Use iodised salt or nothing at all
Information Education and Communication (IEC) strategy for Increasing the Consumption of Iodised Salt
A series of studies carried out by the National Mother and Child Research Institute during 1993 – 2002 found low iodine consumption rates among the Dominican population, as well as low levels of salt iodisation and high rates of rock salt consumption.
A study of urinary excretion and iodised salt consumption among Dominican schoolchildren (2002) revealed that iodine levels in the population surveyed were significantly higher compared to a previous study in 1993, but that 79.4% of families sampled used rock salt, and of these, barely 3% showed satisfactory iodine levels. Twenty per cent of the families consumed refined salt, and of these, just 51% of the salt used was iodised. This study highlighted the fact that despite the percentage found to be consuming iodised salt, the difference in impact on the population was significant compared to 1993.
Likewise, in that same year, 2002, other studies sponsored by UNICEF found that nationally produced salt is low quality, that salt iodisation was not effective and is poorly monitored, that higher quality imported salt, which is often cheaper than the domestically produced variety, is not being controlled either.
To tackle this situation the recommendation was to conduct social mobilisation strategies with activities aimed at families, housewives, traders and key community actors. A report was produced about the communications media with the greatest impact on the population surveyed, as well as references for results and recommendations that together with the interest shown by the Public Health Ministry (SESPAS), is sufficient motivation for re-launching an integrated programme aimed at increasing the use of iodised refined salt by the population.
At the same time, monitoring and evaluation of salt production and marketing is being strengthened, and research on urinary excretion is planned in the near future to test iodine levels among the child and adolescent population and women of childbearing age. These initiatives are led by the Public Health Ministry with the support of UNICEF for the strengthening of the programme for the reduction of Iodine Deficiency Disorders in the country.
Studies conducted reveal a lack of knowledge about the importance of iodised salt consumption, and for this reason education and social mobilisation are one of the key ways of achieving a behavioural change that ensures children and adolescents’ right to health.
A study conducted by the Health Ministry (SESPAS) through the Dr. Defilló National Laboratory to measure the iodine content in salt for human consumption, (Measurement of the Iodine Concentration in Salt for Human Consumption at national level, at points of sale, 2005), found that some 67% of the salt brands on the market did not contain iodine and only 13.7% of the samples contained iodine within the limits established by the state regulations that establishes the range as between 30-100 parts per million (ppm).
As a basis for establishing the Information, Education and Communication strategy, UNICEF also sponsored a Study of Behaviours, Attitudes and Practices in Iodised Salt Consumption in Dominican Homes and the Communications Media, which found that a total of 75% of the population continued to use rock salt despite the fact that this is prohibited by Dominican law (NORDOM 14).
Developing the Information, Education and Communications Strategy:
The Public Health Ministry’s Health Promotion Department (DIGPRES) designed the Information, Education and Communication (IEC) being developed in partnership with other state institutions, with Caritas Dominicana and other non-governmental organisations, community organisations and key community actors across the country, which will prioritise the regions with the highest reported risk or incidence of Iodine Deficiency Disorders in its first phase.
General Objective of the Strategy:
Contribute to the reduction of Iodine Deficiency Disorders (IDD) by organising health promotion activities that encourage the consumption of iodised salt by the general public.
The specific objectives:
1. To promote the consumption of iodised salt through the mass communications media.
2. To promote social and community participation in the iodised salt consumption promotion process.
3. To raise awareness among housewives, mainly in rural areas, so that they take on the consumption of iodised salt and promote the practice through social and community negotiation.
4. To promote participation by community organisations for social mobilisation to promote iodised salt consumption.
5. To support educational activities by health personnel and community sectors.
Mass media component:
Following a tender process with advertising agencies, Forcadell Publicity was selected for its creative ideas for designing a large-scale campaign, with the objective of educating the consumer that the only salt they should buy and use at home should be refined iodised salt, in order to prevent their families from suffering from Iodine Deficiency Disorders.
For the campaign materials, popular musical star Milly Quezada, was chosen to represent the central figure in this campaign, the housewife, due to her fame, credibility and clean track record.
The campaign will be disseminated through the local mass media and groups working at community level. At the same time, a social mobilisation plan will be implemented, through which the campaign will reach housewives, small food store (‘colmado’) vendors, health workers and organised community groups.