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‘A Pinch of Salt’

67-year-old Ganima Tagiyeva at her home in Sheki, 330 km northwest capital Baku. Ms. Tagiyeva has a goiter that has been causing her difficulty swallowing and breathing since childhood. “As long as I can remember, I’ve been suffering from this disease,” she says.

Azerbaijan’s Progress Towards IDD Elimination

By Ali Verdiyev

Azerbaijan has come one step closer to achieving the total elimination of iodine deficiency disorders (IDD) and universal salt iodization (USI) after the consumption of iodized salt in households increased following joint efforts of the Government and international organizations, recent studies show.

A significant proportion of households in this oil rich Caucasus republic – 94.6% use iodized salt as compared to only 41.3% in 2000, according to the results of the nationwide Demography and Health Survey (DHS) conducted by the Azerbaijani government in 2006.

However, the DHS found that only 53.8% of households in Azerbaijan use adequately iodized salt, a figure that is much lower than recommended by the World Helath Organization (WHO), the United Nations Children Fund (UNICEF) and the International Council for the Control of Iodine Deficiency Disorders (ICCIDD)

Another major study, the national biomonitoring of IDD (2007) found that 65% of Azerbaijan households use adequately iodized salt, while the overall number of households using iodized salt was 85.8%.

UNICEF input

UNICEF, a key player in the efforts to eradicate IDD and achieve USI, works hand in hand with the Azerbaijan government to ensure that children in this post-Soviet republic are well protected against the negative consequences of iodine deficiency such as mental retardation and goiter. UNICEF continues providing support and technical assistance to the government in rooting out IDD through supporting various studies and advocacy campaigns.

“We have improved a lot on salt iodization in Azerbaijan over the past years. According to the latest data, the number of households using iodized salt has increased significantly, which means that now children in Azerbaijan have fewer chances of getting mentally retarded because of iodine deficiency. Our task now is to ensure 100% salt iodization in the market and then maintain it forever”, says Hanaa singer UNICEF representative in Azerbaijan..

UNICEF started working with the Azerbaijan Ministry of Health to address IDD back in 1996 and a working group was set up within the ministry in 1999 to deal with the problem.

“The level of public awareness of using iodized salt has much more increased with UNICEF’s advocacy and communication campaigns,” says Ibrahim Ahmadov, the national coordinator on IDD. “Earlier people did not care about the salt they bought, but now they look if it is iodized or not.”

“UNICEF provides 15,000-18,000 test kits every year, which help us determine the level of iodine in salt products. Moreover, goiter, a direct consequence of IDD, has considerably decreased among people,” he says

“We would like to thank UNICEF on behalf of the Ministry of Health for providing us with comprehensive financial, consultative and technical support over these years. Iodine deficiency has nearly been eliminated in our country. The only problem remaining today is the quality of iodized salt,” says Galina Ganiyeva, a nutrition specialist with the Medical University of Azerbaijan and a member of the working group..

Background

Before the collapse of the Soviet Union in 1991 Azerbaijan had tiny capacity for salt production and iodized salt was supplied from other regions of the Soviet Union. Some studies show that IDD is still a significant problem in many regions of Azerbaijan. Marked improvements have been made nationally regarding the production of iodized salt, but despite this, there is still some work to accomplish.

“I suffer from goiter and wake up in sweat every morning. I wish this situation could change for me, but I know that for many others the way out is making sure that they consume iodized salt,” says a doctor in a central Baku clinic.

The Azerbaijan parliament passed legislation on universal salt iodization in 2001 supported by the decrees of the Azerbaijani president and the Cabinet of Ministers in 2002-2003. The Azerbaijan Ministry of Health enforced the legislation by developing and approving guidelines and regulations to control the process and quality of salt iodization. International experience and expertise, as well as iodization supplies and equipment provided to local salt producers, helped improve the quality of salt production and iodization.

Media campaign

Besides strongly supporting the government’s efforts, UNICEF took the lead in pushing ahead wide-scale communication activities concerning IDD, offering training to more than 60 journalists from both broadcast and print media throughout the country and increasing responsibility of the media in the coverage of this issue.

As part of this campaign a lot of journalists contacted UNICEF to get more information on IDD. In response, a number of media efforts, including making press kits on IDD and organizing field trips for journalists to salt production sites, were made. A documentary called “The Lost Intellect” was produced in partnership with a leading local private broadcaster – ANS TV to explain the adverse impacts of iodine deficiency on the future generations and the national economy of Azerbaijan.

To further boost advocacy efforts world-known Azerbaijani chess player Teymur Rajabov was engaged as the National Goodwill Ambassador for IDD elimination efforts. A press conference announcing his commitment to UNICEF, TV and radio PSAs with his participation tackling the issue of IDD were important parts of the awareness campaign.

Challenge

Now, the challenge for the Azerbaijan government is to improve the quality of domestically produced salt. One of the biggest private companies in Azerbaijan, Azersun Holding, and the state-run Azerbaijan Investment Company have stricken a 10 million US dollar worth deal to construct the country’s first and largest salt producing plant by the end of 2008. The government believes that the new enterprise will make an invaluable contribution to the production of duly iodized salt for domestic consumers.

The monitoring of salt products in the Azerbaijani market by the Ministry of Economic Development, however, produced some dire figures concerning the iodization of consumed salt. The ministry tested 17 brands of salt and confirmed that only four of them were adequately iodized, a source in the ministry’s market control department said. Now, the government is bracing itself for cracking down on the faulty salt producers.

Eyyub Huseynov, the head of the Free Consumers’ Union, showed us a shelf full of samples of fake salt products taken from the Azerbaijani market during the union’s monitoring.

“The construction of the new salt production plant will resolve the IDD problem by 97%,” Huseynov believes.

“A matter of nearest future”

Summing up all what has been done in Azerbaijan over the past decade, UNICEF representative Hanaa Singer believes that USI and IDD elimination are just round the corner.

“Azerbaijan is very close to USI and IDD elimination. Azerbaijan could qualify for external verification of successful USI and a country with a status of eliminated iodine deficiency once the quality of salt iodization is improved and the proportion of quality iodized salt reaches 90%. We hope that this is a matter of the nearest future”, says Singer.

 

 
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