Develop an Intervention to adress limitations

I will send you 3 documents which are:

The assignment 1 & 2 you previously did and question outline to guide your writing.

GLOBAL NUTRITION AND FOOD SECURITY
QUESTION
Development of Intervention Strategy
In Assignment 1 you selected and described a population nutrition deficiency/disease. In
Assignment 2 you critiqued an existing intervention that addresses the condition, where you
would have identified limitations/gaps in the existing intervention. For example, this may
have been in relation to unreached population groups, a lack of sustainability, or other
constraints.
For this assignment 3, you are to develop an intervention strategy designed to address
the limitations/gap that you identified from Assignment 2. Your proposed intervention
should be written as a structured report.
Your Intervention report should have:
1. Introduction
Concise introduction to your topic and report.
2. Background (10 marks)
Your report is to first present the background and justification for your intervention strategy
•
•
•
Summary/overview of the diet-related disease/deficiency from your Assignment 1
Summary/overview of the critique of the existing intervention from your Assignment 2
Gap/limitation you identified from your AT2 critique. Identify target population, food source,
etc. as appropriate
In this section you will need to summarise key points from your Assignment 1 and
Assignment 2 to provide enough information to introduce and discuss your proposed
intervention. Do not copy and paste sections from your Assignment 1&2.
Note that the main body of this report are the proposed intervention and evaluation
framework sections. You have previously detailed the background section from your
Assignment 1&2, so this section needs to be a paraphrase of what you have previously
presented.
3. Proposed intervention (20 marks)
Having previously (in Assignment 2) critically analysed an existing intervention that has
already been implemented, you need to consider both the strengths and weaknesses of the
intervention. You are then to develop another intervention that addresses these limitations.
Your response here should include:
•
•
•
•
•
•
Aim of the intervention strategy
Significance of the proposed intervention
A description of the proposed intervention – including population and intervention type
An outline/description of the method of delivery
An acknowledgement of the strengths of the intervention analysed in Assignment 2 that
you would retain in the proposed intervention
A description of the weaknesses that are being addressed in the proposed intervention
e.g. including community involvement, engagement or cultural relevance as appropriate
4. Evaluation (10 marks)
You are then to describe an evaluation of your proposed intervention.
•
Identify the type of evaluation and select an appropriate evaluation framework tool, e.g.,
Program logic, RE-AIM, AIFS evaluation guide
•
•
Links to an external site.
Use the parameters of the tool to describe and discuss how the evaluation will determine
effectiveness of the intervention according to the aim of your intervention strategy
5. Conclusion & References
Finally, your report will provide a brief conclusion in which you should concisely summarise
the key points of your report; all references used should be relevant to the topic.
Length: 2,500 words +/- 10% (including in-text references, but excluding the end
reference list). Referencing style: APA 7, a citation should be provided
upon every mention of an idea, statistic, concept, argument, etc. that has
come from someone other than yourself.
Formatting:
•
•
•
•
•
Microsoft Word document (not PDF)
Report writing
1.5 line spacing
Normal margins
Font 12/ Times New Roman
PLEASE STRICTLY FOLLOW THE CRITERION 1-7 STATED BELOW WHEN
WRITING YOUR REPORT.
CRITERION 1- SUCCINCT
INTRODUCTION
TO
THE
REPORT
(APPROX. 100 WORDS)
–
Please excellently write a concise and informative introduction
•
–
Underpinned by the scientific literature
Please, include citations for all key statement
CRITERION 2- BACKGROUND: SUMMARY OF DIETARY RELATED
ISSUE; SUMMARY OF INTERVENTION CRITIQUE. LIMITATION TO
ADDRESS. (APPROX. 600 WORDS)
–
Please excellently write an informative and clear background.
Excellently present a considered argument
Excellently support argument by adequate and appropriate evidence.
•
Underpinned by the scientific literature
– Please, include citations for all key statement
CRITERION 3- PROPOSED INTERVENTION: INTERVENTION AIM
AND SIGNIFICANCE. DESCRIPTION OF INTERVENTION, TARGET
POPULATION, METHOD OF DELIVERY, STRENGTHS
ACKNOWLEDGED AND WEAKNESSES ADDRESSED. (APPROX. 1,200
WORDS)
•
Please excellently write a Clear and appropriate aim & significance.
Excellently describe the intervention
Excellent consideration of the target population
What is the intervention type and method of delivery?
Excellently consider the strengths and weaknesses with higher-order critical thinking
and analysis.
Underpinned by the scientific literature
–
Please, include citations for all key statement
CRITERION 4- EVALUATION FRAMEWORK (e.g. RE-AIM, Program
Logic, etc.): CHOOSE APPROPRIATE FRAMEWORK; CLEAR
DISCUSSION OF OUTCOMES AND EFFECTIVENESS.
–
Please write an excellent evaluation framework; Very clear, with higher-order
critical thinking and analysis.
Underpinned by the scientific literature
CRITERION 5- SUCCINCT CONCLUSION AT END OF REPORT.
(APPROX. 100 WORDS)
•
Please excellently provide a concise and informative conclusion.
Underpinned by the scientific literature
CRITERION 6- SCIENTIFIC WRITING, FORMATTING, GRAMMAR,
PUNCTUATION, AND SPELLING:
•
Very high quality of scientific writing, logical, clear and eloquent; and meets word limit
and formatting requirements. There are no errors with grammar, spelling, punctuation, and
meaning is easily discernible. The essay should read without interruption.
