The Needs Assessment And Obstacle Analysis Of Iodine Deficiency Disorders Elimination In Three Western Provinces Of China

Iodine Deficiency Disorders (IDD) is an endemic disease that is most widely distributed and with the largest number of victims. According to the statistics of the World Health Organization, IDD of various degrees exists in 130 countries around the world, and the threatened population is about 1.98 billion. The main harm of Iodine Deficiency is that it can cause cerebral dysgenesis. So it is a significant public sanitation problem affecting the population quality. Since 1995, China has taken comprehensive prevention and cure measures with Universal Salt Iodization (USI) as the core, and has made great achievements in eliminating the harm of IDD. However, this effort is unbalanced. Up to now, there are still four provinces (Autonomous Region) (Tibet, Xinjiang, Qinghai and Hainan) that have not achieved the goal of eliminating IDD. Except Hainan, the other three provinces (Autonomous Region) are all in the western part of China. In particular, the fact that Reemerging Cretinism cases were found in Xinjiang in 2006 suggests that although we have achieved the goal of eliminating IDD at the national level, the remote and impoverished western area is still facing serious threat of Iodine Deficiency. It will be the top priority of IDD prevention in our country.Although a lot of measures have been taken for IDD prevention in the western area, including implementing social advocacy and health education on May 15^th each year, spreading relevant knowledge of IDD to the public through various means, and launching health promotion and comprehensive intervention programs, etc., however, due to various factors like relatively backward economy and concentration of minority nationality, the western area is still far from achieving the 2010 goal of IDD elimination. The major problems include the lack of effective Iodized Salt promotion strategy, the high price of Iodized Salt, the imperfect sales network, and the weak consciousness of IDD prevention among the residents. If we don't understand the obstacles for the popularization of Iodized Salt and look for solutions, more cases of Reemerging Cretinism and Sub-clinical Cretinism will inevitably appear. So it is necessary to evaluate the past and present policy and measures of the three western provinces to eliminate IDD and understand the obstacles affecting the coverage rate of Iodized Salt.This research combines qualitative analysis with quantitative analysis. On the basis of the review of second-hand materials, the researcher conducted face-to-face interviews with leaders of Development and Reform committees, financial, commercial, public health and salt industry departments; questionnaire survey of personnel in salt industry and public health departments; household survey of high risk counties. Through the investigation and research, we recognized that three contradictions affect the popularization of Iodized Salt: 1) high salt price vs. low income; 2) health knowledge vs. traditional living habits; 3) convenience of the getting crude salt vs. inconvenience of getting Iodized Salt. To achieve the goal of eliminating IDD in 2010, the three western provinces must take effective countermeasures to solve the above contradictions, among which the price of Iodized Salt is a vital element. If the residents in the western area can afford to buy Iodized Salt through government subsidies and transfer of profits of salt industry, it will be a milestone for achieving the goal of IDD elimination. Finally, the research put forward strategies and measures for solving difficult and important problems facing the three western provinces, which can also provide lessons for IDD prevention in other provinces.