IDD in Kyrgyz Republic: country situation and prevention programmes

1
IDD in Kyrgyz Republic country situation and
prevention programmes
Chinara Aidyralieva
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Extent of the problem
Goiter rate in Kyrgyzstan (1995-2000)
1993 Osh, Bishkek and Naryn oblasts TGR
49.1 THS gt5mU/l 60 1994
Bishkek and Osh city TGR 26-79 THS
gt5mU/l 60,1
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Urinary excretion of iodine 5 oblasts of the
republic out of 6 in 1995-1998 School children
10-12 years 100 boys/100 girls in each oblast
(sample size 1000 ) TGR (19-31 average, with
64 in Jalal-Abad) on the basis of ultrasound
goiter evaluation Median urinary iodine (20-50
?g/L average, at the Jalal-abad oblast
lt20) Household consumption of iodised salt
27 (DHS 1997)
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Sources of salt
25 -local production (4 enterprises, 2 of them
equipped by UNICEF 350 kg of Potassium Iodate
for start-up) 75 -import from Kazakhstan,
Tajikistan, Uzbekistan, Russia, China
Kazakhstan
TERMINAL AK JOL
Russia, ?azakhstan
TERMINAL CHALDOVAR
BISHKEK
?ARAKOL
TALAS
NARYN
J.-ABAD
TERMINALS SAVAI, BEGABAD DOSTLIK
(Andijan oblast)
Uzbekistan, Kazakhstan
Osh
TERMINAL TORUGART
China
Tajikistan
Salt production sites
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Support to the development of Law on the
prevention of IDD

• Law was adopted early in 2000. It states that all
  salt for human and animal consumption should be
  iodised.
• Provisions of the law in general are adequate,
  but
• It lacks a mechanism for the law implementation
  (with regard to the fine for those violating the
  law and control of import of technical salt,
  which is often then being sold as non-iodised).
• Introduction of amendments will require
  simultaneous changes at the Administrative and
  Customs Codes as well as the Law on Licensing.
• Inter-sectoral mechanism of collaboration is not
  in place

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Support to the IDD monitoring

• Laboratories for iodine determination in urine
  and salt and set of reagents were supplied,
  installed, staff trained
• Programme of IDD monitoring at all levels was
  developed with participation of SES, Manas Health
  Reform project, WHO Health Policy Analysis
  project
• -at the production site
• -at the wholesale/retail level
• -at the school (knowledge of children and iodine
  content in salt)
• 60 schools targeted at all oblasts of the
  republic
• 91 knew about IDD, mostly linking it to
  goiter (89), 6 to mental retardation and
  tiredness
• 93 of children were positive about
  possibility of IDD prevention

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84 of urban and 77 of rural children
suggested iodised salt as primary method of
prevention (70 of urban children in Chui oblast
preferred drugs for prevention and 24 of Batken
children were not aware of prevention methods)
Source of knowledge in 42 were medical workers,
26 - TV, 14 newspapers, 11 -relatives 67.7
are consuming only iodised salt, 29.6 - any,
2.8- only non-iodised salt Only 35 of salt
was adequately iodised, 34 had low levels of
iodine, 31 was non-iodised (in Talas - 55 and
in Osh - 43) 23 of urban and 35 of rural
citizens purchase non-iodised salt as iodised
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IDD communication campaign

• First workshop was conducted in 2000 (facilitated
  by Fatima Jatdoeva)
• Two videospots, three audiospots were developed
  and broadcast for 3 months
• Three types of posters (for schools, health
  facilities and public places) and pocket calendar
  were developed, printed and distributed
• Teachers of biology will be trained
• to basic IDD messages through
• the cascade type of training
• Under the ADB/UNICEF project-
• national communication w/shop ?
• NGO engagement
• Swiss Red Cross project

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Challenges

• Poor quality and limited availability of iodised
  salt down to the village level
• IDD activities are mainly led by health people
  and lacking of inter-agency coordination
• Introduction of changes into the law and
  establishment of mechanism of law implementation
  is time-consuming
• Licensing procedure needs to be established for
  all salt, including technical
• Communications strategies are not developed
  /partners are not engaged
• Procurement of potassium iodate by local
  producers is too complicated