-Avoid padding (‘each and every…’ …’both positive and negative’’)
CRITERION 7- REFERENCES AND REFERENCING:
•
References used should be credible, relevant, and of high quality. Mixed use of published
books, peer-reviewed scientific journal articles, high quality databases, and/or
reports. APA 7 referencing should be accurate in all instances. All statements of fact and
ideas taken from elsewhere should be referenced. Use Wide range of references, at least
up to 45 references and above.
-A Citation per Key Statement.
SUMMARY
The Report must contain:
•
Introduction
o
Background including summarised key points from your Assignment 1&2 to
provide enough information to introduce and discuss your proposed intervention
o
Proposed intervention: including an intervention that addresses the limitations
pointed out in assignment 2.
Evaluation: Including selecting an appropriate evaluation framework tool, e.g
RE-AIM or program logic
Conclusion
References
•
•
•
• High quality presentation, in terms of format, meeting general requirements for
task; coherence of expression; and adherence to conventions of writing (spelling,
grammar, length) and referencing
Tips:
(1) Where appropriate, use sub-headings that align with the criterion.
(2) You can also include graph, image or statistical data if need be.
(3) Gauge the number of words and emphasis to use for each section.
ASSIGNMENT 1
TITLE:
A WRITTEN REPORT ON A CHOSEN
DIET-RELATED DISEASE
Introduction
Iodine deficiency is when a person’s mineral intake falls short of what their body
requires (Bashar & Begam, 2020). Iodine is essential for producing thyroid hormones, which
regulate metabolism, growth, and development. Iodine shortage can impair the thyroid’s ability
to produce hormones and result in several other illnesses (Triggiani et al., 2009). This report
will explore iodine deficiency, its aetiology, epidemiology, and determinants of the diet-related
condition, along with critical dietary sources, at-risk populations, and factors.
Aetiology of the Deficiency
The fundamental factors and systems responsible for the body’s insufficient iodine
availability are referred to as the aetiology of iodine deficiency. It is typically brought on by
consuming too few or too many iodine-deficient meals (Hatch-McChesney & Lieberman,
2022). Iodine is a crucial ingredient for synthesizing thyroid hormones; therefore, a deficiency
can affect the thyroid’s functionality and cause various health issues (Sabatino et al., 2021).
The primary dietary supply of iodine is iodized salt (Medin et al., 2020). Physical location, the
amount of iodine in the soil, the supply of food, food choices, and customs are all aspects that
might contribute to iodine scarcity.
Epidemiology of the Deficiency
The extent of iodine shortage determines how frequently goiters occur (Winder et al.,
2022). Goiter occurs 5% to 20% of the time in people with modest iodine insufficiency (Gizak
et al., 2017). According to Hatch-McChesney and Lieberman (2022), moderate insufficiency
ranges from 20% to 30%, while severe deficiency is over 30%. Iodine deficiency constitutes
one of the most prevalent nutritional deficits, affecting 35–45% of the global
demographic (Hatch-McChesney & Lieberman, 2022). These epidemiological markers aid in
pinpointing areas with the highest rates of iodine shortage and directing measures to lessen its
effects (Awuchi et al., 2020).
Iodine deficiency is still a significant problem for worldwide overall health, especially
in specific areas (Toloza et al., 2020). The regions with the fewest options for iodine-rich foods
are frequently impacted. Examples of sub-Saharan African nations with high prevalence rates
of iodine deficiency include Ethiopia, Kenya, and Nigeria (Harika et al., 2017). The main focus
in these areas is the implementation of salt iodization initiatives, which entail iodizing table
salt to guarantee that the populace consumes enough of it (Lei et al., 2023). Tracking the
frequency and severity of iodine deficiency in these locations aids in evaluating the success of
such solutions and directing additional problem-solving tactics (Zimmermann & Andersson,
2011).
The prevalence of iodine insufficiency is considerably lower in more developed nations
due to the better availability of foods high in iodine and the adoption of effective public health
initiatives (Vanderpump, 2019). Nevertheless, there might still be some areas of iodine deficit,
especially in smaller populations (Hatch-McChesney & Lieberman, 2022). Owing to the
heightened iodine need for developing the fetus’s brain, pregnant women are, for example,
regarded as a vulnerable category in the United Kingdom (Hatch-McChesney & Lieberman,
2022). Iodine deficiency in these groups is being monitored, allowing for specific approaches
such as encouraging iodine supplements during pregnancy or increasing public knowledge of
iodine-rich dietary sources (Kayes et al., 2022).
Food Sources Which Contribute To the Presentation of the Deficiency
Iodine shortage can manifest itself from several dietary sources. Iodine deficiency in
some dairy and plant-centered diets is one cause for this (Alzahrani et al., 2023). According to
Kumar and Hemantaranjan (2017), vegetables cultivated on iodine-deficient soil may have low
iodine concentrations. Furthermore, if cows are not provided iodine-rich nutrition, dairy
products like milk and cheese may not be suitable suppliers of the mineral (Witard et al., 2022).
Consuming foods that cause goiter, which obstructs the ingestion of iodine, is another source.
