Effectiveness of health education in promoting the use of iodized salt in Lotkoh, tehsil Chitral, Pakistan.

INTRODUCTION We evaluated the effect of health education on the use of iodized salt in a remote region. METHODS We randomly selected 31 villages in teh Lotkoh tehsil of district Chitral in the North West Frontier Province of Pakistan. We then randomly selected 7 households from each village and inteviewed the eldest women of the family. We also tested samples of salt for iodine concentration at the user's level. RESULTS Eighty-five percent of families (184/217) used iodized salt exclusively. Among the samples population, the Aga Khan Health Services (AKHS) informed 67% about the importance of iodized salt. Shopkeepers and neighbors informed 25%. People informed by AKHS were more likely to know the volatile nature of iodine (76% vs 55%, p < 0.001) and the advantages of iodized salt (91% vs. 75%, p = 0.001) than persons informed by other sources. People who could name any single advantage of iodized salt were more likely to use iodized salt (97%) compared to those who could not name any advantages (62%) (p < 0.001) Iodine concentration in 78% (141/183) samples was acceptable (> or = 15 ppm). One specific brand of salt consistently had sufficient iodine concentration (91%) compared to all others (47%) (p < 0.001). CONCLUSION Health education has been effective in promoting the use of iodized salt in these isolated rural communities. A joint effort by the government, local NGOs and the community can substitute the role of mass media in such areas. Regular evaluation of iodized salt brands should be considered.