1. Child Health Division, Department of Health Services Tek,u,, Kathmandu Iodized Salt Social Marketing Campaign Accham and Doti Districts IDD Situation, Past Achievements and Key Bottlenecks Iodized Salt Social Marketing Campaign Accham and Doti Districts IDD Situation, Past Achievements and Key Bottlenecks 2012

2. Percentage of households consuming salt with 15 ppm or more iodine Nepal is near to USI goal of household using adequately iodized salt since around 80% household are currently consuming adequately iodized salt.

3. Trend in Household Use of Adequately Iodized Salt (15 ppm and above) Nepal made a good progress in achieving IDD goal since 2005 due to promotion of iodized salt in the last decade, 1999 to 2011, strengthening legal system including iodized salt monitoring system in salt warehouses, capacity building of IMS staffs, advocacy and policy, strategy and plan update.

4. Trend in Household Use of Iodized Salt with Two Child Logo Increased household use of iodized salt with two child logo is one factor that contributed in accelerating towards IDD goal.

5. However, Geographical inequity is still persistent in some areas where the household use of adequately iodized salt is still low, around 43%. Ref. NDHS2011

6. In those areas, use of two child logo salt is lowest- Only 25% households in the rural areas of Mid and Far Western Hills are using two child logo salt. Ref. NLSS2011

7. Key Bottlenecks - 1 69% of households in the area have high preference for large crystal salt Easy access Easy to measure during cooking (1, 2, 3,…. Crystal) Traditional behavior Cheaper (Rs.15/- per kg at District Headquater) Reasons:

8. Key Bottlenecks - 2 Around 75% households living in rural areas have low access to iodized salt with two child logo, replaced the demand by large crystal salt Poor attitude and practices, despite of having knowledge Iodized salt with two child logo heaping in District Headquarter since CDO office is the distribution center for subsidized salt. Poor Political Commitment at local level. Little bit expensive for two child logo salt compared to large crystal salt in District Headquater (Rs 20/- kg) Reasons:

9. Saptari, Sunsari, Jhapa Household Salt Consumption Status 52% increase in consumption of 2CL salt

10. Use of Iodized Salt with two child logo at household level in Central and Eastern Terai Iodized Salt Social Marketing Campaign in Eastern and Central Terai Region promoted the use of iodized salt with two child logo from 31% in 2005 level to 55% in 2011.

11. Use of Adequately Iodized salt at household level (>15 ppm) in Central and Eastern Terai The increase in use of two child logo salt in the region has positive contribution in increasing household use of adequately iodized salt from 58% in 2005 level to 83% in 2011 level.

12. Proposed Action The social marketing campaign approach implemented in the Western terai region from 1999 to 2006 and Eastern and Central Terai Region from 2007 to 2011 proved this approach can increase household consumption of adequately iodized salt. Thus, the approach is proposed to implement in the Far Western and Mid Western Hills from the period from 2013 to 2017.

13. Program Planning Social Marketing Campaign will be implemented in two districts of Far Western Hills, Accham and Doti, in 2012 The campaign will be expanded to two other districts of the same hilly region, Bajura and Bajhang, in 2013. Gradually, the program will cover all districts of Mid and Far Western Region.