These meals include soy-based items along with cruciferous vegetables (Wojtas et al., 2019).
Groups Most At Risk of the Deficiency
Pregnant women are the first group to be at risk for iodine deficiency (Kanike et al.,
2020). The need for iodine rises markedly throughout pregnancy to sustain fetal brain
development (Delshad & Azizi, 2020). Iodine deficiency at this time might cause cognitive
problems in the kids, resulting in lower intelligence levels and learning difficulties (Bailote et
al., 2022). Making dietary changes or adding iodine supplements is essential (Brown et al.,
2020). Individuals living in areas with low soil and water iodine concentration make up the
second category of people at risk. Soils in some places are frequently poor in iodine, especially
those that are inland or hilly (Hastuti et al., 2021). As a result, the native livestock and crops
may have less iodine in these regions (Kumar & Hemantaranjan, 2017). Individuals who rely
primarily on locally produced foods from these areas are more likely to have iodine
deficiencies. Adopting iodine fortification initiatives, like encouraging the consumption of
iodine-rich foods or iodized salt, can help reduce this danger while boosting these people’s
iodine levels (Iacone et al., 2021).
Determinants of Deficiency
Iodine deficiency determinants are the various factors that affect the prevalence and
occurrence of iodine deficiency in a community (Torheim et al., 2005). Social, cultural,
economic, and environmental elements can be used to classify these influences reasonably
(Yevglevsky & Gostev, 2021). Regarding social and cultural influences, a lack of
understanding of the value of iodine in the food we consume might cause iodine insufficiency;
this can be ascribed to a lack of accessibility to medical care and educational programs, along
with cultural norms and behaviors that place a low priority on iodine-rich dietary sources (Bath,
2019).
Financial limitations may prevent people or groups from buying iodine-rich meals or
iodized salt, which is a problem from an economic standpoint. Economic variables like
joblessness or poor income may impact the pricing and accessibility of these iodine sources
(Gatseva & Argirova, 2011). Iodine accessibility in the environment, which has an immediate
influence on its inclusion in the food chain, is the fundamental concept (Delange, 2002).
Consuming iodine-rich meals cultivated in iodine-rich soil is the major way to get iodine (Rami
et al., 2022). Iodine deficiency in the soil causes low iodine levels in the grown plants, which
affects the area’s demographics’ iodine consumption (Kumar & Hemantaranjan, 2017).
Conclusion and Intervention Statement
In conclusion, iodine insufficiency is mainly caused by inadequate ingestion of foods
high in iodine. Iodine deficiency must be addressed using an extensive plan incorporating
social groups and people. Table salt is now fortified with iodine in the United Kingdom to
prevent iodine deficiency (World Health Organization, 2014). It guarantees that those who
routinely use salt get this vital mineral properly by reinforcing salt with iodine (Shields &
Ansari, 2021). Because it provides a practical and affordable method to boost iodine
consumption, this intervention successfully avoids and treats iodine insufficiency in people.
References
Alzahrani, A., Ebel, R., Norton, G., Raab, A., & Feldmann, J. (2023). Iodine in plant-based
dairy products is not sufficient in the UK: A market survey. Journal of Trace Elements
in Medicine and Biology, 79, 127218. https://doi.org/10.1016/j.jtemb.2023.127218
Awuchi, C. G., Igwe, V. S., & Amagwula, I. O. (2020). Nutritional diseases and nutrient
toxicities: A systematic review of the diets and nutrition for prevention and treatment.
International Journal of Advanced Academic Research, 6(1), 1-46.
Bailote, H. B., Linhares, D., Carvalho, C., Prazeres, S., Rodrigues, A. S., & Garcia, P. (2022).
Iodine Intake and Related Cognitive Function Impairments in Elementary
Schoolchildren. Biology, 11(10), 1507. https://doi.org/10.3390/biology11101507
Bashar, M. A., & Begam, N. (2020). Role of dietary factors in thyroid disorders: Current
evidences and way forwards. Thyroid Research and Practice, 17(3), 104-109.
https://doi.org/ 10.4103/trp.trp_7_20
Bath, S. C. (2019). The effect of iodine deficiency during pregnancy on child development.
Proceedings
of
the
Nutrition
Society,
78(2),
150-160.
https://doi.org/10.1017/S0029665118002835
Brown, K., von Hurst, P., Rapson, J., & Conlon, C. (2020). Dietary choices of New Zealand
women
during
pregnancy
and
lactation.
Nutrients,
12(9),
2692.
https://doi.org/10.3390/nu12092692
Delange, F. (2002). Iodine deficiency in Europe and its consequences: an update. European
Journal
of
Nuclear
Medicine
and
https://doi.org/10.1007/s00259-002-0812-7
Molecular
Imaging,
29,
S404-S416.
Delshad, H., & Azizi, F. (2020). Iodine nutrition in pregnant and breastfeeding women:
sufficiency,
deficiency,
and
supplementation.
