Bulletin of the World Health Organization

Reaching the poor with adequately iodized salt through the Supplementary Nutrition Programme and Midday Meal Scheme in Madhya Pradesh, India

Jee H Rah, Aashima Garg, Brij RG Naidu, Dwarka D Agrawal, Richa S Pandey & Victor M Aguayo

Problem

In India, adequately iodized salt needs to be made accessible to the most marginalized.

Approach

In an effort to provide adequately iodized salt to the most vulnerable, in 2009 Madhya Pradesh launched a state-wide initiative through two national flagship nutrition programmes: the Supplementary Nutrition Programme of the Integrated Child Development Services and the Midday Meal Scheme. Programme staff members were taught how to correctly store salt and monitor its iodine content. Field monitors assessed the iodine content of the salt in the common kitchens of participating schools and anganwadi centres monthly.

Local setting

Madhya Pradesh, a state in central India, is home to a substantial proportion of India’s poor. In 2009, household coverage of adequately iodized salt in the state was nearly 90% among the richest but only about 50% among the poorest.

Relevant changes

Two hot meals prepared with adequately iodized salt were served daily for more than 21 days per month to approximately 89% of the 12 113 584 children aged 3 to 6 years enrolled in anganwadi centres (June 2011 to March 2012). One meal on school days was served to 78% of 5 751 979 primary-school children and to 79% of 2 704 692 secondary-school children (April 2011 to March 2012). Most of the kitchens visited in 2010 (79%) and 2011 (83%) were consistently using adequately iodized salt to prepare hot meals.

Lessons learnt

India has large-scale social safety net programmes for the poorest. Both national and state policies should mainstream the use of adequately iodized salt in these programmes.

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