Salt Fortification

Fortification of salt is recognised as one of the most cost-effective methods to tackle deficiency of iron and iodine as it is universally consumed by all income groups and age segments. Double fortified salt (DFS) is a form of table salt manufactured with added iron and iodine. When consumed in regular cooking, it can help overcome iron deficiency (anaemia) and iodine deficiency disorders.

The Trusts-supported DFS interventions in the government’s mid-day meal, Integrated Child Development Services (ICDS) and public distribution services programmes have benefitted around 16 million people in Uttar Pradesh, about 3 million in Tamil Nadu, almost 12 million in Andhra Pradesh, around 12 million in Madhya Pradesh, about 26 million in Jharkhand, more than 0.6 million in Maharashtra and around 3 million in Gujarat, in addition to Dadra and Nagar Haveli.

The Tata Trusts have led critical innovations in double fortified salt outreach across the country:

  1. Developing and supporting the salt refinery at the Tamil Nadu Salt Corporation (TNSC): The Trusts have helped the Tamil Nadu Salt Corporation set up a salt refinery that includes a salt fortification plant, for providing the formulation of double fortified salt to the three southern States of Andhra Pradesh, Karnataka and Tamil Nadu. Sold under the Amma Salt brand, the salt manufactured at the TNSC includes DFS, crystal iodised salt, refined free flow iodised salt and low sodium salt.

Previously, salt manufactured by the TNSC was of industrial grade, and any requirements for refined salt at the corporation were met from external sources. Consequently, in-house production of refined salt has helped ease the burden associated with external procurement.

  1. Ensuring the roll-out of double fortified salt via the targeted public distribution system (TPDS):  The Trusts have been a key partner to states such as Andhra Pradesh, Jharkhand, Madhya Pradesh, Maharashtra, and Uttar Pradesh that supply double fortified through the targeted public distribution system.

Specifically, in Uttar Pradesh, the Trusts in partnership with the state government, have ensured a major roll out of the double fortified salt programme. The result is that now, ten districts in the state are being provided DFS through the targeted public distribution system machinery. The population in these two districts is around 24 million and is under the grip of anaemia with critical levels of iron deficiency.

A base-line study was conducted in 2017-2018 in five intervention-led and five control districts in the state, which evidenced that 53.1% of children under the age of five and 36% of women of reproductive age were anaemic. Iron deficiency was identified as the major cause of anaemia in these instances. Such staggering levels of anaemia in the target group offers significant scope for intervention. An end-line survey is proposed to be conducted after a year of continuous usage of double fortified salt amongst TPDS beneficiaries, to assess its impact in addressing iron deficiency anaemia.   

The objective of the DFS programme in Uttar Pradesh is not just the introduction of the fortified salt through the targeted public distribution system. It also aims to ensure sustained availability of DFS at fair price shops and dissemination of greater knowledge and awareness about the benefits of DFS consumption. To achieve this objective, Tata Trusts conducts regular trainings on behavioural change communication to auxiliary nurse midwives and accredited social health workers (ASHAs) and to fair price shop owners. In addition, spot checks are frequently conducted by the Tata Trusts team to ensure that both the shop owners and TPDS beneficiaries are in regular receipt of double fortified salt stocks.

The state government has extended an approximate subsidy of Rs 25 crore annually for a period of two years, to enable double fortified salt to be distributed affordably at prices 30-60% cheaper than that of iodised salt sold through retail. 

16 million beneficiaries are currently being served in Uttar Pradesh under the Targeted Public Distribution System (TPDS).

An approach similar to that of Uttar Pradesh is followed in Andhra Pradesh to ensure that double fortified salt is supplied through the targeted public distribution system to 13 districts. The salt in this instance is procured through the DFS plant at the TNSC that the Trusts have helped set up at Valinokkam, Tamil Nadu and targets 12 million beneficiaries.

In Maharashtra, the Trusts have played a pivotal role in sourcing the Encapsulated Ferrous Fumarate (EFF) formulation of double fortified salt through the open market and introducing it within the targeted public distribution system framework. This variety of the fortified salt is marketed in retail channels under the brand ‘Nutri Nation’ and the Trusts have supported its introduction through the TPDS machinery in six districts in the state, impacting approximately 2 million beneficiaries. In contrast to the model followed in Uttar Pradesh, even non-TPDS beneficiaries have the option to purchase double fortified salt from fair price shops where the salt is retailed at Rs14 per kg. No government subsidy is extended in dissemination of Nutri Nation through TPDS in Maharashtra. As testimony to the potential of the transformative impact the supply of double fortified salt can have through TPDS, Tata Trusts is supporting a proposal for scaling it up in all districts of Maharashtra.       

In Madhya Pradesh, double fortified salt has been introduced in 89 blocks through the targeted public distribution system in the state, targeting a group of approximately 10 million people. These are people who have not only had high anaemia levels, but also belong to impoverished backgrounds, with scant access to resources. All ration card holders (under the PDS scheme) are provided with DFS at Rs1 per kg.

In Jharkhand, DFS outreach has touched 26 million people throughout the State. The programme has ended on March 2019. All ration card holders were provided with DFS at Rs1 per kg in the state. 

  1. Introducing double fortified salt into existing nutrition programmes: Despite strong Government directives for the use of double fortified salt   in the Integrated Child Development Services (ICDS) and mid-day meals programmes, it is a relatively untapped avenue for DFS distribution. As of now, the Trusts are supporting introduction of double fortified salt through the ICDS and mid-day meal schemes in 8 districts in Tripura, targeting nearly 1 million beneficiaries in nearly 6500 schools. In addition, several government hospitals and tribal hostels have also been served DFS. 
  1. Providing double fortified salt for open market retail: Through the Rajiv Gandhi Mahila Vikas Pariyojana (RGMVP) in Uttar Pradesh, the Tata Trusts are providing salt in the open market through retail channels. While this initiative started on a pilot basis, covering 6 blocks, it has since expanded to include 25 blocks.

This is significant as there is a substantial segment of the population outside of the TPDS machinery that also suffers from iodine and iron deficiencies – the two micronutrients present in DFS. This population can source double fortified salt through the open market. Tata Trusts are also in discussion with some leading private-sector stakeholders to undertake DFS manufacture, so that the benefits of fortified salt consumption can be taken to a larger group of people.

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