Add to "My indicators"
Government commitment to salt iodization
Documents that the national government demonstrates commitment to salt iodization to control iodine deficiency disorders.
Resolutions endorsed by the World Health Assembly urge countries to strengthen their national commitment to sustained elimination of iodine deficiency (1, 2). The World Health Organization states that national government commitment is critical to achieving sustained salt iodization, and political commitment at the highest levels of government is essential for effective salt iodization programmes (3). This is necessary for the assignment of Ministry of Health staff to support salt iodization, to include iodine deficiency as an integral part of the national public health nutrition policies and strategies (and potentially other government policies and strategies), and to assign staff specifically to support the salt iodization programme. Further, political commitment is necessary to support the allocation of adequate resources to carry out the following key responsibilities: promulgation and enforcement of salt iodization laws, standards and regulations, tracking the population’s consumption of iodized salt and iodine status by the public sector, as well as ensuring the production, importation and marketing of adequately iodized salt by the salt industry and the use of iodized salt by the food industry (1, 2).
Evidence of government commitment and support: Yes/No.
Evidence of government commitment and support will be locally defined and may include:
a. There is an agreement or pledge from the government to support the prevention of iodine deficiency through a national public health and/or nutrition programme objectives.
b. The iodine deficiency disorders control programme is included in the national budget (either as specific programme funds or through inclusion in existing programme funds) or through the assignment of Ministry of Health staff to the work in prevention and control of iodine deficiency disorders.
c. Key government documents usually specify that ensuring adequate iodine nutrition in the population is a priority. This is an important acknowledgement of national commitment toward salt iodization.
Considerations for the estimation:
a. The Ministry of Health is usually the key government body responsible for coordinating the prevention and control of iodine deficiency disorders at the national level. Additional government agencies such as the Ministry of Trade and Industry (which may oversee the salt production sub-sector), Ministry of Mines (which may oversee the mining sector, including salt), the President's Office, Prime Minister's Office or the Secretariat of the Cabinet may also have substantial roles at the public sector level.
Salt iodization, national government, Ministry of Health, national health policy, national nutrition policy, national development strategy
Food fortification
Input, Activity
Policies
All
Early childhood development, Emergency setting or displaced population, Lactation, Pregnancy
Iodine
Market-based
None
Demonstrated government commitment to salt iodization is defined by each country to be locally relevant and useful. Once locally defined, documenting government commitment is relatively feasible and easy to collect, and the collection and reporting might catalyze resource allocation.
The government’s acknowledgement of the importance of salt iodization may not lead to the actual implementation of an effective programme. Government commitment is not always followed by resource allocation and/or the sustained implementation of the necessary activities.
The Ministry of Health (or other government institution responsible for nutrition) may have limited claim on central government resource allocation in support of salt iodization.
There is no standard definition of the indicator, which limits comparability to other countries.
Example 1: In a country, a top member of the national government officially coordinates the national iodine deficiency disorders elimination programme. On a day-to-day basis, the Ministry of Health takes the lead in coordination and implementation of the programme and shares information with the National Iodine Deficiency Disorders Steering Committee. At lower administrative levels, local departments and offices implement the programme. Important plans or decisions, such as the establishment of national goals or monitoring plans are drafted by the Ministry of Health and sent to relevant ministries for endorsement. Official documents related to the national iodine deficiency disorders programme are either published in the name of the Steering Committee or under relevant ministries. Two regulations form the basis of the salt iodization programme. The National Iodine Deficiency Disorders Steering Committee reviews the results of national monitoring activities annually. Based on this information and consultation, the Ministry of Health develops national goals, plans, and strategies for iodine deficiency disorders elimination.
Example 2: In another country, the successful iodine deficiency disorders programme is a collaborative effort of senior staff of the Ministry of Health and other Ministries and Agencies, in the cooperation with the domestic salt producers. A legal framework for universal salt iodization has been introduced in the country and there is high level commitment of the major stakeholders coupled with political commitment at the level of the President and Cabinet. A high level government official chairs the National Iodine Deficiency Disorders Steering Committee. The Ministry of Health has devoted considerable resources to: a) the development and implementation of the salt iodization laws to ensure universal salt iodization and its adherence by all relevant parties; b) the development of efficient salt iodization machines for small to medium-sized producers, and educating salt producers; c) education of the public and salt producers about the importance of iodized salt for better health; d) the development of learning centers for salt producers; and e) advocating to the government for subsidies and financial support to small and medium-sized producers to purchase new salt iodization machines.
In both of the examples above for the indicator 'Government commitment to salt iodization', the response was “Yes.”
1. Resolution WHA58.24. Sustaining the elimination of iodine deficiency disorders. In: Fifty-eighth World Health Assembly, Geneva 16-25 May 2005. Resolutions and decisions, annex. Geneva: World Health Organization; 2005:100-102 (WHA58/2005/REC/1 (http://apps.who.int/gb/ebwha/pdf_files/WHA58-REC1/english/A58_2005_REC1-en.pdf, accessed 28 January 2015).
2. Resolution WHA60.21. Sustaining the elimination of iodine deficiency disorders. In: Sixtieth World Health Assembly, Geneva 14-23 May 2007. Resolutions and decisions, annexes. Geneva: World Health Organization; 2005:84 (WHASS1/2006-WHA60/2007/REC/1 ( http://apps.who.int/gb/ebwha/pdf_files/WHASSA_WHA60-Rec1/E/reso-60-en.pdf , accessed 28 January 2015).
3. WHO/UNICEF/ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers, third edition. Geneva: World Health Organization; 2007 (http://whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf, accessed 28 January 2015).