Economic evaluation of water iodization program in Thailand

Area of Science:

• Public Health
• Nutritional Science
• Health Economics

Background:

• Iodine deficiency disorders (IDD) are a significant public health issue in Thailand, affecting 15 million people across 57 provinces.
• A multi-pronged strategy including iodized salt, water, and oil capsules is employed for IDD control.
• Water iodization programs are implemented in both school and household settings.

Purpose of the Study:

• To evaluate the cost-effectiveness of Thailand's water iodization program in 1996.
• To determine costs per beneficiary, per microgram of iodine consumed, and per goiter case averted.

Main Methods:

• Primary data collected through field visits and interviews with health personnel.
• Secondary data sourced from the Department of Health, Government of Thailand reports.
• Cost analysis included capital, training, recurrent costs (potassium iodate, salaries), monitoring, and communication.

Main Results:

• Household-based water iodization was significantly more cost-effective than school-based methods.
• Cost per beneficiary: household ($0.12) vs. school-based ($0.64-$0.72).
• Cost per microgram of iodine: household ($0.001) vs. school-based ($0.01).

Conclusions:

• Water iodization is a low-cost public health intervention for combating iodine deficiency disorders.
• The household-based approach demonstrated superior cost-efficiency.
• Long-term sustainability hinges on addressing behavioral modification for consistent iodine intake.