Promoting universal salt iodisation in Mozambique
Boane, Maputo Province, November 2010 – In spite of enormous challenges in the production and promotion of iodised salt, many producers have demonstrated that commitment, proper training and monitoring can lead to more and more children and their families getting access to quality salt in the country.
Inocência Vasco Cuco, manager of Salinas Zacarias, proudly refers to the role of her company, located at the mouth of the river Matola, Boane district, in Maputo province. The Salinas Zacharias employs about two hundred workers – mostly women from the local community – and produces up to 15,000 tonnes of salt per annum for local markets, hospitals and various industrial sectors.
“Since the day we learned the importance of iodised salt for public health, we have followed all the recommendations to ensure that our salt always has the appropriate levels of iodine,” she says, as she leads us to a large salt evaporation and crystallisation area.
At that moment, teams of men and women were relentlessly extracting and transporting salt bags to the transit areas, forming large white piles on the banks of the salt field. But before sacking it, there is a key step that is never forgotten, which has been part of the production process for nearly a decade. Inocência takes us to the warehouse and explains.
She points to an artisanal device powered by a small engine. “In this machine is where we iodise the salt with the drip method. We built the machine ourselves here,” she says. The iodised salt comes out of the machine and is directly fed into the bags, weighed, sealed and then stored for subsequent distribution.
“We regularly use the portable laboratories and the rapid test kit provided by the authorities to test the iodine levels in salt,” she explains, showing us one of the bags ready to be sold, which had a label certifying it to have been properly iodised. “We have a trained employee to monitor the process”.
Under the National Salt Iodisation Programme, implemented by the Government with the support of UNICEF and partners, local producers have been trained on the techniques and importance of salt iodisation. This intervention also includes support in procuring potassium iodate and supply of portable laboratories and rapid test kits for them to test iodine levels themselves. There is also a national laboratory in Maputo.
Some large-scale producers, such as Salinas Zacarias, have been built their own iodisation machines. But the programme has also supported them in procuring equipment such as manual sprayers used by smaller salt producers. The company Salinas Wane Pone, located at the mouth of Matola River and employing only 10 workers, is one of the small companies benefiting from this support.
Despite its limitations, which include lack of electricity, appropriate warehouses and modern equipment suitable for the production of salt, the Salinas Wane Pone has been striving to iodise salt since 2000, when the law was enacted requiring salt iodisation.
“For us, iodising salt is a simple process. We use a manual spray and control the level with the portable laboratory and the rapid test kit that we received during training. All producers should do the same,” said Wane Pone Jr., manager of the company. With the utmost efficiency, an employee prepares the spray and shows us how the process has been implemented.
Salt companies like these – there are hundreds throughout the country – have been instrumental in supplying the markets and local communities with salt, supplying it also to stockists from other provinces. However, many salt producers – particularly the smaller ones – have failed to comply with this salt iodisation requirement. For this reason inspection is a fundamental aspect to be addressed, according to the coordinator of the National Salt Iodisation Programme, Mr António Dambi.
Consumer awareness on the importance of iodised salt has also been a challenge. Cultural beliefs and ignorance of the benefits of iodine for health are sometimes a barrier.
“Some female market traders use to come here asking us not to iodise salt because some customers do not like iodised salt”, says Inocência Cuna. “Very often we are required to go to markets to raise awareness, just as we do with our employees.”
Communities living in areas of salt production are generally major consumers of non-iodised salt.
“Families living around here by the salt fields usually consume non-iodised salt. The problem is that they extract their own salt for their own consumption without proper treatment, and even try to get salt from the company before it is sacked, before we iodise it” alerts Wane Pone Jr. “Awareness is essential!" he concludes.
The National Salt Iodisation Programme has been carrying a communication and awareness campaign in collaboration with partners. Population Services International (PSI Mozambique) supports the programme in capacity and awareness raising efforts in four provinces.
“We have been working on the promotion of iodised salt together with women's groups, community leaders and promoters of iodised salt in the communities, outlets and health facilities, and through community radios,” explains Rafael Nzucule, PSI Nutrition Manager.
However, according to Rafael Nzucule, there is still some reluctance in using iodised salt because of its limited availability in the market. For this reason, many consumers continue to use non-iodised salt. Data from the 2008 Multiple Indicator Cluster Survey indicated that only 58 per cent of households use iodised salt, and that only 25 per cent consume adequately iodised salt.
A study among nearly 500 women of reproductive age in Nampula undertaken by PSI, found that knowledge about the fact that iodised salt improves school performance had increased from 9 per cent to 35 per cent after a year and a half of promotional interventions in this province. Use of iodised salt had not increased, which is why PSI is now also targeting retailers, and advocating with the Ministry of Industry for strengthened law enforcement.
“Iodine deficiency in the body is a major cause of slow mental and psychomotor development among young children, and also increases the risk of stillbirths and miscarriages in pregnant women. That is why we put so much emphasis on the expansion and strengthening of the salt iodization program,” said UNICEF Nutrition Specialist Maaike Arts.
Some big producers are also increasingly investing both in improving the quality of salt and in expanding the market. The company Afrisal do Mar, for example, has also been supplying the market with washed and iodised fine salt. To make the use of national iodised salt even more attractive, the company - which is established in Maputo Province and is one of the largest salt producers in the country - is planning to provide the fine table salt in salt shakers and plastic containers of different sizes.
"There is still no big demand for iodised salt. But as part of our corporate responsibilities we do iodise and always try innovative ways to satisfy consumers' needs with quality salt” says Rajat Troy, Managing Director of Afrisal do Mar.
The National Salt Iodisation Programme aims to promote salt iodisation through continuous capacity-building of the producers, procurement of basic equipment, promoting greater collaboration among larger and smaller producers and establishment of more effective monitoring mechanisms of law implementation.