Trends in Household Salt Iodization and Program Monitoring under the National Iodine Deficiency Disorders Control Programme in Birbhum, West Bengal, India: 2020-2022.

Background Universal salt iodization is the cornerstone strategy for the prevention and control of iodine deficiency disorders. This study assessed trends in the household availability of adequately iodized salt and evaluated program monitoring performance under the National Iodine Deficiency Disorders Control Program (NIDDCP) in Birbhum district, West Bengal, India. Methodology We conducted a retrospective analysis of routine NIDDCP monitoring data using monthly reports from the District Integrated Disease Surveillance Programme (IDSP) Cell, Birbhum Health District. Data for the period from January 2020 to September 2022 were provided by the Birbhum Health District IDSP Cell with permission for analysis and were analyzed accordingly. Indicators assessed included ASHA participation, household salt sample collection, achievement of monitoring targets, the proportion of tested salt samples with an iodine concentration ≥15 ppm, and block-wise program performance. Descriptive analysis was performed using Microsoft Excel 2019. Results The number of Accredited Social Health Activists (ASHAs) engaged in household salt sample collection increased from 1,514 in 2020 to 1,676 in 2021 and 1,724 in 2022. Program performance varied across blocks, with some areas consistently achieving monitoring targets while others showed interruptions and fluctuations. Iodine adequacy among tested salt samples remained high across the district, with Suri I, Suri II, Khoyrasole, and Suri Urban Local Body achieving 100% adequacy. At the district level, 623,532 (95.38%) of 653,765 tested household salt samples had an iodine concentration ≥15 ppm during January-September 2022. Routine salt sample collection was interrupted in several blocks during 2020 and early 2021, with collection resuming during the later observation period. Conclusions Routine NIDDCP monitoring in Birbhum district demonstrated sustained high iodine adequacy in tested household salt samples despite operational disruptions during the COVID-19 pandemic. Strengthening routine surveillance systems, ensuring continuity of community-based monitoring, and utilizing program-generated data for decision-making are essential to sustain progress toward elimination of iodine deficiency disorders.