|
Trivandrum |
16.5% |
83.5% |
|
Kollam |
78.7% |
21.3% |
|
Malappuram |
48.4% |
51.6% |
Analysis
of about 800 samples of salt
collected from all over Kerala
and sent here jointly by the Department
of Community Medicine, Medical
College, Trivandrum and AIIMS showed that,
34% of the people use Iodine Deficient Salt, whereas 66% use Iodised salt.
Constraints
: Funds
allotted per district (Rs 10000/-) is insufficient for
surveys.
: Transport
of samples from the districts to State level
IDD
: Lab
cannot efficiently be carried out due to paucity of funds and facilities.
: Urinary
iodine excretion is not being done due to lake
of reagents and equipment.
Policy
: Is
ban on non-iodised salt necessary in Kerala
: Reducing
the price of Iodised salt.
: Possibility of raising the capabilities of
small scale industries by providing subsidies so that
they can supply iodised salt.
: Increased
awareness creation is being carried out so
that the community realises the
need to use Iodised
Salt.
STATUS REPORT
ON NATIONAL IODINE DEFICIENCY
DISORDERS CONTROL
National Iodine Deficiency Disorders Control
Programme (NIDDCP) was launched during
88-89 at the State Health Directorate as 100% centrally sponsored scheme with
the creation of IDD Cell. The IDD Cell consists of the following posts:
1. Technical Officer -
1
2. Asst. Statistical Officer - 1
3. Clerk-cum-Typist -
1
During
93-94 the following posts were created for the
monitoring lab attached to Public Health Institute.
1. Laboratory
Technicians -
1
2. Laboratory
Assistant - 1
The
programme has been initiated with the objective of
1. Mapping out endemic areas in the
state by Goiter Survey.
2. Supply of Iodised salt to the endemic
areas to control IDD
3.
Re-survey after five years of continuous supply
of Iodised salt to assess the
impact of the control
Programme
As per the first objective initial surveys
covering around 2.37 Lakhs individuals
in the entire state were completed
and four districts viz.,
Chikkamagalur, Dakshina Kannada,
Kodagu and
Uttara
Kannada were identified as endemic districts. The results of the survey are as follows:
PERCENT
PREVALENCE OF GOITRE IN KARNATAKA STATE.
|
Nameofthe Districts |
Total No.of Village |
Total population covered |
No.ofGoitre cases |
Prevalence |
|
1 |
2 |
3 |
4 |
5 |
|
Chikkamagalur |
5 |
3,196
|
1,314 |
41.11% |
|
Kodagu |
66 |
4,623 |
1,069 |
23.12 |
|
DakshinaKannada |
17 |
15,644
|
2,219 |
14.18 |
|
UttaraKannada |
25 |
15,091 |
1,611 |
10.67 |
|
Shimoga |
50 |
22,003
|
1,525 |
6.90 |
|
Bidar |
12 |
8,805 |
473 |
5.37 |
|
Gulbarga |
21 |
9,582 |
465 |
4.85 |
|
Bijapur |
11 |
5,303
|
244 |
4.6 |
|
Kolar |
4
|
2,048 |
61 |
2.53 |
|
Belgaum |
21
|
16,243 |
411 |
2.53 |
STATEMENT
SHOWING THE QUANTITY OF SALT REQUIRED FOR THE
STATE
|
Name of the District |
Population 2001Census (in Lakhs) |
Quantity of salt
required
(in Kgs) |
Quantity in Metric Tonnes. |
|
1.Bangalore(U) |
65.23 |
39138000 |
39138 |
|
2.Bangalore(R) |
18.78 |
11268000 |
11268 |
|
3.Belgaum |
47.07 |
25242000 |
25242 |
|
4.Bijapur |
18.09 |
10854000
|
10854 |
|
5.Bagalkot |
16.52 |
9912000 |
9912 |
|
6.Bellary |
20.25 |
12150000 |
12150 |
|
7.Bidar |
15.10 |
9006000 |
9006 |
|
8.Chitradurga |
15.10 |
9060000 |
9060
|
|
9.Chamarajanagara |
9,64 |
5784000 |
5784 |
|
10.Chikkamagalur |
11.39 |
6834000 |
6834 |
|
11.Dakshina Kannada |
18.96 |
11376000 |
11376 |
|
12.Davangere |
17.90 |
10740000 |
10740 |
|
13.Dharwad |
16.04 |
9624000 |
9624 |
|
14.Gadag |
9.72 |
5832000 |
5832 |
|
15.Gulbarga |
31.25 |
18750000 |
18750 |
|
16.Hassan |
17.21 |
10326000 |
10326 |
|
17.Haveri |
14.38 |
8628000 |
8628 |
|
18.Kodagu |
5.45 |
3270000 |
3270 |
|
19.Koppal |
11.94 |
7164000 |
7164 |
|
20.Kolar |
25.23 |
15138000 |
15138 |
|
21.Mysore |
26.25 |
15750000 |
15750 |
|
22.Mandya |
17.62 |
10572000 |
10572 |
|
23.Raichur |
16.48 |
9888000 |
9888 |
|
24.Shimoga |
16.40 |
984000 |
9840 |
|
25.Tumkur |
25.80 |
15480000 |
15480 |
|
26.Udupi |
11.10 |
6660000 |
6660 |
|
27. Uttara Kannada |
13.53 |
8118000 |
8118 |
|
State Total |
527.34 |
316404000 |
316404 |
The
Department of Food & Civil Supplies took initiative to supply Iodised Salt
through PDS.
