Iodine Deficiency Control Programme

A 28-year-old primigravida from rural Bihar attends the antenatal clinic at 20 weeks gestation. She reports no prior iodized salt use and lives in a region with known iodine deficiency. Thyroid-stimulating hormone (TSH) is 8.2 mIU/L (normal <2.5 mIU/L) and free T4 is 0.8 ng/dL (normal 0.8–1.8 ng/dL). The health worker notes that the village has no access to iodized salt distribution. Which of the following best describes the maternal and fetal consequences of untreated iodine deficiency at this stage of pregnancy?

What is the recommended dietary allowance (RDA) of iodine per day for adult non-pregnant women in India according to the National Programme for Prevention and Control of Iodine Deficiency Disorder?

Which of the following is the target level of iodine content in salt as per the Universal Salt Iodization (USI) strategy in India's Iodine Deficiency Control Programme?

A 35-year-old woman from a rural village in Odisha presents to the primary health centre with a 2-year history of progressive neck swelling and difficulty swallowing. On examination, she has a firm, diffuse, non-tender thyroid enlargement (Grade II goitre). She reports that her 8-year-old son has similar neck swelling and poor school performance. Urine iodine excretion is 45 µg/L (normal >100 µg/L). The village has no access to iodized salt. What is the most appropriate immediate public health intervention for this community?

A 35-year-old woman from a rural district in Odisha presents with a 2-year history of progressive neck swelling. She reports fatigue, weight gain despite poor appetite, and cold intolerance. On examination, she has a firm, diffuse thyroid enlargement (Grade II goiter). Her serum TSH is elevated at 8.2 mIU/L, free T4 is low-normal at 0.9 ng/dL, and urinary iodine excretion is 45 µg/L (normal >100 µg/L). She has no history of autoimmune thyroid disease. The district has no salt iodization program in place. Which intervention would be most appropriate as part of the National Iodine Deficiency Control Programme to prevent similar cases in this population?