Revitalizing a program with problems
Early progress towards universal salt iodization in Madagascar started on a good footing with mandatory legislation for the iodization of all food-grade salt since 1995. However, between 2006 and 2015, Madagascar’s salt iodization program collapsed due to political and economic instability. In 2014, just 21% of households used iodized salt, and there was deficiency among pregnant and non-pregnant women.
IGN conducted several missions to Madagascar to rebuild national commitment for Universal Salt Iodization (USI) using some $50,000 of donations for this work. Through consultative workshops and technical expertise, IGN worked with government and UNICEF and USAID to create a new policy and action plan for USI in Madagascar.
UNICEF Madagascar
Benefiting 13.8 million people with iodized salt
With a $900,000 investment from USAID, the program is implemented by UNICEF, IGN, and other partners over a 5-year period. Also, IGN facilitated the Japanese donation of a significant initial amount of potassium iodate.
The percentage of households using iodized salt in Madagascar has increased from 21% 2014 to 70% in 2022. This increased access to iodized salt has benefitted 13.8 million people, with an investment of only 6-7 US cents per person. IGN collaborates with UNICEF, as members of the USI-IDD ESA Regional Coordination Mechanism (RCM), to update analysis of salt production, iodization, and distribution to further improve iodine nutrition and eliminate iodine deficiency disorders.
Despite this progress, a 2024 survey found that around 20% of salt is still not iodized, and iodine deficiency persists in some regions, including among pregnant women. Addressing these gaps requires continued monitoring, quality assurance, and support to both producers and government authorities.
UNICEF Madagascar
Safeguarding progress during disruption
Under the USAID-funded UNICEF project, planned training for salt producers and government control agencies was intended to strengthen quality assurance and optimal iodization practices. When the cancellation of USAID programs threatened to halt this work, the Government of Madagascar and UNICEF asked IGN to step in.
With support from the Rapid Response Fund, launched by The Life You Can Save and Founders Pledge, IGN retrained national and provincial government staff, as well as salt producers, on salt quality assessment and quality control, in close collaboration with UNICEF. The training was successful, although a planned follow-up visit to support long-term sustainability had to be postponed due to renewed political unrest.
Another challenge facing the program is the rising cost of potassium iodate, placing it increasingly out of reach for many producers. To address this, IGN is supporting the establishment of a revolving potassium iodate fund. The mechanism allows pooled procurement and sale to producers on a no-profit, no-loss basis, ensuring replenishment over time. To help strengthen the fund, the Japan Industries Association will provide an initial donation of potassium iodate while encouraging national ownership to safeguard iodine nutrition in the future.
UNICEF Madagascar
Impact
Reaching 90% household coverage
Raising awareness of iodine nutrition in Madagascar remains essential to sustaining demand for iodized salt among policymakers and the general population. While recent disruptions have highlighted the fragility of progress, the country remains on a positive trajectory and has the potential to reach 90% household coverage with adequately iodized salt if all large- and medium-scale producers consistently iodize their salt
Programs are continuing, and IGN is working closely with government and partners to ensure that donor investments in Madagascar are optimally used to consolidate recent gains and extend coverage to remaining underserved populations.
UNICEF Madagascar