Hormones,
19(2),
179-186.
https://doi.org/10.1007/s42000-019-00160-2
Gatseva, P. D., & Argirova, M. (2011). Public health: the science of promoting health. Journal
of Public Health, 19, 205-206. https://doi.org/10.1007/s10389-011-0412-8
Gizak, M., Gorstein, J., & Andersson, M. (2017). Epidemiology of iodine deficiency. Iodine
deficiency disorders and their elimination, 29-43. https://doi.org/10.1007/978-3-31949505-7_3
Harika, R., Faber, M., Samuel, F., Mulugeta, A., Kimiywe, J., & Eilander, A. (2017). Are low
intakes and deficiencies in iron, vitamin A, zinc, and iodine of public health concern in
Ethiopian, Kenyan, Nigerian, and South African children and adolescents?. Food and
nutrition bulletin, 38(3), 405-427. https://doi.org/10.1177/0379572117715818
Hastuti, P., Sadewa, A. H., Farmawati, A., Rubi, D. S., & Pramana, A. A. C. (2021).
Hypothyroidism and stunting around the Merapi Volcano. Journal of Community
Empowerment for Health, 4(2), 103-107. https://doi.org/10.22146/jcoemph.61025
Hatch-McChesney, A., & Lieberman, H. R. (2022). Iodine and Iodine Deficiency: A
Comprehensive Review of a Re-Emerging Issue. Nutrients, 14(17), 3474.
https://doi.org/10.3390/nu14173474
Iacone, R., Iaccarino Idelson, P., Russo, O., Donfrancesco, C., Krogh, V., Sieri, S., … &
Minisal-Gircsi Study Group. (2021). Iodine Intake from food and iodized salt as related
to dietary salt consumption in the italian adult general population. Nutrients, 13(10),
3486. https://doi.org/10.3390/nu13103486
Kanike, N., Groh-Wargo, S., Thomas, M., Chien, E. K., Mhanna, M., Kumar, D., & Shekhawat,
P. S. (2020). Risk of iodine deficiency in extremely low gestational age newborns on
parenteral nutrition. Nutrients, 12(6), 1636. https://doi.org/10.3390/nu12061636
Kayes, L., Mullan, K. R., & Woodside, J. V. (2022). A review of current knowledge about the
importance of iodine among women of child-bearing age and healthcare professionals.
Journal of Nutritional Science, 11, e56. https://doi.org/10.1017/jns.2022.50
Kumar, P., & Hemantaranjan, A. (2017). Iodine: a unique element with special reference to
soil-plant-air system. Advances in Plant Physiology, 17, 314.
Lei, C., Tao, X., & Xiao, Y. (2023, May). Dietary Iodine Intake and Related Factors among
Secondary School Students in Macao. In Healthcare (Vol. 11, No. 10, p. 1472). MDPI.
https://doi.org/10.3390/healthcare11101472
Medin, A. C., Carlsen, M. H., & Andersen, L. F. (2020). Iodine intake among children and
adolescents in Norway: Estimates from the national dietary survey Ungkost 3 (20152016). Journal of Trace Elements in Medicine and Biology, 58, 126427.
https://doi.org/10.1016/j.jtemb.2019.126427
Rami, A., Saeid, N., El Mzibri, M., El Kari, K., Idrissi, M., Lahmam, H., … & Aguenaou, H.
(2022). Prevalence of iodine deficiency among Moroccan women of reproductive age.
Archives of Public Health, 80(1), 147. https://doi.org/10.1186/s13690-022-00901-7
Sabatino, L., Vassalle, C., Del Seppia, C., & Iervasi, G. (2021). Deiodinases and the three types
of thyroid hormone deiodination reactions. Endocrinology and Metabolism, 36(5), 952964. https://doi.org/10.3803/EnM.2021.1198
Shields, A., & Ansari, M. A. (2021). Review of experience of the production of salt fortified
with iron and iodine. The Journal of Nutrition, 151(Supplement_1), 29S-37S.
Toloza, F. J., Motahari, H., & Maraka, S. (2020). Consequences of severe iodine deficiency in
pregnancy:
evidence
in
humans.
Frontiers
in
Endocrinology,
11,
409.
https://doi.org/10.3389/fendo.2020.00409
Torheim, L. E., Granli, G. I., Sidibé, C. S., Traoré, A. K., & Oshaug, A. (2005). Women’s
iodine status and its determinants in an iodine-deficient area in the Kayes region, Mali.
Public health nutrition, 8(4), 387-394. https://doi.org/10.1079/PHN2004689
Triggiani, V., Tafaro, E., Giagulli, V. A., Sabbà, C., Resta, F., Licchelli, B., & Guastamacchia,
E. (2009). Role of iodine, selenium and other micronutrients in thyroid function and
disorders. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current
Drug Targets-Immune, Endocrine & Metabolic Disorders), 9(3), 277-294.
https://doi.org/10.2174/187153009789044392
Vanderpump, M. P. (2019). Epidemiology of thyroid disorders. In The thyroid and its diseases:
A comprehensive guide for the clinician (pp. 75-85). Cham: Springer International
Publishing. https://doi.org/10.1007/978-3-319-72102-6_6
Winder, M., Kosztyła, Z., Boral, A., Kocełak, P., & Chudek, J. (2022). The impact of iodine
concentration
disorders
on
health
and
cancer.
