Outline webinar Notes I have tried to create
Outline webinar • Notes: I have tried to create a framework for discussing the main data needs and program action that needs to follow from it. In this way the recommendations from the Guidance will be better understood. • Please note that these are just drafts and not complete yet. • The question to you is if one or more of these frameworks are useful for explaining the Guidance in a webinar form. To be honest I struggle a lot with this because of the complexities of the program, the technical content of some of the recommendations (which will not be understood by some but not all), and trying to reflect reality will make it difficult to understand. • So I need your feed back on which framework of these 3 or a combination of them are good to use. After that I will further develop these. I don’t want to invest too much time now and then have to change everything later. • The 3 slides: • • • The first slide shows the program framework for iodine nutrition, the sources of iodine The second slide tries to define the program pathways and monitoring pathways (in green). Monitoring pathways identify the data needs for program decisions (and therefore is not an overview of all monitoring) The last slide is splitting the program into 3 component: supply, coverage, impact. Meeting the objectives for each of them form a successful program. • • Supply: ensure quality ie all salt is iodized as set in the standard Coverage: ensure all people use one or both of the types of iodized salt, through table salt or processed food salt Impact: ensure supply and coverage requirements are met (ie people using quality iodized salt) are their requirements met so that there is no deficiency and no excess? The next step would then be to ask the program questions linked to these, then determine what data does one need to answer these questions, the common mistakes observed, and the recommendations (as mentioned in the Guidance) So to recap: objective program question data required common mistakes recommendation I have not fully implemented this pathway yet, but the logic is there I think If acceptable this slide will be spread into several slides and forms the basis for the webinar content
OPTIMIZE IODINE NUTRITION THROUGH DIFFERENT DIETARY SOURCES OF IODINE Salt iodization is essential to optimal iodine nutrition Household Adequately Iodized Salt Other MN interventions (home fortification, maternal supplements. . ) Iodized Salt in Processed Foods & Condiments Iodine Status (Urinary Iodine) Iodine in soil & water (affects iodine in local drinking water & agricultural products)
Using data to achieve and sustain optimum iodine intake level ation iz d io t food adjus salt / f Set / o s rce y sou ify ke Ident GOAL: Achieve and sustain optimum iodine intake / nutrition 9µ 29 010 g/L RA 49 µ / W -2 C 50 SA 1 PW Program focus: iodization of HH and PF salt - If > 300 (SAC) & pregnant women >250 reduce iodization level - If < 100 (SAC) & pregnant women < 150 increase iodization level L g/ legislation and standards: Iodization level, types of salt, supply type, food standards, etc Iodine status Production, import, processors of salt iodization of HH and PF salt Production, import of processed food products: use of iodized salt Distribution and consumption of salt and processed food No Iodine intake Is program fully implemented? Note: We can enter more green monitoring boxes ie iodine in salt at supply and HH level; I can also bring in the external factors such as salt intake changes and process food consumption Monitoring: - If program well implemented, is iodine status sufficient? What is median UIC for those HH that have adequate iodine in salt?
GOAL: Achieve and sustain optimum iodine intake / nutrition PROGRAM QUESTIONS DATA NEEDED TO INFORM PROGRAM EFFECTIVENESS OR IMPACT PROGRAM: Iodize salt for household use and/or for common processed foods (that contain salt) COMMON MISTAKES RECOMMENDATIONS FROM PROGRAM GUIDANCE % adequate and inadequate iodized salt using RTK Rapid test kits (RTKs) should only be used to differentiate between non-iodized and iodized salt. 1. Supply: is salt iodization implemented by industry? Is salt iodized according to standards at production / import and market level? Iodine level in salt at production / import, and market level Is iodized salt used in production of targeted processed foods? Iodized salt use in targeted processed foods 2. Coverage: does program reach those that are targeted? % of households using iodized salt? Iodine in salt from households (no iodine, any iodine, adequate) % of households using targeted processed foods (w iodized salt)? Use of iodized salt in targeted processed foods Taking HHIS as reflection of level of USI progam status 3. Impact: what is the effect of the intervention? what is the Iodine status among vulnerable groups (SAC, WRA, PW)? Iodine status among SAC, WRA, PW For households using iodized salt is the iodine status adequate? What is the impact of the intervention? Does it protect everyone? Is there a risk for excess intake for anyone? Iodine status where coverage may be low, poorer areas % of population with UIC < 100 mcg/L as deficient; > 100 as adequate National salt iodization programmes should monitor the use of iodized salt in processed foods With currently available methods, the m. UIC can only be used to define population iodine status and not to quantify the proportion of the population with iodine deficiency or iodine excess The acceptable range of ‘adequate’ iodine intake among school-age children can be widened from 100– 199 μg/L to 100– 299 μg/L. As resources allow, the adequacy of iodine intakes should be examined among different subsets of the population, especially among groups vulnerable to deficiency
- Slides: 4