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Current Iodine Deficiency Disorder Situation
Population
Population: 19.9 million
Population growth rate: 1.8%
Population < 15 years: 41.2%
Birth rate: 28.95 per year
Life expectancy at birth: 57.2 years
Infant mortality: 56.5 per 1000
Prevalence of Goiter/ UIE
Median urinary iodine: 196 mcg/L (2001). A 1993 National Survey included four towns or villages from each of the country's ten districts, conducted by the Ministry of Health and the University of Ghana . 500 children, aged 10-19 yrs, and 500 women, aged 15-45 were included in the sample of each district. (n = 30,000)
The national total goiter rate was 20%, ranging from 7% in Shama Ahanta East to nearly 30% in Wassa Amenfi. The average urinary iodine was 77 mcg/L, but in the upper west region, 10-30 mcg/L. The range was 28 mcg/L to 183 mcg/L. Further survey information is not available.
Preliminary data from ThyroMobil visit in 2001 are median UI 196 mcg/L.
Despite careful assessment and recognition of severe IDD especially in the north, there is little recent evidence of progress with salt iodization. The University of Ghana has been involved in IDD assessment and is carrying out studies in fortification.
Iodized salt Coverage
Household iodized salt use: 28% (1998)
Salt Situation Analysis Production
Ghana imports approximately 2-50 tons/year of salt from the UK , small amounts from Germany and China . 58% of salt is iodated, yet below 20 ppm.
Salt indigenously produced along the sea coast of Ghana by the solar evaporation of sea water in open ponds. Current production is about 200,000 tons, of which 100,000 is exported in crude form. While the quality of salt produced by the larger producers is fairly good, that produced by the smaller producers tends to be of poor quality. Organizing the multiple salt producers into cooperative units for salt iodization has been planned. Salt is bagged in woven polypropylene or high-density polyethylene bags ranging in size from 25-100 kg for domestic and export use. Ghana is a major exporter to Burkina Faso , Togo , Niger , Benin , Nigeria , Mali , Cote d'Ivoire , Congo .
Consumption
- Estimated daily per capita salt consumption: 11 g, range 5-17 g.
- Estimated % of all salt consumed by people which is adequately iodized (household level): 28%
Iodine Procurement and Utilization
KIO3 at 20-40 ppm. 100 ppm at factory, 50 ppm at retail (proposed). As of 1999 a constraint was that the FDA did not have the legal authority to enforce iodization of salt by the industry. Many small-scale salt industries exist, making introduction of iodization more complicated.
Universal Salt Iodization Program
Information, Education, Communication (IEC) Activities
In 2001, there was increased interest in communication, including advocacy material for regional coordinating councils to form regional salt iodization committees, follow-up seminars with the media, promotion of iodized salt developed with Unilever Popular Foods (a dominant salt producer), and celebration of IDD Month. Regional-based iodized salt coverage surveys were planned for late 2001, and also development of pilot salt iodization by small-scale salt producers along the coast. Meetings of salt producers, salt retailers, policy makers, and other regulatory agencies participated in a stakeholders meeting to identify means of increasing household consumption of iodized salt, especially in the north.
Legislation
- Legislation: yes
- Legislation for Animals: yes
- Year Enacted: no data
Program Monitoring and Evaluation
MOH, The Nutrition and Food Science Department, University of Ghana , the Minerals Commission. A National Plan of Action for Nutrition has been developed with a multisectoral group, further details not known.
There is increased awareness of monitoring of salt for iodine content, but further details not available. Recent data on urinary iodine also not available
Other Interventions
From 1991-1993, 81,000 received oral iodized oil, average dose 200 mg, to children through the age of 15 and to women 15-45 in areas with a visible goiter rate > 10%.
Key Lessons Learned
Challenges and Constraints
Future Plans for Sustained IDD Elimination
Sources:
Annual report to ICCIDD (J. Egbuta, Subregional Coordinator for Anglophone West Africa, 2001)
IDD NL 16(2):25, 2000
IDD NL 15(2):27, 1999
IDD NL 11(4):52, 1995
IDD NL 11(3):34, 1995
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