Nutrients,
14(11),
2209.
https://doi.org/10.3390/nu14112209
Witard, O. C., Bath, S. C., Dineva, M., Sellem, L., Mulet-Cabero, A. I., Dongen, L. H. V., &
Smeuninx, B. (2022). Dairy as a source of iodine and protein in the UK: Implications
for human health across the life course, and future policy and research. Frontiers in
Nutrition, 9, 800559. https://doi.org/10.3389/fnut.2022.800559
Wojtas, N., Wadolowska, L., & Bandurska-Stankiewicz, E. (2019). Evaluation of qualitative
dietary protocol (Diet4hashi) application in dietary counseling in hashimoto thyroiditis:
Study protocol of a randomized controlled trial. International journal of environmental
research and public health, 16(23), 4841. https://doi.org/10.3390/ijerph16234841
World Health Organization. (2014). Salt reduction and iodine fortification strategies in public
health: report of a joint technical meeting convened by the World Health Organization
and The George Institute for Global Health in collaboration with the International
Council for the Control of Iodine Deficiency Disorders Global Network, Sydney,
Australia,
March
2013.
https://apps.who.int/iris/bitstream/handle/10665/101509/9789241506694_eng.pdf
Yevglevsky, A., & Gostev, A. (2021). Iodine deficiency: socio-economic problems and new
approaches to its solution in veterinary medicine. In BIO Web of Conferences (Vol. 32,
p. 04002). EDP Sciences. https://doi.org/10.1051/bioconf/20213204002
Zimmermann, M. B., & Andersson, M. (2011, April). Prevalence of iodine deficiency in
Europe in 2010. In Annales d’endocrinologie (Vol. 72, No. 2, pp. 164-166). Elsevier
Masson. https://doi.org/10.1016/j.ando.2011.03.023
ASSIGNMENT 2
TITLE:
CRITICAL ANALYSIS OF A CHOSEN
INTERVENTION.
Introduction
Public health issues like iodine deficiency affect worldwide nutrition and health. Iodine
shortage occurs when a person’s mineral intake falls below the body’s needs. Iodine is needed
to make thyroid hormones, which control growth, metabolism and development (Sorrenti et
al., 2021). Thus, iodine deficiency may significantly damage the thyroid glands hormone
production, causing several health problems. As mentioned in assessment 1, iodine
insufficiency is caused by dietary choices, geography, soil iodine levels, and cultural traditions.
It is caused by eating iodine-deficient foods or not enough iodized salt, a vital nutritional supply
(Shanahan et al., 2019). The epidemiological aspect of iodine deficiency examines its
prevalence, causes, and impact on communities. Assessment 1 underscored the global
prevalence of iodine deficiency, affecting a substantial percentage of the world’s population,
particularly in regions with limited access to iodine-rich foods. This epidemiological context
helps identify areas with the highest rates of deficiency, guiding targeted interventions.
Furthermore, determinants of iodine deficiency encompass social, cultural, economic,
and environmental factors that influence its occurrence (Abebaw and Oumer, 2020). As
explored in assessment 1, these determinants can range from a lack of awareness about iodine’s
importance to economic constraints that hinder access to iodine-rich sources. This assessment
2 delves deeper into the critical analysis of an intervention aimed at mitigating iodine
deficiency, building upon the foundational knowledge presented in assessment 1.
Description of the Chosen Intervention
The chosen intervention to address iodine deficiency is iodized salt fortification. This technique
adds iodine to table salt, making it a vital mineral supply.
Aims and Objectives: Iodized salt fortification aims to maintain a constant and adequate
iodine consumption. Increasing diet iodine levels prevents iodine deficient illnesses including
goiter and intellectual deficits (Pearce and Zimmermann, 2023). The intervention aims:
1. Improve thyroid function: Iodized salt supports thyroid hormone production, which is
essential for metabolism and wellness.
2. Goiter, a visible sign of severe iodine deficiency that may cause physical pain and
health issues, can be reduced by iodized salt fortification.
Target Population: The whole community is targeted for iodized salt fortification since iodine
deficiency affects all ages and ethnicities (Vatandoust & Diosady, 2022). However, pregnant
women and children are at greater risk of iodine shortage owing to increased iodine needs
during pregnancy and development.
Type/Design of the Intervention and Method of Delivery: Iodized salt fortification is a
passive intervention that integrates easily into existing dietary habits (Farebrother et al., 2019).
It involves the following key components:
1. Iodization Process: Salt producers or manufacturers add a predetermined amount of
iodine to table salt during the production process. Iodine is commonly supplied as
potassium iodide or iodate.
2. Packaging: Iodized salt is packaged and sold via retail channels, making it accessible
to customers.
3. Public Awareness Campaigns: Public health authorities also promote iodized salt and
its use in cooking.
4. Monitoring and Regulation: Government agencies and health organizations monitor
the quality and iodine content of salt in the market to ensure compliance with
recommended standards.
Effectiveness of the Chosen Intervention
Iodized salt fortification has proven to be an effective and globally recognized intervention in
addressing iodine deficiency (Desta et al., 2019). Iodized salt fortification is a cost-effective,
durable, and scalable population-level strategy that prevents and controls iodine deficiencyrelated health concerns.
1. Significant Iodine Deficiency Reduction: Iodized salt fortification has reduced iodine
deficiency in several research and public health reports. The strategy enhanced thyroid
function by increasing iodine consumption.
2. Improved Thyroid Health: Iodized salt fortification has led to a significant decrease
in the prevalence of goiter, a visible indicator of severe iodine deficiency (AguilarPérez et al., 2023). By ensuring an adequate iodine supply, the intervention has
contributed to healthier thyroid function and, by extension, overall well-being.
