However, compliance with the regulations has depended more on advocacy and the potential for legal action than on enforcement. Although extensive data are not available due to the weak monitoring systems, country-specific studies show that there has been some improvement in the situation according to both process and impact indicators. Two major indicators are pertinent here. The second is evidence of consumption of the iodated salt, as measured both by the proportion of households consuming the salt and increased iodine urinary excretion. In Kericho District, Kenya, the median urinary iodine excretion rose from a baseline of 15 g per 24 hours in 1972, when the first law to iodate salt was passed, to 90 g per 24 hours in 1994.
Similar examples are available in Cameroon, Tanzania, and Zambia.
Another example of impact is the effect of iodine supplementation on the intelligence of children in Malawi. Effects of iodine supplementation on the intelligence of children. This commitment has also been incorporated into the national programmes and plans of action emanating from the global initiatives. As a result, intersectoral and interagency collaboration has been excellent. There has also been a strong collaboration between the public and private sectors that is unprecedented in public health intervention in Africa.