The evolution, progress, and future direction of Nepal's universal salt iodization program

Area of Science:

• Public Health Nutrition
• Endocrinology
• International Health

Background:

• Nepal historically faced high rates of iodine deficiency disorders (IDD) within the Himalayan Goitre Belt.
• The region's past prevalence of IDD posed significant public health challenges.

Purpose of the Study:

• To review Nepal's successful universal salt iodization (USI) program over 25 years.
• To identify key factors contributing to the elimination of IDD in Nepal.
• To examine trends and challenges in salt iodization and iodine status.

Main Methods:

• Comprehensive review of policy, legislation, surveys, and program reports.
• Analysis of historical data on salt iodization coverage and iodine content.
• Evaluation of population iodine status trends over two decades.

Main Results:

• Nepal has achieved optimal iodine intake, effectively eliminating IDD consequences.
• The 2016 national micronutrient survey confirmed the program's success.
• Key program components included advocacy, managing trade issues, and monitoring.

Conclusions:

• Nepal's universal salt iodization program stands as a model for IDD elimination.
• Sustained efforts in monitoring and addressing emerging challenges are crucial.
• The program's success highlights the impact of long-term public health initiatives.