Child Health Division,Department of Health Services

Tek,u,, Kathmandu

Iodized Salt Social Marketing Campaign Accham and Doti Districts

IDD Situation, Past Achievements and Key Bottlenecks

2012

Percentage of households consuming salt with 15 ppm or more iodine

Urban households Rural households Total

94

78 80

Nepal is near to USI goal of household using adequately iodized salt since around 80% household are currently consuming adequately iodized salt.

Trend in Household Use of Adequately Iodized Salt (15 ppm and above)

Nepal Iodine Deficiency Disorder Status Survey,

2005

Nepal Demographic Health Survey, 2011

0102030405060708090

58

80H

ouse

hold

%

Nepal made a good progress in achieving IDD goal since 2005 due to promotion of iodized salt in the last decade, 1999 to 2011, strengthening legal system including iodized salt monitoring system in salt warehouses, capacity

building of IMS staffs, advocacy and policy, strategy and plan update.

Trend in Household Use of Iodized Salt with Two Child Logo

Nepal Iodine Deficiency Disorder Status Survey,

2005

Nepal Demographic Health Survey, 2011

0

10

20

30

40

50

60

70

38

59

Hou

seho

ld %

Increased household use of iodized salt with two child logo is one factor that contributed in accelerating towards IDD goal.

Eas

tern

Mou

ntai

n

Cen

tral M

ount

ain

Wes

tern

Mou

ntai

n

Eas

tern

Hill

Cen

tral H

ill

Wes

tern

Hill

Mid

- Wes

tern

Hill

Far-

Wes

tern

Hill

Eas

tern

Ter

ai

Cen

tral T

erai

Wes

tern

Ter

ai

Mid

- Wes

tern

Ter

ai

Far-

Wes

tern

Ter

ai

0

10

20

30

40

50

60

70

80

90

100

85

67 68

79

88 86

68

43

83 84

92

63 66

Percentage Household with Adequately Iodized Salt

However, Geographical inequity is still persistent in some areas where the household use of adequately iodized salt is still low, around 43%.

Ref. NDHS2011

Eas

tern

Mou

ntai

n

Cen

tral M

ount

ain

Wes

tern

Mou

ntai

n

Eas

tern

Hill

Cen

tral H

ill

Wes

tern

Hill

Mid

- Wes

tern

Hill

Far-

Wes

tern

Hill

Eas

tern

Ter

ai

Cen

tral T

erai

Wes

tern

Ter

ai

Mid

- Wes

tern

Ter

ai

Far-

Wes

tern

Ter

ai

0

10

20

30

40

50

60

70

80

90

37 37 3731

64

77

25 25

5357

62

49 49

Percentage Household using two child logo salt

In those areas, use of two child logo salt is lowest- Only 25% households in the rural areas of Mid and Far Western Hills are using two child logo salt.

Ref. NLSS2011

Key Bottlenecks - 169% of households in the area have high preference for large crystal salt

• Easy access• Easy to measure during

cooking (1, 2, 3,…. Crystal)

• Traditional behavior• Cheaper (Rs.15/- per kg at

District Headquater)

Reasons:

Key Bottlenecks - 2Around 75% households living in rural areas have low access to iodized salt with two child logo, replaced the demand by large crystal salt

• Poor attitude and practices, despite of having knowledge

• Iodized salt with two child logo heaping in District Headquarter since CDO office is the distribution center for subsidized salt.

• Poor Political Commitment at local level.

• Little bit expensive for two child logo salt compared to large crystal salt in District Headquater (Rs 20/- kg)

Reasons:

Saptari, Sunsari, Jhapa

Household Salt Consumption Status

52% increase in consumption of 2CL salt

2CL Indian Loose0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

-60%

-40%

-20%

0%

20%

40%

60%

30

53

17

82

16

2

52

-38

-14

Baseline Endline Increase/Decrease

2CL , 52 % Households converted

Indian Packet, 38 % Reduced

Loose, 14 % Re-duced

Use of Iodized Salt with two child logo at household level in Central and Eastern Terai

NIDDSS 2005 NDHS 20110

10

20

30

40

50

60

31

55

Surveys

Hou

seho

ld %

Iodized Salt Social Marketing Campaign in Eastern and Central Terai Region promoted the use of iodized salt with two child logo from 31% in 2005 level to 55% in 2011.

Use of Adequately Iodized salt at household level (>15 ppm) in Central and Eastern Terai

NIDDSS 2005 NDHS 20110

10

20

30

40

50

60

70

80

90

100

58

83

Surveys

Hou

seho

ld %

The increase in use of two child logo salt in the region has positive contribution in increasing household use of adequately iodized salt from 58% in 2005 level to 83% in 2011 level.

Proposed Action

The social marketing campaign approach implemented in the Western terai region from 1999 to 2006 and Eastern and Central Terai Region from 2007 to 2011 proved this approach can increase household consumption of adequately iodized salt.Thus, the approach is proposed to implement in the Far Western and Mid Western Hills from the period from 2013 to 2017.

Program Planning

• Social Marketing Campaign will be implemented in two districts of Far Western Hills, Accham and Doti, in 2012

• The campaign will be expanded to two other districts of the same hilly region, Bajura and Bajhang, in 2013.

• Gradually, the program will cover all districts of Mid and Far Western Region.

Thank you