The challenges of iodine supplementation: a public health programme perspective.
An adequate iodine intake during pregnancy, lactation and early childhood is particularly critical for optimal brain development of the foetus and of children 7-24 months of age. While the primary strategy for sustainable elimination of iodine deficiency remains universal salt iodisation, the World Health Organization and the United Nations Children's Fund recommend a complementary strategy of iodine supplements as a temporary measure when salt iodisation could not be implemented. This article aims to review current evidence on efficacy and implications of implementing iodine supplementation as a public health measure to address iodine deficiency. Iodine supplementation seems unlikely to reach high coverage in a rapid, equitable and sustained way. Implementing the programme requires political commitment, effective and efficient supply, distribution and targeting, continuous education and communication and a robust monitoring system. Thus, universal salt iodisation should remain the primary strategy to eliminate iodine deficiency.
Untoro
Juliawati
J
United Nations Children's Fund, New York, NY 10017, USA. juntoro@unicef.org
Timmer
Arnold
A
Schultink
Werner
W
D019587:Dietary Supplements / Q000191:economics; D005260:Female; D006266:Health Education / Q000331:legislation & jurisprudence / Q000379:methods / Q000458:organization & administration; D006293:Health Promotion / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods / Q000458:organization & administration; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects / Q000172:deficiency / Q000600:supply & distribution; D009313:National Health Programs / Q000458:organization & administration*; D011057:Politics; D011247:Pregnancy; D015397:Program Evaluation; D011635:Public Health Administration / Q000379:methods
D007455:Iodine