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Iodized salt in India: Insights from National Family Health Survey-4
Authors: Arun Kumar, Sanjay Kalra, and AG Unnikrishnan
Source: Thyroid Research and Practice, 13(2): 49-51; DOI: 10.4103/0973-0354.183272
Topic(s): Iodine
Country: Asia
Published: JUN 2016
Abstract: The importance of iodine for thyroid health, and the role of salt iodization in achieving this, are well known.[1] In spite of multiple legislation, use of iodized salt is still not widely accepted in India.[2] Multiple reasons exist for this. While availability is usually not a challenge, cultural beliefs and taste often lead to use of noniodized salt. The recently conducted National Family Health Survey (NFHS)-4 reports on the usage of iodized salt in 15 states.[3] The percentage of all households which use iodized salt varies from 81.6% in Andhra Pradesh (AP) to 99.6% in Sikkim. While most states report >90% usage of iodized salt, the outliers include AP (81.6%), Tamil Nadu (82.8%), and Karnataka (86.8%). Other southern states such as Telangana (95.8%) and Puducherry (92.7%), however, report much higher rates of iodized salt usage. Smaller states and union territories, too, including Sikkim (99.6%), Andaman and Nicobar Islands (99.5%), Meghalaya (99.1%), and Tripura (99.1%), enjoy near universal iodized salt consumption. A focused analysis of the three states with low usage of iodized salt shows heterogeneity in iodized salt use across different districts.[4] In AP, for example, prevalence of iodized salt use ranges from 69.1% in Vizianagaram to 90.4% in Visakhapatnam (97.9% in urban Visakhapatnam). In Karnataka, only 66.4% households of Chikkaballapura (60.5% of rural Chikkaballapura) use iodized salt while 96.3% households in Belgaum do the same. Tamil Nadu usage varies from 54.9% usage in Tirunelveli (44.7% in the rural households) to 96.4% in Chennai. Further analysis of the districts with low iodized salt use reveals lack of geographical contiguity.