This is discussion about Power from below: test kits in the hands of retailers pressure producers to iodize salt.
It’s really interesting how the tool-kits were used to address a very important issue, and we would love to hear more about how you plan on scaling this to other issues related to nutrition. Have you thought about packaging this model to roll out in other countries? What are your plans for sustainability when tool-kits or materials are not free? Also, since this is a volunteer-based program, how do you plan on making this a sustainable initiative? This is a really great initiative, and the strategy is extremely innovative. Thanks for a great entry!
- Naveen Shakir, Ashoka’s Changemakers
thank you, Naveen, for you comments and questions.
regarding scaling this approach to other issues: the test kits are giving only a qualitative indication of the iodine content, not a quantitative. The next issue in Kyrgyzstan is too ensure that iodised salt contains the correct amount of iodine, as most producers still do not add enough iodine. We are about to use the same principle of market power that was used in the test kit approach. We will test regularly samples of all salt producers for iodine content and then publish the results, indicating clearly for the population which salts fulfill the criteria and which not. This should create the same market pressure on producers as with the test kits. Preparations for this strategy are on the way.
Regarding sustainability of the test kit strategy: 1) the Ministry of Health has taken it up to purchase the test kits (the amount needed is small) and 2) the Village Health Committees, whose members distribute the test kits to the retailers, are supported by the governmental health system and exist in 85% of all villages; with this official support they are likely to sustain. Because of these two reasons we think the approach is as sustainable as it can be.
I agree with Naveen and truly applaud you for your strategy and success. Are there examples in other countries that use a similar 'empowerment of retailers to quality test' model?
I would suspect ultimate success depends on consumers demanding the higher quality and being willing to pay for it.
Sub-quality pharmaceuticals are such a large problem throughout the developing world but price is usually the determining factor for both consumers and point of sale retailers. How do you educate consumers or provide incentives to retailers to sell the higher quality salts?
Thank you, David, for your comment. To my knowledge, test kits have only been used for educational and monitoring purposes, not as a tool to create market pressure. I believe that this is what is new in our approach. Of course you need a lot more test kits for this, but they are very cheap. The yearly costs for the whole country of Kyrgyzstan are about 10000 USD.
Regarding consumer demand, our intervention included also large scale testing of salt in households, by volunteers from the Village Health Committees; this had a very strong educational effect, which increased further the already high awareness about iodised salt among Kyrgyz consumers. But the issue remained that fraudulent producers labeled non-iodised salt as iodised. These were driven out of the market by the test kits in retailers' hands. In addition, of course, retailers are realise through this intervention the importance of iodised salt and therefore strive to offer only iodised salt. And consumers buy what is on offer... Retailers don't need incentives to offer the higher priced iodised salt - higher prices=higher profits. But we found that many retailers simply care about offering a healthy product to their communities of which they are a part. For those who don't care - the Village Health Committees keep up the pressure by checking a few packets at the retailers twice yearly.
It would be wonderful if there were such easy test kits for pharmaceuticals...
On January 18, 2010 the judges reviewed the entries for the Changemakers Improved Nutrition: Solutions through Innovation competition and would like to pass on the following feedback (listed below) for your entry. Thank you for applying and for your hard work in the field. We are excited to archive your entry to serve as a leading solution for the worldwide community of innovators. We wish you continued luck with your innovative, sustainable, and socially impactful initiatives.
All the best, The Changemakers Team
“I really liked this initiative and I thought it was quite compelling. It has a lot of potential and it seems like the best way to motivate business and industry from below. However, based off my experience in the field, I have found that testing urinary iodine may be more effective rather than having people testing themselves.”
“The social impact of this initiative is quite high, and it seems to have been quite successful already. The fact that it is government dependent works too, since it’s important to have a monitoring system that is on a national scale. I’m interested in learning more about what the motivation is for retailers.”
- Changemakers Improved Nutrition: Solutions through Innovation Judges
Dear Naveen, thanks for your new comment. Regarding the urinary iodine testing - this is something completely different. It is a laboratory based research tool that can only be applied to a small sample of the population, and it is purely for monitoring/research purposes, not for motivational purposes. Our goal was not research but change.
Using test kits in people's kitchens who then see immediately whether their salt turns blue or stays white, ie. contains iodine or not, is very convincing educationally and creates demand. The question on the motivation of retailers I answered in my previous answer to David's comment. As my entry explains test kits in the hands of retailers are the real change tool that translates people's demand into pressure on whole sellers and producers.