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Sustained Elimination of Iodine Deficiency Disorders in CEE/CIS

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Assessment conducted by Johns Hopkins Bloomberg School of Public Health: ... Johns Hopkins Bloomberg School of Public Health Center for Communication Programs ... – PowerPoint PPT presentation

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Title: Sustained Elimination of Iodine Deficiency Disorders in CEE/CIS


1
Sustained Elimination of Iodine Deficiency
Disorders in CEE/CIS Baltics
  • Assessment of UNICEF Supported Communication
    Activities

2
Purpose
  • Assess the status of IDD communication programs
  • salt iodized / salt situation
  • existing communication strategies
  • media environment
  • knowledge among the public
  • stakeholder involvement
  • Provide lessons learned and recommendations for
  • role of communication within USI programs
  • communication strategy design (including
    messages)
  • using experience and expertise across countries

3
The Countries
  • Albania Kazakhstan Turkmenistan
  • Georgia Kyrgyzstan Russia
  • Moldova Tajikistan Ukraine
  • Assessment conducted by Johns Hopkins Bloomberg
    School of Public Health
  • Lisa Cobb
  • Raisa Scriabine

4
Presentation Structure
  • Goals and Strategy
  • Role of Communication
  • Communication Framework
  • Overview of Findings
  • Findings from each framework element
  • Supportive Environment
  • Increasing Immediate Use
  • Ensuring Sustained Use
  • Recommendations by framework element

5
UNICEF Supported Goal A Regional Priority
  • Goal
  • Sustainable elimination of IDD by 2005
  • Measured by
  • Household use of iodized salt (gt90)
  • adequate iodine status (urinary iodine)
  • Strategy
  • Universal salt iodization by 2003
  • All salt for human and animal consumption
  • table or household salt
  • salt for food processing
  • animal salt

6
Iodine Deficiency The Problem

7
The network of connections are less dense
Iodine Sufficient Brain
Iodine Deficient Brain
Source From Legrand, 1967.
8
The focus shifts to the brain

Science shows the real issue
9
Role for Communication?
  • Communication can change behavior at many levels
  • Leaders (political medical)
  • Communities
  • Families
  • Uses advocacy, education, information, marketing,
    mobilization, and persuasion

10
Iodized Salt From the Law to the Table
11
Framework for IDD communication
  • Aims to support the sustained production and use
    of iodized salt
  • Multiple intervention points to achieve aim, from
    legislation to household use
  • Each country puts emphasis on different elements
    depending on their situation, but all elements
    should be included

12
Framework for IDD Communication
IDD Program Strategy
Supportive Environment Increasing Immediate
Use Ensuring Sustained Use
13
Overview
  • Congratulations to UNICEF staff! They should be
    proud of their large role in changing the way
    governments, salt producers, and populations
    legislate, supply, and use iodized salt
  • Reaching UNICEF-supported goal to eliminate IDD
    is important to all country offices. Staff
    showed they are ready to move their programs
    forward

14
Overview (cont)
  • The goal (sustained elimination of IDD by 2005)
    is achievable in all of the countries visited,
    but not at the current level of activity
  • Programs are creative, responsive to local needs
    and desires, and carried out in collaboration
    with local partners. Its time to take them to
    scale everywhere

15
Supportive Environment
Moldovan Legislation
16
Supportive Environment - Overview
  • Creating a supportive environment for sustained
    elimination of IDD is UNICEFs strength and great
    achievement
  • All country programs assessed had activities
    designed to create a supportive legislative
    environment
  • Level of success in creating legislation may have
    more to do with country dynamics than
    programmatic issues

17
Supportive Environment - Overview
  • Staff sometimes expressed disappointment that
    legislation did not mandate USI - what they have
    achieved so far is an accomplishment, however,
    and they should continue advocacy for mandatory
    legislation
  • Regulatory measures are necessary to enforce the
    legislation that is in place

18
Supportive Environment - Salt Situation
Salt Packaging from Albania
19
Supportive Environment Overview (Salt Situation)
  • Commercial salt trade across region regulated by
    supply and demand
  • Many countries have problems with salt smuggling
    and fake iodized salt
  • In every country, iodized salt is a market-based
    product, and the market must sustain its
    production with incentives (profits) and
    regulation (legislation)

20
Increasing Immediate Use
The Healthy Food Brand Kazakhstan
21
Increasing Immediate Use - Overview
  • In countries with communication plans, activities
    designed to immediately increase use of IS
    carried out in partnership with governments,
    NGOs, and commercial partners
  • Most countys programs were designed to raise
    awareness of IDD. Another approach is to market
    or promote iodized salt