The
availability of Iodised Salt is also being monitored through field visits.
In this regard the Department of Salt, Govt.
of India also had done a situation analysis in Chikkamagalur
District during August 94 and reported
that 80% of the retail outlets in
Chikkamagalur were selling
Iodised salt.
During 1994, 113 wholesale and retail outlets in 28
villages of Kodagu District (3 Taluks)
were visited to know the availability of
Iodised Salt. This revealed that 78% of the shops were selling
only Iodised salt 15% both Iodised and Non-Iodised
salt and
7% only on Non-Iodised salt.
Training
/ Educational Activities:
11323
health functionaries were trained on IDD control Programme and
also in the methods of testing Iodised salt by using fields kits.
Nearly 1.27 lakhs of field kits
supplied by UNICEF were
distributed
to 27 districts till to date.
TRAINING
CONDUCTED TO THE HEALTH FUNCTIONARIES
|
Name of the Districts |
No. of Persons Trained |
|
1. Kodagu |
242 |
|
2.Dakshina Kannada |
879 |
|
3.Chikkamagalur |
427 |
|
4.Uttara Kannada |
500 |
|
5. Shimoga |
620 |
|
6.Belgaum |
1018 |
|
7. Bangalore(U) |
320 |
|
8.Mysore |
772 |
|
9.Mandya
|
500 |
|
10.Dharwad |
903 |
|
11.Bijapur |
823 |
|
12.Kolar |
671 |
|
13.Raichur |
435 |
|
14.Hassan |
577 |
|
15.Chitradurga |
586 |
|
16.Bangalore (R) |
356 |
|
17.Bellary |
404 |
|
18.Tumkur |
471 |
|
19.Gulbarga |
422 |
|
20.Bidar |
397 |
|
Total |
11323 |
Buyers and
Sellers meets were also organized
at Chikkamagalur with the help of Deputy Salt Commissioner,
Chennai, to sort out the problems of the
whole sellers, retailers and other
merchants of salt.
In order to develop interaction between the IDD
Experts and the Officers concerned with NIDDCP two campaigns were organized
on 31st of October, 1997 at Bangalore.
Taluk level
Buyers and sellers
meet at three
taluks of Chikkamagalur District i.e., Sringeri, Koppa and Mudigere
were organized during the month of June 98. District level buyers and
sellers
meet at Kodagu Distict was also Organized during July 98
One day
workshop on IDD at Mangalore was
organized on 12th September 2001. The state level Officers from the
Department of Health and
Women and Child Development,
the District level Officers from three Endemic Districts (Dakshina Kannada,
Udupi and Kodagu) Deputy Salt
Commissioner, Chennai, Deputy Directors
of Food
and Civil Supplies representatives from Media and
AIR were participated in the above workshop.
In view
of the Global IDD day
different Health Educational activities like
Seminar, Demonstration ,
Lectures on IDD to
School Children, Jatha by the school
children, Distribution of Education materials etc., were undertaken
in the District as well as at the State Head Quarters every year.
Sensitization workshop on promoting the use of Iodised
Salt for the Anganwadi
workers, Health voluntaries and leaders
of self help groups was organized on 2-2-2000, similar
programme at the
block level
was also organized at Hosakote
town of Bangalore Rural District on 23-3-2002.
Taluk level
one day sensitization
workshop to the
Health functionaries and Anganwadi
Supervisors of Uttara
Kannada District has organized in the month of August 2002.
Printed
materials like poster folders, flash cards and flip book have been prepared and supplied to all
the Districts.
Quality
Control:
In order
to maintain the quality of Iodised
salt supplied at different
levels, the district authorities of all the districts have been
informed about the notification and
also have been requested to collect samples of salt for quality control
under
PFA &
also non-PFA and send to Public Health Institute Bangalore, for analysis.
