Goitre, as you know, is a condition in which the thyroid gland (located in front portion of the neck) is enlarged. This condition is caused due to the deficiency of iodine. In fact, iodine deficiency leads not only to goitre but also to a number of other disabilities like physical and mental retardation, hearing and speech defects among children and spontaneous abortions and-still birth among women.
As you have read the problem of iodine efficiency is endemic in certain areas of the country. The surveys conducted indicated that the problem of goitre is present in a broad sub-Himalayan belt of mountain slopes of our country., It stretches from Kashmir in the north-west to the Naga Hills in the East and includes parts of the states of Himachal Pradesh, Punjab, Haryana, Uttar Pradesh, Bihar, West Rengal, Sibim, Assam, Mizoram, Meghalaya, Tripura, Manipur, Nagaland and Arunachal Pradesh. In addition, pockets of endemic goitre have been recently detected in the states of Gujarat, Mahgrashtra, Andhra Pradesh and including Kerala and Delhi.
It is estimated that a population of nearly 140 million, live in endemic areas and out of this. nearly 40 million are said to suffer from obvious manifestations of IDD (Iodine Deficiency Disorders).
Realizing the serious health and social implications of the problem of iodine deficiency disorders, Government of India launched a National Goitre Control Programme (NGCP) in 1962. The Government has given directions to change the nomenclature of the National Goitre Control Programme (NGCP) to "National IDD Control Programme" from August 1992. The basis of the programme was a study conducted in the mid-fifties in the Kangra Valley, by the Scientists of All India Institute of Medical Sciences. The study showed that the prevalence of goitre comes down considerably when the common salt supply to the population is replaced by iodized salt. In keeping with the results of this study the control programme was initiated.
Objectives : The main objectives of the control programme are to :
- identify goitre endemic regions
- supply iodized salt in place of ordinary common salt in goitre endemic areas
- assess the impact of the programme over a period of time.
The questions which may arise in your mind at this stage are why is salt fortified with iodine? Why can't some other foodstuff be fortified with iodine? The answers to these questions are provided in Highlight 1
Distribution Strategy : The iodized salt is produced at some selected locations in the country. From production plants (which are located in Gujarat, Rajasthan and Tamil Nadu) the iodized salt is transported to endemic areas by Railways and/or roads on priority basis. In endemic areas the traders are prevented from selling non-iodized salt. The local administration while ensuring regular flow of iodized salt in the endemic area, is expected to see that non-iodized salt does not enter from the neighboring non-endemic areas.
Difficult terrain, inadequate production of iodized salt, transport bottlenecks and difficulties in persuading the local traders to cooperate with the administration (in the absence of adequate profit incentives) are some of the problems in the way of efficient implementation of this Programme.
The programme is in operation since past several decades yet there has been no remarkable improvement in the condition of goitre and other iodine deficiency disorders. This is attributed to the dual supply of salt i.e. iodized acid non-iodized salt are available to public in endemic areas. To overcome this problem, the government, is now considering to iodize the total salt produced in the country so that iodized salt reaches all places.
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