Iron fortified salt distribution through integrated child development services in Orissa - an assessment

The present study was undertaken in two backward districts namely Phulbani and Sundargarh, of Orissa State, India, to study operational aspects of the distribution programme of iron fortified salt (IFS), and the extent of any overlap with the ongoing National Nutritional Anaemia Control Programme (NNACP) and possible toxic effects thereof. All IFS samples tested showed iron levels in the range of 800-1000 mg of elemental iron per I kg of iron fortified salt. Distribution of IFS to households was irregular and only 40% of the households had stocks of IFS at the time of home visits. None of the households using IFS reported any kind of adverse effects. Prevalence of anaemia (blood haemoglobin level of less than 11 g/dl) was highest among pregnant women (90.9%) followed by lactating women (88.7%), school aged children (84.4%) and preschool children (77.9%) respectively. Folifer tablets are being distributed to pregnant, lactating women and preschool children. Adult tablets contain 60 mg of elemental iron in the form of ferrous sulphate (FeSO4) and 500 m g of folic acid. Tablets distributed to children contain 20 mg of elemental iron and 100 m g of folic acid. Enquires regarding distribution of folifer tablets showed that 71% of pregnant women, 22% of lactating women and 22% of children received the folifer tablets at sometime or other and no toxic effects were reported. These results indicate the necessity for some modifications in existing strategies for distribution of IFS in order that it be effective in the prevention of widespread anaemia.