1. Quality Control at production sites and in sales channels ARNOLD TIMMER, UNICEF REGIONAL OFFICE CEE/CIS & Baltics 13 October 2004

2. This presentation: Linking quality control with overall programme aim Identify main programmatic challenges Identify main monitoring attention points Discussion and apply lessons learned to your own monitoring system

3. Purpose Establishment of a monitoring system that can –identify problems, –provide solutions, and –ensure that corrective measures are taken.

4. Main Aim External Monitoring Ensure adequate iodine levels in salt at household level Ensure consumers’ access to iodized salt

5. Programmatic Issues Quality of iodized salt production? Iodine loss in salt between factory and consumption? Use of iodized salt for food processing? Use of iodized salt for animal consumption? Access of all population groups in all geographic areas to iodized salt?

6. Programmatic Issues Enforcement challenges? –Illegal salt: repackaging as iodized? –Sale of non-iodized salt (originally produced as technical salt or edible salt)? –Access of consumers to technical and/or non-iodized animal salt? –Capacity to implement government standards (as spelled out in legislation): technical (testing equipment, training), inadequate manpower, roles/responsibilities not defined?

7. Use of information Who reports on information collected? How is the information reported? Does the reported information address your programmatic concerns? How will monitoring information be used? Who will use the information? How will the collected information lead to corrective measures in the production, distribution and use of iodized salt? Will the corrective measures have an effect on the final aim to ensure adequate iodine status of the consumer?

8. Salt Iodizaton Monitoring System AccessCoverage Utilization and Impact Salt Producers Salt Importers Retail Stores Households Target Population

9. Salt Iodization Monitoring System Industry (internal)ExternalCommercial Locally Produced salt Imported salt Quality Assurance Quality Control Inspection Technical Auditing Retail Inspection Certificate of quality Certificate of conformity

10. WholesaleRetailTradersSaltProduction Salt Producers And Distributors For food Industry For House- hold use Market Consumer Household Population Nutrient Status Impact Salt Iodization Monitoring System Iodine content in salt 40 + 15 ppm min. 15 ppm Illegal production & trade

11. Salt Iodization Monitoring System Iodine content in salt Factors of influence: -Time -Humidity -Temperature/light -Packaging material -Quality of salt -KIO3 or KI

12. Studies: China Salt used: –572 samples from 58 salt companies from 31 provinces –Refined (purified, crushed) and unrefined crude salt Storage conditions, in kitchen: –Plastic container with cover –Closed plastic bag –In plastic bag but open –Sealed big sack in factory Thoroughly mixed and samples analyzed at: –3 – 6 – 9 – 12 months

13. Results - China Results: –No changes in iodine content during 1 year even in unrefined salt, even in open bags. –Concentration varied over time in crude salt because iodine is less homogeneous in the salt.

14. Studies - Macedonia 1.Normal temperature (20 C), humidity (40%) and light 2.Normal temperature (20 C), humidity (40%) and no light 3.High temperature, normal humidity and no light 4.Normal temperature (20 C), high humidity and no light Duration 5 months

15. Macedonia: Iodine Content (mg/kg)

18. Studies: Micronutrient Initiative: - salt from several countries - Humidity: 60% and 100% Temperature: 20 and 40 C Packaging: polyethylene, woven bags Analyses 1, 2, 3, 6 and 12 months Results:

19. Source: Micronutrient Initiative

21. Main iodine losses Refined salt retains iodine better than unrefined salt KIO3 is better retained than KI in salt Polyethylene package retains iodine better than carton or jute package, and better than no package In high humidity iodine retention is lower In high temperature iodine retention is lower Light does not influence iodine retention Retention of KIO3 in salt is 70-80% after 1 year in low humidity, polyethylene packages.

22. Programmatic Considerations What can be easily changed?? –Fortificant: KI or KIO3 –Quality of salt –The way and time salt is stored between factory and household –The way people use and store salt at the household –The way salt is packaged

23. Programmatic Considerations What can be easily changed?? –Fortificant: KI or KIO3 –The way salt is packaged

24. source: USI monitoring manual - 1995

25. External monitoring: Focus: what, where to monitor? Iodine level adequate? –Production! –Wholesale? –Retail? –Household? Check if the monitoring you propose answers the programmatic questions that apply –Is iodized salt production adequate and reliable? –Do you need to identify areas/population groups with no availability to iodized salt? –Is counterfeited salt/smuggling an issue? –Etc.

26. Monitoring at retail level Retail shops may sell iodized salt and/or non-iodized salt. The main purpose for monitoring at retail level is to identify areas where: –An inadequate proportion of shops is selling iodized salt –Non-iodized salt is available in the market –Salt packaged and labelled as iodized is not adequately iodized

27. How to collect the information? Traditionally, iodine in salt tests: –Test kit –Titration –WYD checker Salt situation analysis Salt producers: where does salt flow, clients Household surveys NGO and other reports National coalition meetings Observations

28. Use of information Who reports to whom? –SES to national coalition –Salt producers to salt association –National coalition to Minister of Health How is information used? –Define clear corrective actions to be taken: Change number of samples and where samples should be taken Change standards Information campaigns Strengthen partnerships

29. Consider importance of corrective action Moderate climate, refined (high quality) salt in polyethylene, retention of iodine is of no concern if used within 1 year. Monitor: –Establish QA at factory level to ensure iodized salt produced according to standard –Monitor iodine in salt at retail or household level; –If acceptable, no action required –If not acceptable, check and improve quality of iodized salt, or increase iodization level –Address other programmatic issues in your monitoring system Measures to improve household storage and use are a waste of time and effort and will show little result

30. Discussion Identify programmatic concerns Identify weaknesses in current monitoring and reasons Recommendations for further discussion in group work