The current performance indicator for universal salt iodisation (USI) is the percentage of households using adequately iodised salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the Global Alliance for Improved Nutrition (GAIN)-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodised salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodised salt in selected food products was modelled according to the formula: quantity of salt per unit of food product × minimum regulated iodine level of salt at production × average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodised salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodised salt use in the food industry in order to achieve optimal population iodine status.

The Philippines has adopted policies to protect, promote, and support breastfeeding on par with global standards, yet the impact of these policies is not well understood. This study assesses the adequacy and potential impact of breastfeeding policies, as well as the perceptions of stakeholders of their effectiveness and how to address implementation barriers. This mixed methods study entailed a desk review of policies and documents and in-depth interviews with 100 caregivers, employees, employers, health workers, and policymakers in the Greater Manila Area. Although the Philippines has a comprehensive breastfeeding policy framework, its effectiveness was limited by structural and individual barriers. Structural barriers included inconsistent breastfeeding promotion, limited access of mothers to skilled counseling, limited workplace breastfeeding support, gaps in legal provisions, weak monitoring and enforcement of the Philippine Milk Code, and the short duration and limited coverage of maternity leave. Individual barriers included knowledge and skills gaps, misconceptions, and low self-confidence among mothers due to insufficient support to address breastfeeding problems, misconceptions in the community that undermine breastfeeding, limited knowledge and skills of health workers, and insufficient support extended to mothers by household members. Breastfeeding policies in the Philippines are consistent with global standards, but actions to address structural and individual barriers are needed to enhance their effectiveness for improving breastfeeding practices.

Background: The salt iodization law of the Philippines required that iodized salt sold at retail not be exposed to direct sunlight, high temperature and relative humidity, and contamination with moisture and dust from the environment. However, because the majority of local consumers buy salt displayed in open heaps, it was suggested that iodized salt should be sold in the same manner for greater accessibility and availability. Objective: We aimed to provide evidence on the stability of iodine in local aged and fresh salt iodized at 100 ppm iodine and exposed to various market and storage conditions. Methods: Samples of salt in open heaps and repacked salt were exposed for 4 weeks, and salt packed in woven polypropylene bags was stored for 6 months. The iodine content of the salt was determined by the iodometric titration method, and the moisture content was determined by the oven-drying method. Results: For all types of exposed salt, iodine levels were above 60 ppm after the end of the study (4 weeks). Within each salt type, losses were greater for open-heap salt than for repacked salt. The greatest drop in moisture content occurred in the first week for most types of salt and exposure combinations. Moisture content was linearly correlated with iodine content. Iodine levels in stored salt remained above 60 ppm even after 6 months. Conclusions: Iodized salt is able to retain iodine above the recommended levels despite exposure to an open environment and use of ordinary packaging materials while being sold at retail and kept in storage.

To determine the content, implementation, and effectiveness of policies aimed at improving breastfeeding practices in the Philippines. This study used mixed methods, including a desk review of relevant policies and documents and in-depth interviews with 100 caregivers, workers, employers, health workers, and policymakers. Although the Philippines has a strong regulatory framework to protect breastfeeding, the implementation and effectiveness of breastfeeding policies are limited by structural and individual barriers. Structural barriers include: a lack of consistent breastfeeding promotion, limited access to skilled counselling support from health system to community level, and limited breastfeeding support in workplaces for working mothers. Inappropriate marketing of commercial milk formula, including cross-promotion and engagement of industry representatives with health professionals, persists due to gaps in legal provisions and weak monitoring and enforcement of the Philippine Milk Code. Individual barriers include failure to address early breastfeeding problems, misconceptions that undermine breastfeeding, limited knowledge and skills of health workers and caregivers, and lack of support from family members. Breastfeeding promotion, protection, and support policies in the Philippines are consistent with global standards, but their effectiveness for improving breastfeeding practices can be improved by addressing persistent barriers at the structural and individual levels. Bill & Melinda Gates Foundation (Grant Number OPP50838) and Irish Aid.