Achieving Universal Salt Iodization Goal in Georgia by 2005

Achieving Universal Salt Iodization Goal in Georgia by

2005

Recommendations for 2004-2005

Action Plan

Ms. Tamar Lobjanidze – Deputy Head, Public Health

Department

What is the Goal

The action plan targets to outline essential steps and activities for achievement of the virtual elimination of IDD through attainment of Universal Salt Iodization in Georgia

by end 2005

Objectives:

1. Increasing HH consumption of adequately iodized salt to > 90% by end 2005;

2. Decreasing goitre prevalence among children < 35% by end 2005 for sustainable elimination of IDD < 5% by 2007

International Criteria for Sustainable elimination of IDD to be Met?

SALT IODIZATION

• National needs for iodized salt supplies met by production/import

• > 95% of imported supplies to be iodized

• HH consumption of adequately iodized salt > 90%

Status in Georgia: > 100%

Status in Georgia: > 90%

Status in Georgia: 67%


SALT IODIZATION

• IS checked at import, wholesale & retail levels by titration

• Iodized Salt checked at HH by titration or testing

HH Surveys performed in 1999 & 2003, not routinely

Checked by State Standardization and Sanitary Departments (2). Database to be more consolidated


Population Iodine Status

• Median Urinary Concentration should be at least 100

mcg/dl, with less than 20% of values below 50 mcg/dl

• The most recent monitoring data (national or regional) should have been collected in the last 2 years

Status in Georgia: Not continuous data available

Not regularly collected, last in 2002 following Lipiodol distribution; Data mostly mixed up with referral

Status of the National Programme 10 Criteria for Programme Success

1. Functional effective multi-sectoral committee for IDD Programme coordination: state, private, media, NGOs

2. Evidence of political commitment to USI and IDD Elimination

Status: High Commitment from Government

Status: Existent since 1996, to be renewed


3. Appointment of a responsible executive officer for the IDD elimination programme

4. Legislation or regulations on USI (ideally covering salt for both human and animal consumption)

Status: National Centre for Nutrition

Status: Available, Law covering both human & livestock, submitted to Parliament in 2003


5. Assessment & Reassessment of IDD Progress, Access to Labs for Urine and Salt Testing

6. Information-education programme on IDD

Status: Labs Available, quality and coordination to be improved

Status: Supported since 1998, but a research based strategy to be developed


7. Cooperation with Salt Industry to Maintain Quality

7. Regular laboratory data on urinary iodine in school-aged children with appropriate sampling for higher risk areas

Status: To be built and strengthened

Status: No systemic approach, financial Constraints, needs to be prioritized


9. Regular data on salt iodine at import, retail & household levels

10. A database for monitoring procedures for salt content urinary iodine, neonatal TSH, with mandatory public reporting

Status: Data available at sectoral institutions & partners responsible for each specific point of monitoring chain

(Sanitary, Standardization, SDS, PHD, NCN, Customs), need for data reconciliation under single database

Status: Available from import (Dept. of Standardisation), retail/wholesale (Sanitary Surveillance), HH – survey data

4 Key Directions of the 2004-2005 Action Plan

HH Consumption

of Iodized Salt

> 90%

1. Legislation for

Quality Control &

Quality Assurance

2. Monitoring and

Disease Surveillance

3. Information-Education

Support

4. Multi-sectoral Partnership

and Private Sector

Component 1

Legislation & Regulations

Objective

• Establishment of a strong legislative and administrative framework for ensuring attainment of USI Goals by end 2005

• banning import and sale of non-iodized salt other than under exceptional provisions, introducing sanctions & regulative norms, QC systems at each level, etc.

Component 1

Legislation & Regulations Recommended Activities

• Establishment of effective functional co-ordination committee/task force - July 2004

• Finalisation of the 2004-2005 Action Plan for USI by the Inter-agency Co-ordination Committee/Task Force - July-August 2004

• Revision of the existing legislation (including standards for iodized salt for human and animal consumption) and submission to the Parliament

Cabinet of Ministers, MLHSA(Sectoral Ministries, Private Sector, NGOs, UNICF)

Inter-agency Co-ordination Committee/Task Force

Inter-agency Co-ordination Committee/Task ForceHealth & Social Affairs Commitete if the Parliament

Component 1


• Adoption of the Draft Law by Parliament of Georgia - 2004 Autumn Sessions

• Revision of the registration systems on iodized salt import, refinement of QC system and the procedures (coding, testing, sanctions, etc.) Following adoption of the draft law, by end 2004

• Capacity building for staff from Customs, State Standards and Sanitary Surveillance Departments, (Training, International exprince sharing, Seminars, etc.) - Before end 2004

Parliament of Georgia

Inter-agency Co-ordination Committee/Task Force

Sectoral Ministries - Finance, Economy, MLHSA, etc.

