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BUCHAREST, Romania, Sept. 12, 2003 — PSI/Romania launched a nationwide campaign in September to increase awareness about the dangers of iodine deficiency disorders (IDDs) and the benefits of using iodized salt, in collaboration with UNICEF and the Ministry of Health. The national campaign, Such a Small Thing for Such a Big Benefit, uses free commercials and messages in the national press, television, radio and billboards to promote the use of iodized salt. IDDs are the single largest cause of preventable brain damage and mental retardation worldwide, according to the World Health Organization. Romania has an overall mild IDD problem, but there are regions within the country where IDD is an endemic disease. Additionally, the campaign focuses on producers and distributors of salt by supporting field workers who make direct contact with each salt sales point, educating shop owners and promoting the sale and use of iodized salt. The current campaign is based on extensive qualitative and quantitative research on salt use completed by PSI in July 2002. UNICEF and Kiwanis International funded the research, which found that overall only 53% of Romanian households have iodized salt, with rates as low as 30% in the northeast region and 42% in the southeast region. Nearly 47% of households were found to be at high risk of moderate to severe IDD because they only consume non-iodized salt. Awareness of the risks of iodine deficiency disorder was found to be very low and knowledge of the benefits of iodized salt even lower. Being an essential micronutrient, iodine is required for normal human development from conception through adulthood and is critical during periods of rapid growth. The nature of IDD puts several population groups at risk: infants, children and women of childbearing age whose iodine status affects fetal development. Iodine is essential for proper fetal and newborn brain development, and a severe lack of iodine can result in congenital hypothyroidism or even fetal death. On average, iodine deficiency results in a loss of 13 intelligence quotient points in adults (Appleton and Lange, 1999). The Such a Small Thing for Such a Big Benefit campaign addresses the primary barrier against iodized salt use - knowledge. PSI/Romania research confirms that there is a general lack of knowledge regarding the dangers of IDD and the benefits of iodized salt, and many Romanians are uninformed or misinformed about the dangers of IDD and the benefits of iodized salt. The campaign uses lively animated sheep, showing the "smart" sheep families using iodized salt, while the other sheep families who don't use iodized salt are shown doing silly and foolish things. The campaign's overall message is: don't be like sheep and do what everybody does; be smart, use iodized salt. Campaign posters show sheep being rained on, with only one sheep protected from the rain with an open umbrella. The header asks, "Why are some better able to stand apart from the flock?" The footer answers, "Iodized salt." Another poster shows sheep sweating profusely under a scorching sun, with only one sheep staying cool with the use of a fan. The header and footer show the same message, "Some are better able to stand apart from the rest because they use iodized salt." With television, radio and billboard ads, as well as extensive work by field agents with shop owners and salt producers and distributors, PSI/Romania is tackling the misconceptions and lack of knowledge people have regarding iodized salt. The PSI/Romania campaign uses promotional strategies that stimulate greater supply and distribution of iodized salt through the private sector. PSI/Romania creates product "push" from the private sector by promoting iodized salt, and balances this with consumer "pull" by creating informed consumer demand. The primary target is adults who make purchasing decisions, but the campaign also reaches salt retailers, local health authorities, NGO outreach promoters, health providers and children. The total effort is self-reinforcing. The campaign increases knowledge of the risks of IDD, helps consumers identify iodized salt easily, gets consumers to associate iodized salt and its benefits and motivates the salt trade and other collaborators to be more proactive in making iodized salt available to consumers. — Daun Fest and Georgia McPeak, PSI/Romania and the Balkans
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