3. Ease of Implementation: Iodized salt fortification is relatively straightforward to
implement, as it utilizes existing salt production and distribution channels (Larson et
al., 2021). This simplicity facilitates widespread adoption and ensures that the
intervention reaches a broad segment of the population.
4. Cost-Effective: The cost of adding iodine to salt is minimal, making it an economically
viable intervention (Shields, and Ansari, 2021). It does not substantially increase the
price of salt for consumers, ensuring affordability.
Community Involvement, Engagement, and Cultural Relevance
Community Involvement and Engagement: Community participation is crucial to iodized
salt fortification projects. Community engagement varies by geography and public health
program efficacy (Patel et al., 2022). The intervention works better in communities with
significant involvement. Local health professionals and leaders may promote iodized salt,
provide educational seminars, and advocate for its usage (Vatandous et al., 2023). Community
monitoring and reporting of iodized salt non-compliance may assist assure its supply.
Cultural Relevance: The cultural relevance of iodized salt fortification is a critical
consideration, as cultural norms and practices related to salt consumption can vary significantly
across regions (Arab, 2022). In some cultures, salt holds symbolic or traditional importance in
rituals or culinary practices (Ilie, 2023). Therefore, introducing iodized salt must be done with
sensitivity to these cultural nuances. Public awareness campaigns should address these cultural
aspects, emphasizing that iodized salt does not alter the taste or culinary traditions.
Additionally, some cultures may have specific dietary preferences or taboos related to
salt sources (Krasteva and Bogueva, 2021). Understanding these cultural intricacies and
incorporating them into educational materials and communication strategies can enhance the
intervention’s cultural relevance. This approach fosters acceptance and encourages the adoption
of iodized salt while respecting local customs.
Strength of the Evaluation Framework
The evaluation framework employed to measure the impact of iodized salt fortification
interventions has several strengths, but it also presents areas for potential enhancement.
Strengths:
1. Comprehensive Monitoring: The evaluation framework typically includes regular
monitoring of salt iodine content at the production and distribution levels (Ittermann et
al., 2023). This ensures that iodized salt meets the recommended standards,
contributing to the intervention’s effectiveness.
2. Health Outcome Assessment: Many evaluations assess health outcomes such as goiter
prevalence and thyroid function in the target population (Olson et al., 2021). This
allows for a direct measurement of the intervention’s impact on public health.
3. Surveillance Systems: In some regions, surveillance systems have been established to
track iodine status in populations. These systems provide valuable data for evaluating
the intervention’s effectiveness over time (Vargas et al., 2019).
Reliability and Validity:
1. Reliability: The evaluation methods used, such as salt iodine content analysis and
health assessments, are generally reliable when conducted with appropriate quality
control measures (Zimmermann, 2023). However, challenges related to inconsistent
sampling or laboratory procedures may sometimes affect reliability.
2. Validity: The validity of the evaluation framework largely depends on the accuracy of
the measurement tools and indicators. Health outcomes like reduced goiter prevalence
are valid indicators of iodine sufficiency (Gorstein et al., 2022). However, ensuring the
validity of iodine intake assessments in individuals can be more challenging.
Suggestions for Improvement:
1. Long-Term Impact Assessment: Enhancements can be made by conducting longterm impact assessments to measure the sustainability of iodine sufficiency beyond
short-term gains.
2. Community Feedback: Collecting feedback from communities about their
experiences with iodized salt and any challenges they face can inform improvements in
distribution and communication strategies.
3. Regular Quality Control: Ensuring consistent quality control measures in salt
production and iodine content analysis is essential to maintain the reliability of the
evaluation methods.
Intervention Sustainability and Limitations
Sustainability of the Iodized Salt Fortification Intervention: Iodized salt fortification
demonstrates a reasonable degree of sustainability due to several factors:
1. Cost-Effective: The intervention is cost-effective, requiring minimal financial
resources for iodine addition during salt production (Brewer et al., 2020). This
affordability facilitates long-term sustainability, as it does not pose a significant
financial burden on governments or consumers.
2. Integration into Existing Systems: Iodized salt can be easily integrated into existing
salt production and distribution systems. This integration ensures that the intervention
becomes a routine part of the salt supply chain, reducing the risk of discontinuation.
3. Public Acceptance: Over time, public acceptance of iodized salt has grown, leading to
increased demand. As consumers become accustomed to iodized salt, the market
demand for such products remains stable (Pandav, 2019).
4. Health Impact: The demonstrable health benefits of the intervention, such as reduced
goiter prevalence and improved thyroid function, motivate ongoing support from health
authorities and the public (Outzen et al., 2022).
Limitations and Drawbacks: Despite its strengths, the iodized salt fortification intervention
faces certain limitations and challenges:
1. Monitoring and Compliance: Ensuring consistent iodine levels in salt and monitoring
compliance with iodized salt usage can be challenging, especially in remote or
underserved regions with limited oversight (Abdurrahim et al., 2023).
2. Awareness and Behavior Change: Sustained public awareness campaigns are
essential to promote iodized salt adoption continually (Ariyo et al., 2023; Chirsanova
et al., 2020). Behavior change can be slow to occur, and some individuals may still
prefer non-iodized salt.