Component 1


• Establishment of unified database on import, quality control; of iodised salt and ensuring functioning of the system by IT equipment - end 2004

• Incorporation of iodised salt consumption indicators within HH surveys (test kits) - 2005

• Revision of the MoU on Establishment of Salt Iodization/Re-iodization Chain

Sectoral Ministry Department - Customs, Sanitary, Standardisation

Statistics Department, Ministry of Economy

Interagency Committee MoLHSA, MOH Adjara, UNICEF

Component 2

Impact Assessment & Disease Surveillance

Objectives:

• Establishment of reliable monitoring systems and data base on IDD prevalence in Georgia disaggregated by location, age & gender

• ensure continuous availability of UIE & goitre prevalence data through a representative sample of the population

Component 2


• Revision of state standards for monitoring and surveillance and medical statistics reports - August –September 2004

• Establishment and Launching of regional level infrastructures for IDD surveillance - before end 2004

• Procurement of UIE test kits & lab equipment if required, upgrading technical facilities of regional and central IODD centres - October 2004 – February 2005

NCN, PHD, NCDC and Medical Statistics, (UNICEF)

MLHSA(UNICEF, World Bank, USAID, PHC Sector)

Component 2


• Revision of the guidelines for health care providers on prevention, diagnostics & treatment of IDD, printing and provision of training - August-December 2004

•

• Scholl based cross-sectoral survey representative on sub-national level detecting prevalence of UIE and goitre among school aged children - 2005

• Considering possibility for using regional reference labs for UIE testing for quality assurance in CEE/CIS - 2005

MoHLSA, PHD, NCN

(UNICEF, World Bank, USAID, Other PHC System Donors)

Component 3

Information-Education Support

Objectives:

• Increasing awareness of the population on IDD and benefits of the iodized salt for prevention of IDD through design and implementation of research-based communication strategy

• Multisectoral involvement - media, education system , private sector, children and youth, etc.

Component 3


• Development of a communication strategy under leadership of interagency co-ordination committee for various target audience - August 2004

- Legislative/executive authorities

- population: Maternal and Child Health Focus

- Youth

- Health

- Education

- Private Sector

Ministry of LHSA Charitable Foundation “SOCO”

UNICEF(NGOs, Child and Youth

Parliament, Salt Importers, Ministry of Education)

Component 3


• Development/printing of printed IEC materials (posters, brochures, billboards) and distribution among health & education facilitieis, private sectors - October 2004 - May 2005

• Development of TV/Radp spots and promotion of iodized salt consumption through avrious Media programmes (Talk-Show, Culinaryprogrammes) - October 2004 - May 2005

• Training of Media representatives on health promotion issues including IDD prevention - October- November 2004

TV/Radio Corporation Ministry of LHSA

Charitable Foundation “SOCO”UNICEF

(NGOs, Child and Youth Parliament, Salt Importers,

Ministry of Education)

Component 3


• Innovative activities - Contest on Child Stories on IDD/USI, 1 minute videos - January-September 2005

• Introduction of School Day for Conbating IDD among pre-school and secondary school facilitieis (salt testing, information support) - September-December 2004

• Supprot to private sctor for promotion of iodizeds salt promotion (Special quality sertificate, dissemination of information materials) - 2004-2005

TV/Radio Corporation Ministry of LHSA

Charitable Foundation “SOCO”UNICEF

(NGOs, Child and Youth Parliament, Salt Importers,

Ministry of Education)

Component 4

Multi-sectoral Partnership & Role of Private Sector

Multi-sectoral to be mainly referring to components 1-3

Private Sector:

• Improving participation and involvement of salt industry/importers within the national IDD/USI efforts.

Component 4

Multi-Sectoral Partnership and Private Sector

• Major salt importers joining the National IDD Council/TF - July-August 2004

• Meeting/w-shop for salt importers on IDD/USI. Involvement of major food producers for advocacy and consensus building on utilization of iodized salt for food production

• Involvement in design of the IDD/USI Communication campaign, Distribution of IEC materials provided by national ICC Committee in line with salt distribution channels

National IDD Committee(Ministry of LHSA, education, Finance, Economy

SOCO FounationNGO Networks

Youth organizations

All major salt importers Major Food Producers

Achieving Universal Salt Iodization Goal in Georgia by 2005

Documents

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