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46FEATURESFigure 2: IDD/USI Taskforce Partnership in Nigeriawww.unsystem.org/scnNigeria USI Program OverviewIDD Program Coordination, Activities & Implementing AgenciesCoordinating Focal Point: FMOHIECDatabaseNutrition SurveillanceIDD-USI TASK FORCE: SONFMOHFMEIECINDUSTRYNAFDACSONFood ControlNAFDACFMEFMOHNationalMNMEventsConsumerHealthEducationBrandedCampaign&SchoolsGenericCampaign& GovtAdvocacyPortFactoryInspectionDistributorRetailInspectionSchoolHouseholdSurveysSentinelSites.Labs.This partnership has enabled all stakeholders to monitor trends in compliance at factory, wholesale, retail andhousehold levels and intervene where necessary.ResultsResults in terms of coverage of iodization:• Iodization at factory level: Since 1995, records of inspection at ports of entry and at salt factoriesconsistently indicate 90 100% of consignments with iodine levels above 50ppm.• Iodization at wholesale and retail levels: Results of wholesale and retail level surveys for 2002, 2003 and2005 indicate that 97-100% of salt meet the standard of more than 30ppm iodine content. Since 2002,approximately 20,000 salt samples have been analyzed.• Access to iodized salt at household level: Results consistently indicate that access to adequately iodizedsalt at the household level is over 98%.• Median urinary iodine excretion levels: Biochemical assessments of urinary iodine mirrors the dramaticallylower TGR recorded during the 1990s. A study published in Public Health Nutrition in 1998 reported meanlevels of urinary iodine content of 146.5 μg/dl with a median of 133.9 μg/dl. In 2002, the study of the 16endemic states by Egbuta et al reported urinary iodine content of 90-156 μg/dl. These results werereaffirmed by the Nigeria Food Consumption and Nutrition Survey (NFCNS) undertaken by theInternational Institute of Tropical Agriculture (IITA) in 2001, which found median urinary iodine levels inchildren under 5 years of age to range from 119 to 309 μg/dl. The UNICEF 2005 National TGR andUrinary Iodine Survey recorded a value of 131 μg/dl urinary iodine level.• Total goitre rate: Studies confirm the impact of Nigeria’s USI law on goitre prevalence: In 30 states, peopleaffected dropped from 40 million in 1990 to less than 11 million in 1999 (ICCIDD 2000). The Nigeria‘Damage Assessment Report’ (UNICEF/MI 2004) estimated a lower TGR of 7.7%. A national survey in2005 put the national TGR at 6.2% (UNICEF 2005).Having achieved sustained 98% of households’ access to adequately iodized salt since 1998, a goitreprevalence rate of about 6%, and a median urinary iodine excretion of more than 130 μg/dl since 1999,Nigeria was certified as USI compliant in 2005 by the Network for Sustained Elimination of Iodine Deficiency.This made Nigeria the first country in Africa to achieve this feat. Nigeria currently ranks 6 th on the globaliodized salt consumption out of the 200 countries assessed and reported on the 2006 Global Score Card.Furthermore, the 10 point criteria for USI certification had been met, namely evidence of politicalcommitment, a functional national multi-disciplinary body on IDD/USI, a national executive officer for IDDelimination, legislation and regulation on USI, commitment to assessment and re-assessment of progress,SCN NEWS # 35 back to contents
www.unsystem.org/scn FEATURES 47public education and social mobilization, regular data at factory, retail and household levels, regularlaboratory data on urinary iodine, industry maintenance of quality control, and a database for recordingresults of monitoring procedures. Nigeria has propelled West Africa to achieve household access to iodizedsalt of 71%; this figure would have dropped to 46% without Nigeria (Figure 3).ConclusionIDD is a silent threat to the growth and development of the child and also to national development. Accordingto projections made by UNICEF and the Micronutrient Initiative (2004), the national benefits derived from adecrease in TGR (from 20% in 1993 to 7.7% estimated for 2004 in Nigeria, thereby saving 590,000 babiesfrom intellectual impairments annually), would result in productivity gains of $220 million per year to theNigerian economy.From Nigeria’s success story, it is clear that with Government and public support, determination and hardwork by key players, any country can do it. With the lessons learned from USI, Nigeria have decided to movebeyond salt iodization and a range of staple foods are now fortified with Vitamin A.Acknowledgements: Professor Akunyili is grateful for the technical assistance of Dr. Isiaka Stevens Alo, Micronutrient Specialist, UNICEF, Nigeria.ReferencesEgbuta J and Onyezili FN (2002) Impact evaluation of efforts to eliminate iodine deficiency disorders in Nigeria. PublicHealth Nutrition 6(2), 169-73.Ekpechi OL (1967) Pathogenesis of Endemic Goitre in Eastern Nigeria. Br. J of Nutrition, 21 (3).ICCIDD (2000) IDD Newsletter 16(1).Nigeria Food Consumption and Nutrition Survey (NFCNS); 2001-2003. IITA.UNICEF (2005) Assessment of Total Goitre Prevalence and Urinary Iodine in Nigeria.UNICEF/MI (2004) Nigeria Damage Assessment Report: A Damage Assessment Report. UNICEF/MicronutrientInitiativeContact: dnakunyili@yahoo.com1009883Figure 3: Percentage of households with access to iodized salt in West AfricaUSI7472 716760 59505044313123082 2NigeriaLiberiaMaliBeninWest AfricaTogoGuineaBurkina FasoGhanaNigerCôte d'IvoireSenegalSierra LeoneGambiaGuinea BissauMauritaniaback to contents SCN NEWS # 35
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