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Review
. 2022 Jan;18 Suppl 1(Suppl 1):e12945.
doi: 10.1111/mcn.12945. Epub 2020 Feb 3.

The evolution, progress, and future direction of Nepal's universal salt iodization program

Naveen Paudyal  1 , Stanley Chitekwe  1 , Sanjay Rijal  1 , Kedar Parajuli  2 , Chandrakant Pandav  3 , Macha Maharjan  4 , Robin Houston  5 , Jonathan Gorstein  5
Affiliations
Review

The evolution, progress, and future direction of Nepal's universal salt iodization program

Naveen Paudyal et al. Matern Child Nutr. 2022 Jan.

Abstract

Nepal is located in what was once known as the Himalayan Goitre Belt and once had one of the highest prevalence's of iodine deficiency disorders in the world. However, through a well-executed universal salt iodization program implemented over the past 25 years, it has achieved optimal iodine intake for its population, effectively eliminating the adverse consequences of iodine deficiency disorders. A comprehensive review of policy and legislation, surveys, and program reports was undertaken to examine the key elements contributing to the success of this program. The paper reviews the origins and maturation of salt iodization in Nepal, as well as trends in the coverage of iodized salt, the iodine content in salt, and population iodine status over the past two decades. The paper describes critical components of the program including advocacy efforts, trade issues with India, the role of the Salt Trading Corporation, monitoring, and periodic program reviews. The paper discusses the recent findings from the 2016 national micronutrient survey demonstrating the success of the salt iodization program and describes emerging challenges facing the program in the future.

Keywords: Iodine deficiency; Nepal; micronutrients; salt iodization.

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Conflict of interest statement

Naveen Paudyal, Sanjay Rijal, and Stanley Chitekwe, in their capacity working for UNICEF, support the government of Nepal's effort toward universal salt iodization but have no conflict of interest in developing this summary. The opinions and statements in this article are those of the authors and may not reflect official UNICEF policies. Kedar Parajuli, in his capacity working for government of Nepal to prevent and control iodine deficiency in Nepal, has no conflict of interest in developing this summary. Robin Houston, Chandra Pandav, Macha Raja Maharjan, and Jonathan Gorstein have all both undertaken consultancies with various agencies working in Nepal on nutrition issues, including in support of the USI program, but have no conflict of interest related to this paper.

Figures

Figure 1
Figure 1
Trends in iodine status (school age children)—by ecological region
Figure 2
Figure 2
Trends in use of refined salt—by eco region
Figure 3
Figure 3
Trend in household iodized salt coverage
Figure 4
Figure 4
Association between iodine status (school age children) and proportion of households using refined salt. MUIC, median urinary iodine concentration
Figure 5
Figure 5
Iodine content in HHIS—by ecological region
Figure 6
Figure 6
Population iodine status—by iodine content in salt
See this image and copyright information in PMC

References

    1. Achard, T. (1987). Some aspects of iodine deficiency in Nepal. Tropical Doctor, 17, 5–6. - PubMed
    1. Clear Tax . (2018). Report of GST rates in rail transport. Retrieved from https://cleartax.in/s/impact-of-gst-rates-on-rail-transport
    1. Codling, K. , Rudert, C. , Begin, F. , & Pena‐Rosas, J. P. (2017). The legislative framework for salt iodization in Asia and the Pacific and its impact on programme implementation. Public Health Nutrition, 20(16), 3008–3018. 10.1017/S1368980017001689 - DOI - PMC - PubMed
    1. Delange, F. (2000). In Braverman L. E., & Utiger R. D. (Eds.), Endemic cretinism. In the thyroid. A fundamental and clinical text (pp. 743–754). Philadelphia: Lippincott publ.
    1. Eckholm, E. (1985). Iodine deficiency in Himalayas is believed to disable millions. New York Times Archive, April, 2, 00001. Retrieved from. https://www.nytimes.com/1985/04/02/science/iodine-deficiency-in-himalaya...