Executive Summary:

Iodine Deficiency Disorder Problem is a world wide major public health problem. It affects 7% of the world population. Iodine deficiency in pregnant women may cause miscarriages, Iodine Deficiency may leads to still birth, birth defect etc. Iodine deficiency impairs growth and development of children, child may be less active, stunted grown up, mentally retarded with impaired movements of speech o hearing, Iodine deficiency also cause Goiter.

To control Iodine Deficiency Disorder in forth coming years has to be improve the quality of information on the magnitude of iodine deficiency, has to be increase Household coverage of iodized salt, has to be strengthen collaboration with respective dept., has to be strengthen surveillance system for quality dept. of iodized salt, population iodine status etc.

Background

Assam has a total area of 78523sq. kms. which is 24%of the size of India. State is divided into two natural regions, one of the plain division consisting of Brahmaputra and Barak valleys and the hill division consisting of KarbiAnglong and North Cacher hill districts.

In 2001 census recorded population of Assam is 26,638,407. The percent of literacy is 64.25 approximately. Children population of Assam is estimated as 4,350,248(0-6yrs.).

National Iodine Deficiency Disorders Control Programme (NIDDCP) formerly known as National Goitre Control Programme (NGCP) is being implemented from 1962. The Central Council of Health and Family Welfare in 1984 decided to implement compulsory iodisation of Salt for human consumption in the entire country. The Programme started in a phased manner with effect from 1st April, 1986.

The Director of Health Services of Assam is the Technical Head of implementation of the National Programme in the state.

Process of plan preparations

1. Intersectoral involvement of related dept., Communication with the other dept. including head quarter, Dist. Level, Block level etc.
2. Conducted by no. of awareness programmes.
3. Topics to be discussed-Magnitude and epidemiology of National Iodine Deficiency disorder Control Programme.
-Prevention measures and monitoring and information system for NIDDCP and iodized salt.
-Goiter Survey.
-Involving the press/mass media.

Situation Analysis-

To be analyzed through survey & awareness programme in state level, district level and block level etc.

State Profile and Progress made during 2005 to December 2008-

Although we have not got any support from the State and Central Govt. but with the help of UNICEF we had organized awareness meeting in the dist.and the state head quarters. We are doing analysis of salt in our state IDD monitoring lab.
Activities and Salt testing report in the year 2005-2007 are indicated below:

Report of Salt tested by Salt testing kits in district:

Salt Testing Report (From August 2006 - Dec 2007)
Monitoring in State IDD Monitoring Lab., Directorate of Health Services, Assam, Hengrabari

Collected from the Different Districts by Food Inspectors & Self

Activities from 2005-07

1. Goiter Survey was conducted in two districts namely Karbi - Anglong & Nalbari in the month of April-May/2005. The report not yet compiled.
2. From 12,09,07 - 5 district level Workshop was conducted in Kamrup, Jorhat, Sonitpur, Dibrugarh and Cachar.
3. One State Level meeting on Global IDD Day was conducted in Guwahati - followed by 3 nos. of district level orientations & workshop on Global IDD Day in Morigaon, Bongaigaon and Nalbari.
4. One State Level Meeting and One State Level Review Meeting was conducted in Guwahati on 31st August, 2007 and 11th January, 2008 respectively.

Bottleneck/Problems and the measures proposed to be taken for implementation of service delivery -

1. Due to non-appointment of the staff meant for NIDDCP leads to a stand still of the programme.
2. Due to lack of vehicle it is difficult to run the programme.
3. Though this Directorate has received the allocation of fund from the Govt. of India, as it is 100% Central Assistance Programme, it is difficult to get sanction from the state govt. Due to non release of fund, no activities can be performed presently. Also due to the vacancy, it is difficult to perform the activities.

Objectives - Strategy - activity of the programme.

The general objectives of the NIDDCP is to emphasis the wider implications of Iodine deficiency with focus on provision of Iodated salt and identification of endemic areas.

The specific objectives are:-

Statement of the strategies:

The strategies are to reduce the Iodine Deficiency among the public and make awareness about the problem and also about the universal salt Iodization.

Activities Done:

1. Training of Senior Officers from Health, Food & Civil Supplies, ICDS, Education departments are conducted in various time by the state IDD cell since 1994 till the dates, where 229nos. of participants were covered.
2. Orientation seminars for Medical, Paramedical personals were conducted for 148 nos. participants.
3. District level Social Mobilization and Sensitization programme in eighteen (18)nos. of district were conducted covering 715nos. for personals from 1995-98.
4. Awareness creating programme among Students, Teachers and Mothers of Elementary, L.P.& High School were conducted in eight districts from 1997 -99 covering 37 nos. of schools.
5. Special Sensitization and Mobilization at tea gardens in 1994 covering 64 numbers of participants. In 2000,another 20 nos. of tea gardens covering about 1100numbers of participants was done.
6. The state level workshop on PEM and Micronutrient were held in 1994 and 1996.
7. Salt monitoring review meeting in three regions namely Silchar, Tezpur & Jorhat was conducted in 1997.
8. Orientation for the personals of Urban Basic Services for the Poor (UBSP) was conducted on Urban Salt Monitoring System at Guwahati in 1997 and 1998.
9. Global IDD Day was observe on 21st October of every year from 1996-2001 with various activities.
10. Training for Anganbadi Worker (ICDS) was conducted in 10 blocks of Kamrup District in the month of August to September 2000.
11. Block level orientation was conducted in Six (6) block of Kamrup and Sonitpur District in 1999 among the ANM's & AWW'S.
12. Goiter Survey was conducted in two districts namely Karbi - Anglong & Nalbari in the month of April-May/2005. The report not yet compiled.
13. From 12,09,07 - 5 district level Workshop was conducted in Kamrup, Jorhat, Sonitpur, Dibrugarh and Cachar.
14. One State Level meeting on Global IDD Day was conducted in Guwahati - followed by 3 nos. of district level orientations & workshop on Global IDD Day in Morigaon, Bongaigaon and Nalbari.

One State Level Meeting and One State Level Review Meeting was conducted in Guwahati on 31st August, 2007 and 11th January, 2008 respectively.

Monitoring & Evaluation:

Monitoring is done through three methods: Field Salt Testing Method, Laboratory Methods and Goiter Survey
i) F&CS deptt. has to do monitoring during procurement of salt.
ii) Food inspector has to collect salt sample from whole sales and retailers level
iii) ANM, AWW's now ASHA, School teachers has to do the testing at field level.
iv) Laboratory testing is being done at DHS monitoring lab and Public Health lab.

Question to be answered while monitoring and evaluation of IDD control programme:

Work Plan:

Work Plan

Monitoring Indicator:

1. Numbers of orientation meeting organized in block level/ state level.
2. Numbers of orientation meeting held among ASHA/ ANM /AWW/ PRI/ members NGO,s
3. Numbers of block level training among BEE / HE / supervision & CDP'S / PRI / NGO'S teachers.
4. Numbers of orientation meeting tea gardens
5. Nos of advocacy meeting with press / mass media / T V Program also with salt traders.
6. Monitoring of Iodization plant (Numbers of visit to the iodization plant
7. Celebration of global IDD by (No of participants attended )
8. Number of PHC / CHC covered by postering, wall painting.
9. Numbers of salt samples analyzed from the district.