22
Increasing Immediate Use - Overview
  • Only a few countries included a marketing
    perspective as a part of their strategy.
    Kazakhstan was one of the few, with its Healthy
    Food brand
  • Iodized salt is sold in the open market. When it
    is promoted the messages compete with other
    messages about food products good for health. IS
    messages must be more powerful than others to be
    remembered

23
Increasing Immediate Use - Overview
  • Little audience segmentation, without specific
    messages targeted to the most vulnerable group
    mothers-to-be
  • General iodized salt is good for your health
    messages may not reach this group as powerfully
    as a message on preventing brain damage in their
    child

24
Ensuring Sustained Use
School Curricula in Ukraine
25
Ensuring Sustained Use - Overview
  • Some country programs have large sustained use
    components, with training of doctors and work
    with school children as priority elements in
    their strategy
  • Work with health works and school children is a
    valuable, long-term strategy to ensure sustained
    elimination of IDD (not a quick fix)

26
Ensuring Sustained Use - Overview
  • For this component, UNICEF support has focused on
    educational and medical institutions. Sometimes
    NGOs and community groups also actively engaged,
    for example
  • Russia consumer groups played a dynamic role in
    the program
  • Kyrgystan community leadership and village health
    committees became forces in applying pressure on
    retailers and producers to supply iodized salt

27
Ensuring Sustained Use -Overview
  • Producers of iodized salt will always be
    responsible for providing and marketing iodized
    salt to their customers
  • Some UNICEF country programs are working with the
    salt producers actively, others less so
  • Salt producers have a role to play in legislation
    and enforcement, increasing household use, and in
    particular in ensuring there will always be
    demand for iodized salt

28
Iodized Salt From the Law to the Table
  • Supportive Environment
  • Advocacy for USI legislation
  • Creation of IDD coalitions and monitoring bodies
  • Engagement of IS producers in advocacy and IS
    agenda
  • Increasing ImmediateUse
  • IS marketing to consumers
  • Branding and packaging with IS producers
  • Point of sale promotion
  • Ensuring Sustained Use
  • IS promotion by medical professionals
  • IDD education and IS promotion in schools and
    civil society groups
  • Engaging private sector salt production in
    marketing

Adequate iodine nutrition
29
Regional RecommendationsGeneral
  • All country offices should develop communication
    strategies tailored to their specific audiences
    (leaders, private sector, communities, families)
    within available resources
  • Communication plans should include objectives,
    roles responsibilities, timelines, audiences,
    message concepts, and relationship to overall USI
    goal.
  • Development should be done through workshops
    that bring together all IDD stakeholders in the
    government, private sector, and civil society

30
Regional RecommendationsGeneral
  • All country officer should integrate
    communication into the USI program.
    Communication should not be seen in isolation
    from USI programs, and communication officers and
    program officers need to plan and coordinate
    their work to reach the goal
  • UNICEF (at the regional level) should disseminate
    lessons learned, successful methodologies,
    messages and materials, toolkits, and strategies
    among countries

31
Regional RecommendationsSupportive Environment
  • Advocate for strengthened mechanisms for
    designing, implementing, and enforcing policy at
    the national level. Not all countries have an IDD
    coalition , and some are not adequately staffed,
    or have low-level representation without
    political impact
  • Where legislation is incomplete or absent,
    continue advocacy for USI (as a priority)
  • Advocate and provide support for adequate
    enforcement measures in legislation.

32
Regional RecommendationsIncreasing Immediate Use
  • Consider strategies that directly target
    mothers-to-be (both pregnant women and women
    likely to become pregnant sometime soon)
  • Focus on message that iodized salt prevents brain
    damage. Messages that say iodized salt leads to
    better health" are not memorable enough -
    iodized salt must then compete with other
    products offering better health
  • Use marketing strategies to harness the power of
    families and individuals to drive IS use.
    Develop tools such as point-of-sale promotion and
    branding

33
Regional RecommendationsEnsuring Sustained Use
  • Engage health workers and teachers in delivery of
    the iodized salt message. Train teachers and
    health workers carefully to make sure they teach
    the material correctly, with the right messages
  • Involve the salt industry in planning for
    sustainable production and use of iodized salt
    through their own marketing activities
  • Look at additional ways of engaging civil
    society, such as involving womens and youth
    groups, consumer groups, and teachers
  • Disseminate IDD messages through other programs
    activities - UN agencies, NGOs, and international
    organizations active in relevant health areas

34
  • Johns Hopkins Bloomberg School of Public Health
    Center for Communication Programs
  • International Council for Control of Iodine
    Deficiency Disorders
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