It was emphasized that programs for the prevention of micronutrient deficiencies must be integrated with other public health measures of importance, including the promotion of breastfeeding, birth spacing, clean water supplies, appropriate immunization, control of infectious diseases, and health education. Because of the glaciation and mountainous areas of the countries of the region, iodine deficiency is a common and frequently severe problem in areas of each country. The most common and obvious manifestation of iodine deficiency is a swelling of the thyroid gland of the neck, identified as a goiter.
Goiter is endemic in areas of low environmental iodine.
It has long been recognized that severe iodine deficiency during pregnancy can result in cases of cretinism , or feeble-minded dwarfs. In the last two decades, it has been increasingly understood that the brain of the developing fetus must be adequately supplied with thyroid hormone by the mother during pregnancy. The fetus is at risk if the mother is deficient in iodine. Probably the most damage occurs in the first half of pregnancy, when there is the most rapid development of brain neurons. When cases of cretinism are few in number, they indicate a much larger number of persons whose linear growth, intellectual capacity, and other neurological functions are compromised to varying degrees, usually irreversibly.