Salt
Samples analyzed under PFA
|
Year |
TotalSamples |
Satisfactory |
Not satisfactory |
|
1998-1999 |
36 |
35 |
1 |
|
1999-2000 |
23 |
21 |
2 |
|
2000-2001 |
19 |
19 |
- |
|
2001-2002 |
52 |
25 |
27 |
|
2002-2003 upto Sept 2002 |
11 |
8 |
3 |
Salt
Samples analyzed under Non-PFA
|
Year |
Total samples |
Satisfactory Above 15ppm |
Not satisfactory
Below 15ppm |
|
1998-1999 |
1024 |
625(61.01%) |
399(39.9%) |
|
1999-2000 |
634 |
353(55.7%) |
281(44.3%) |
|
2000-2001 |
549 |
292(53.2%) |
257(46.8%) |
|
2001-2002 |
608 |
307(50.50%) |
301(49.5%) |
|
2002-2003 up to Sept2002 |
458 |
178(39%) |
280(61%) |
SAMPLES
OF SALT TESTED WITH THE HELP OF FIELD TESTING KITS BY THE
HEALTH
FUNCTIONARIES
|
Year |
Total sample |
Above 15ppm |
Below15ppm |
0 ppm |
|
1998-1999 |
10,19,702 |
4,09,511 (40.2%) |
3,51,369 (34.5%) |
2,58,822 (25.3%) |
|
1999-2000 |
6,76,720 |
2,55,376 (37.7%) |
2,44,118 (36.1%) |
1,77,226 (26.2%) |
|
2000-2001 |
10,23,013 |
4,17,947 (40.9%) |
3,17,707
(31.1%) |
2,87,359 (28%) |
|
2001-2002 |
10,77,897 |
5,12,455 (47.5%) |
3,36,166 (31.2%) |
2,29,276 (21.3%) |
|
2002-2003 up to Sept2002 |
4,33,586 |
75,433 (17.4%) |
1,18,363
(27.3%) |
2,39,790 (55.3%) |
Continuous
Monitoring:
All the
above activities like supply of Iodised
salt, Quality control, Training
and other educational
activities are frequently monitored by the IDD cell and the State IDD
Control
Programme
Officer:
To study
the impact of the Programme,
are -survey in Chikkamagalur District has also been
conducted by the Government of India Survey Team in collaboration with the
State Government
during August/September 1998, the report of the
survey revealed that there is decline in
Goitre prevalence from 41.11% in 1986 to 25.01% in 1998.
Action has
been initiated to take
up re-survey in
Kodagu, Dakshina Kannada, Udupi
and Uttara Kannada
through Medical Colleges.
IDD Monitoring Lab:
As per the
advice of the Government of India one post of the Lab Technician and one post of Laboratory
Assistant have been created under
IDD Cell for
the purpose of monitoring the
programme through regular analysis
of the samples
of salt and
also monitoring urinary iodine excretion in urine samples.
State
Level Co-ordination Committee:
A state level co-ordination committee has also
been for mulated during 1988
with the Health Secretary as
the Chairman for monitoring the implementation of the
programme from time to time and to review
the National Iodine Deficiency Disorders
Control
Programme.
The following are the members:
1. Secretary, Health & Family Welfare -
Chairman
2. Director, Health & Family Welfare -
Member
3. Commissioner for Transport -
Member
4. Commissioner for Transport -
Member
5. Deputy Secretary, Finance Department - Member
6. Joint Director Health & Planning, -
Member
D.H. & F.W.S.
7. Deputy Director (Nutrition) & Programme
Programme Officer of IDD Control
Programme
- Member
Secretary
So far
eight state level meetings were held as follows:
1st
meeting - January 1989
2nd
meeting - September1989
3rd
meeting - July 1990
4th
meeting - September 1991
5 th
meeting - August 1992
6 th
meeting - August 1993
7 th
meeting - February 1995
8 th
meeting
Financial
Outlay (Amount in Rs.)
|
Year |
Central allocation |
Expenditure Rs. |
Amount re-imbursed |
Amount
to Be re- imbursed |
|
1998-99 |
4.30Lakhs |
4,15,999/- |
4,15,999/- |
Nil |
|
1999-2000 |
5.80
Lakhs |
4,79,583/- |
4,79,583/- |
Nil |
|
2000-2001 |
5.80Lakhs |
5,86,131/- |
5,86,131/- |
Nil |
|
2001-2002 |
5.40Lakhs |
6,61,243/- |
5,50,287/- |
1,10,956
IV Quarter |
|
2002-2003 |
5.60Lakhs |
3,50,958/- |
- |
3,50,958
I
& II quarters |
Challenges: Non Iodised Salt is Being sold under the
different brand names of Iodised salt in Karnataka.