Towards Elimination Of Iodine Deficiency Disorders In The African Region

Main Category: Pregnancy / Obstetrics
Also Included In: Pediatrics / Children's Health
Article Date: 04 Sep 2008 - 14:00 PDT

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Since the 1990s, Africa has made steady progress in controlling iodine deficiency disorders (IDD), but countries need to intensify elimination efforts, advises the WHO Regional Director for Africa, Dr Luis Sambo.

IDD refers to a wide range of health problems associated with inadequate intake of iodine such as goitre, still birth, stunted growth, thyroid deficiency and mental defects. Pregnant women and young children living in iodine-deficient areas are particularly at risk.

"Although no country in the Region has severe IDD, insufficient or excessive iodine intake nevertheless persists in many countries," Dr Sambo says in a report presented Tuesday at the fifty-eighth session of the meeting of health ministers of the WHO African Region in Yaoundé, Cameroon.

The percentage of households using iodized salt in the Region increased by 20% between 1997 and 2007, he says, but he adds that due to decreased IDD control efforts, 15% of the increase in the use of iodized salt occurred between 1997 and 2000. Only a 5% increase was recorded between 2001 and 2007. This shows that the rate of uptake of IDD interventions has slowed down considerably in recent years so member states will need to refocus and catch up on lost gains for better outcomes.

Dr Sambo proposes concrete steps which African countries should take to achieve elimination of IDD in order to increase children's cognitive development; reduce stillbirths and stunted growth; contribute to improving the quality of primary education; reduce child mortality, under nutrition and miscarriages; and, generally, improve maternal health.

These proposed actions include mobilization of political support and commitment at all levels through continuous advocacy and effective partnerships; reviewing, updating and enforcing existing legislation and policies on salt iodization; establishing or strengthening national multi-sectoral structures; capacity building; and mobilizing communities and public health authorities.

The Regional Director also recommended the consolidation of collaboration with key stakeholders; reinforcement of public-private partnerships; expansion of salt iodization programmes to reach populations at risk; mobilization of financial resources; and development of communication strategies.

Due attention also needs to be given to measuring progress towards the goals of IDD elimination through regular monitoring, provision of essential elements for IDD surveillance, and improving quality control systems.

Salt iodization is relatively cheap, according to WHO, which estimates that the cost of iodized salt is about US$ .07 per person per year, and of iodized oil, US$ .20 per year. An investment of US$ 1.00 in IDD prevention leads to a return of US$ 28.00, but government and donor funds are limited, as IDD programmes must compete with other priority health problems.

Currently, only Nigeria has been certified as having achieved the goal of sustained elimination of IDD in the African Region. This achievement has been possible because of a decentralized monitoring system, an efficient ultra-modern analytical laboratory, a sanitized salt market, strict inspection and enforcement of universal iodization laws, intensive mass communication, social marketing, public-private partnerships, collaboration with international organizations, and high-level advocacy.

http://www.afro.who.int