3. Environmental Impact: There are concerns about the environmental impact of iodized
salt production, such as the disposal of iodine-containing waste (Pénélope et al., 2022).
Managing these environmental aspects is crucial for long-term sustainability
(Shegelman et al., 2019).
Long-Term Effects and Challenges: Maintaining iodine sufficiency over the long term
necessitates ongoing commitment and adaptation to evolving circumstances:
1. Changing Diets: As dietary patterns evolve, especially in urban areas, reliance on
processed foods may increase (Sievert et al., 2019) Ensuring iodine sufficiency in
processed foods becomes critical.
2. Population Growth: As populations grow, the demand for iodized salt also increases
(Ren et al., 2022). Ensuring consistent iodine fortification across a growing population
presents logistical challenges.
3. Economic Factors: Economic fluctuations can impact the affordability and
accessibility of iodized salt, potentially affecting its sustained use.
In conclusion, iodized salt fortification offers a sustainable means of addressing iodine
deficiency, primarily due to its cost-effectiveness and integration into existing systems.
However, challenges related to monitoring, behavior change, and environmental impact must
be addressed to maintain iodine sufficiency effectively over the long term. Continued
commitment, public awareness, and adaptations to changing circumstances are crucial for the
intervention’s lasting success.
References
Abdurrahim, M., Haque, S. E. M., Roy, D. C., Arefin, P., Ruchita, F. F., Sarkar, M. R., &
Faroque, A. (2023). Iodine concentration in edible salt from production to retail level
in Bangladeshi territory: A comparative study following standard regulations. Journal
of
Food
Composition
and
Analysis,
120,
105334.
https://doi.org/10.1016/j.jfca.2023.105334
Abebaw, B., & Oumer, A. (2020). Determinants of iodine deficiency among school age
children in Guraghe Zone, Southwest Ethiopia. International Journal of Public Health,
9(2), 90-96. https://doi.org/ 10.11591/ijphs.v9i2.20387
Aguilar-Pérez, K. M., Ruiz-Pulido, G., Medina, D. I., Parra-Saldivar, R., & Iqbal, H. M. (2023).
Insight of nanotechnological processing for nano-fortified functional foods and
nutraceutical—opportunities, challenges, and future scope in food for better health.
Critical
Reviews
in
Food
Science
and
Nutrition,
63(20),
4618-4635.
https://doi.org/10.1080/10408398.2021.2004994
Arab, R. (2022). Cultural semantics of the ‘salt’word in Persian. International Journal of
Language and Culture, 9(1), 119-150. https://doi.org/10.1075/ijolc.21038.ara
Ariyo, O., Akintimehin, O., Taiwo, A. F., Nwandu, T., & Olaniyi, B. O. (2023). Awareness,
practices and perspectives on ensuring access to ideally packaged iodized salt in
Nigeria. Dialogues in Health, 3, 100148. https://doi.org/10.1016/j.dialog.2023.100148
Brewer, L. C., Fortuna, K. L., Jones, C., Walker, R., Hayes, S. N., Patten, C. A., & Cooper, L.
A. (2020). Back to the future: achieving health equity through health informatics and
digital health. JMIR mHealth and uHealth, 8(1), e14512. https://doi.org/10.2196/14512
Chirsanova, A., Boaghe, E., Capcanari, T., Suhodol, M. N., Deseatnicova, O., Boiştean, A.,
Reşitca, V., & Sturza, R. (2020). Consumer behavior related to salt intake in the
Republic
of
Moldova.
Journal
of
social
sciences(4),
101-110.
https://doi.org/10.5281/zenodo.4296387
Desta, A. A., Kulkarni, U., Abraha, K., Worku, S., & Sahle, B. W. (2019). Iodine level
concentration, coverage of adequately iodized salt consumption and factors affecting
proper iodized salt utilization among households in North Ethiopia: a community based
cross sectional study. BMC nutrition, 5(1), 1-10. https://doi.org/10.1186/s40795-0190291-x
Farebrother, J., Zimmermann, M. B., & Andersson, M. (2019). Excess iodine intake: sources,
assessment, and effects on thyroid function. Annals of the New York Academy of
Sciences, 1446(1), 44-65 https://doi.org/10.1111/nyas.14041
Gorstein, J. L., Bagriansky, J., Pearce, E. N., Kupka, R., & Zimmermann, M. B. (2020).
Estimating the health and economic benefits of universal salt iodization programs to
correct
iodine
deficiency
disorders.
Thyroid,
30(12),
1802-1809.
https://doi.org/10.1089/thy.2019.0719
Ilie, A. (2023). Salt in the Traditions of the Romanians. Notes for the Intangible Heritage in
Dâmbovița County. In Mirrors of Salt: Proceedings of the First International Congress
on the Anthropology of Salt: 20-24 August 2015, ‘Al. I. Cuza’University, Iași, Romania
(p.375). Archaeopress Publishing Ltd.
Ittermann, T., Albrecht, D., Arohonka, P., Bilek, R., De Castro, J. J., Dahl, L., Filipsson
Nystrom, H., Gaberscek, S., Garcia-Fuentes, E., & Gheorghiu, M. L. (2020).
