While the coincidence with the success of the movie 'Borat' will not pass unnoticed, the NY Times has a profile of a true public health success story for make benefit glorious nation of Kazakhstan.
The article describes the trials and tribulations of adding iodine to the salt supply of the country and the marketing campaign that went along with it. World-wide, the lack of iodine in the diet is the leading preventable cause of mental retardation. In seven years, the combination of product enhancements (adding iodine to table salt) and the use of multiple promotion channels and tactics has resulted in the number of households in Kazakhstan using iodized salt increasing from 29 to 94%. But it wasn't easy (as veterans of water fluoridation efforts will tell you). Among the issues encountered were:
- Industry resistance, fueled by concern over the costs of adding iodine to their product, fear of negative public reaction and lack of awareness of the causal relationship between iodine and brain functioning.
- Private companies who conducted fear-mongering campaigns in the media about the safety of iodized salt and offered the alternative of iodine pills.
- Cardiologists concerned that iodized salt will lead to an increase in consumption and more cases of hypertension (take note that the competition for public health initiatives comes from the 'good guys' too).
The cheap part, experts say, is spraying on the iodine. The expense is always for the inevitable public relations battle.
Social marketing is never invoked in the article, but all the elements are clearly there. As important as the successful introduction of iodized salt are the on-going monitoring and surveillance systems of the salt supply (process evaluation) to sustain the effort and provide quality control.
In the 1999 survey that found stunted children, a smaller sampling of urine from women of child-bearing age found that 60 percent had suboptimal levels of iodine.
“We just did a new study, which is not released yet,” said Dr. Feruza Ospanova, head of the nutrition academy’s laboratory. “The number was zero percent."
Another campaign to add to your list of success stories.
Logo from The International Council for the Control of Iodine Deficiencies Disorders.
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