Double Fortified Salt: A Simple Solution to Combat Anaemia

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Key takeaways

The renewed 7X7X7 Anaemia Mukt Bharat (AMB) strategy targets anaemia, which currently affects over 50% of Indian women and nearly 75% of children.
Double Fortified Salt (DFS) combines iodine and iron into everyday salt to bypass the low compliance rates of traditional iron-folic acid pills.
Central rules make DFS mandatory in child schemes like PM POSHAN and ICDS, but its distribution via the Public Distribution System (PDS) to 800 million citizens remains uneven.
Manufacturing DFS requires advanced encapsulation techniques to avoid food discoloration and must include pre-screening in tribal areas to protect people with Sickle Cell Disease or Thalassemia.

The Indian government has renewed its 7X7X7 Anaemia Mukt Bharat (AMB) strategy to focus on underused health interventions.
This renewed strategy highlights Double Fortified Salt (DFS) as an affordable and scalable solution to solve iron deficiency across the country.

Anaemia is a major health issue where the body lacks enough healthy red blood cells or hemoglobin to carry oxygen to tissues.
It currently affects over 50% of Indian women and nearly 75% of children across the nation.
This widespread health problem increases maternal mortality, slows mental growth in children, and passes poor nutrition down through generations.

Double Fortified Salt is everyday edible salt mixed with two key nutrients: iodine and iron.
The iodine prevents goiter and mental disabilities, while the iron fights off microcytic iron-deficiency anaemia.
People consume salt daily in steady amounts regardless of income, so DFS works better than traditional iron pills.

The Food Safety and Standards Authority of India (FSSAI) sets strict rules for making and mixing Double Fortified Salt.
These standards require using special iron compounds like encapsulated ferrous fumarate or ferric pyrophosphate to stop food from darkening or losing iodine.
Central guidelines mandate using DFS in key child feeding schemes like PM POSHAN for schools and ICDS for young children.
The 7X7X7 Anaemia Mukt Bharat strategy guides these efforts by connecting 7 beneficiary groups, 7 interventions, and 7 institutional mechanisms.
India uses its existing Universal Salt Iodisation system, which already reaches 95% of homes with refineries and testing labs.

The Public Distribution System (PDS) reaches about 800 million citizens, but states must choose and fund whether to give out DFS.
Because of this financial choice, only a few states distribute DFS through local fair-price shops today.
Early versions of this salt caused food to turn dark or change taste because raw iron reacted with iodine.
This bad taste and dark color caused some rural families to stop using the salt during early field trials.
Giving extra iron without testing can harm people who carry blood conditions like Thalassemia major or Sickle Cell Disease.
Programs under the National Sickle Cell Anaemia Elimination Mission must mark salt packages carefully in tribal areas.
Private shops mostly sell plain iodized salt, while high-quality DFS stays expensive or hard to find in regular markets.
Health officials struggle to promote iron-fortified salt while also asking people to eat less total salt to prevent high blood pressure.

The government should add DFS directly to the central National Food Security Act (NFSA) to help pay for state distribution costs.
Factories should focus salt processing in main coastal states like Gujarat and Tamil Nadu to keep quality high and costs low.
Producers must use strong packaging and lipid-coated ferrous fumarate to shield salt against moisture and color changes.
Local health workers should test families for Sickle Cell traits so affected people receive safe, non-fortified salt options.
Community workers like ASHA and Anganwadi staff should run cooking tests to show families that the salt is safe to use.

Double Fortified Salt offers an effective way to fix national iron deficiency without relying on daily medicine pills.
Expanding this program across the nation requires combining regular PDS sales with strict quality controls.
Scaling up DFS will help India achieve an Anaemia Mukt Bharat and set an example for other developing nations.