Standardized map of iodine status in Europe. Thyroid, 30(9), 1346-1354.
https://doi.org/10.1089/thy.2019.0353
Krasteva-Blagoeva, E., & Bogueva, D. (2021). Balkan food cultures and traditions. In
Nutritional and Health Aspects of Food in the Balkans (pp. 21-33). Elsevier.
https://doi.org/10.1016/B978-0-12-820782-6.00018-9
Larson, L. M., Cyriac, S., Djimeu, E. W., Mbuya, M. N., & Neufeld, L. M. (2021). Can double
fortification of salt with iron and iodine reduce anemia, iron deficiency anemia, iron
deficiency, iodine deficiency, and functional outcomes? Evidence of efficacy,
effectiveness, and safety. The Journal of nutrition, 151(Supplement_1), 15S-28S.
Olson, R., Gavin-Smith, B., Ferraboschi, C., & Kraemer, K. (2021). Food fortification: The
advantages, disadvantages and lessons from sight and life programs. Nutrients, 13(4),
1118. https://doi.org/10.3390/nu13041118
Outzen, M., Lund, C. E., Christensen, T., Trolle, E., & Ravn-Haren, G. (2022). Assessment of
iodine fortification of salt in the Danish population. European Journal of Nutrition,
61(6), 2939-2951. https://doi.org/10.1007/s00394-022-02826-x
Pandav, C. S. (2019). Iodized Salt Consumption. The Indian Journal of Pediatrics, 86(3), 218219. https://doi.org/10.1007/s12098-019-02893-9
Patel, A., Desai, S. S., Mane, V. K., Enman, J., Rova, U., Christakopoulos, P., & Matsakas, L.
(2022). Futuristic food fortification with a balanced ratio of dietary ω-3/ω-6 omega fatty
acids for the prevention of lifestyle diseases. Trends in Food Science & Technology,
120, 140-153. https://doi.org/10.1016/j.tifs.2022.01.006
Pearce, E. N., & Zimmermann, M. B. (2023). The prevention of iodine deficiency: A history.
Thyroid, 33(2), 143-149.. https://doi.org/10.1089/thy.2022.0454
Pénélope, R., Campayo, L., Fournier, M., Gossard, A., & Grandjean, A. (2022). Solid sorbents
for gaseous iodine capture and their conversion into stable waste forms. Journal of
Nuclear Materials, 563,153635. https://doi.org/10.1016/j.jnucmat.2022.153635
Ren, Z., Wu, W., Li, S., Guo, W., Qi, Y., Shi, N., Qin, Y., Li, X., & Zhang, W. (2022).
Cognition, behavior and demand of iodine nutrition in residents of North China Region
from 2019 to 2020. Wei Sheng yan jiu= Journal of Hygiene Research, 51(4), 556-560.
https://doi.org/10.19813/j.cnki.weishengyanjiu.2022.04.010
Shanahan, D. F., Astell–Burt, T., Barber, E. A., Brymer, E., Cox, D. T., Dean, J., Depledge,
M., Fuller, R. A., Hartig, T., & Irvine, K. N. (2019). Nature–based interventions for
improving health and wellbeing: The purpose, the people and the outcomes. Sports,
7(6), 141. https://doi.org/10.3390/sports7060141
Shegelman, I., Vasilev, A., Shtykov, A., Sukhanov, Y., Galaktionov, O., & Kuznetsov, A.
(2019). Food fortification-problems and solutions. Eurasian Journal of Biosciences,
13(2).
Shields, A., & Ansari, M. A. (2021). Review of experience of the production of salt fortified
with iron and iodine. The Journal of nutrition, 151(Supplement_1), 29S-37S.
Sievert, K., Lawrence, M., Naika, A., & Baker, P. (2019). Processed foods and nutrition
transition in the Pacific: regional trends, patterns and food system drivers. Nutrients,
11(6), 1328.. https://doi.org/10.3390/nu11061328
Sorrenti, S., Baldini, E., Pironi, D., Lauro, A., D’Orazi, V., Tartaglia, F., Tripodi, D., Lori, E.,
Gagliardi, F., & Praticò, M. (2021). Iodine: Its role in thyroid hormone biosynthesis
and beyond. Nutrients, 13(12), 4469. https://doi.org/10.3390/nu13124469
Vargas-Uricoechea, H., Pinzón-Fernández, M. V., Bastidas-Sánchez, B. E., Jojoa-Tobar, E.,
Ramírez-Bejarano, L. E., & Murillo-Palacios, J. (2019). Iodine status in the Colombian
population and the impact of universal salt iodization: a double-edged sword? Journal
of nutrition and metabolism, 2019. https://doi.org/10.1155/2019/6239243
Vatandoust, A., & Diosady, L. (2022). Iron compounds and their organoleptic properties in salt
fortification with iron and iodine: an overview. Current Opinion in Food Science, 43,
232-236. https://doi.org/10.1016/j.cofs.2021.12.007
Vatandoust, A., Krishnaswamy, K., Li, Y. O., & Diosady, L. (2023). Triple fortification of salt
with iron, iodine and zinc oxide using extrusion. Journal of Food Engineering, 339,
111258. https://doi.org/10.1016/j.jfoodeng.2022.111258
Zimmermann, M. B. (2023). The remarkable impact of iodisation programmes on global public
health.
Proceedings
of
the
Nutrition
https://doi.org/10.1017/S0029665122002762
Society,
82(2),
113-119.