A micronutrient survey planned for 2025 but halted due to funding crunch, is now set to start soon, as the US government has provided $3 million for the study.

Officials said that the survey will determine the status of vitamin A, iron, folic acid, iodine, and zinc, breastfeeding practices, and the prevalence of anaemia, among others, in the Nepali population.

The findings will also help formulate policies and make decisions on whether to continue ongoing health programmes that have continued for decades, according to officials.

“This is a very crucial study, which was suspended last year due to a funding crunch,” said Lila Bikram Thapa, chief of the Nutrition Section at the Family Welfare Division, under the Department of Health Services. “Without an updated report, we would not have an accurate picture of the disease status. Now, the US government is funding the study through the United Nations Children’s Fund (UNICEF).”

The nationwide survey, which is carried out every 10 years, was originally planned with financial assistance from the United States Agency for International Development (USAID).

However, the plan was suspended indefinitely after the US government froze nearly all US assistance worldwide after Donald Trump assumed office for his second term in January last year.

Officials said Health Minister Dr Sudha Gautam made personal efforts to secure funding for the study.

“We will hold a formal meeting next week and conclude the remaining procedure to start the study,” said Thapa. “Earlier, it was agreed that the US Centres for Disease Control and Prevention would provide technical help for the survey and New Era would conduct the study.”

New Era is a non-governmental research agency that has carried out various national level research in Nepal, including the Nepal Demographic Health Surveys.

“This time, we plan to check lead levels in the general population as lead contamination has emerged as a serious public health issue in Nepal,” said Thapa.

Exposure to lead, a toxic heavy metal, is linked to IQ loss and behavioural disorders in children, growth impairment, kidney damage, hypertension, infertility, and adverse pregnancy outcomes. The World Health Organisation maintains that no level of lead exposure is safe, particularly for children, who absorb lead at much higher rates than adults.

A recent study by the Centre for Public Health and Environmental Development (CEPHED) found high concentrations in nearly one-third of cosmetic products including gajal (a black eyeliner also known as kajal) and sindoor (vermilion powder), and toothpaste sold in Nepal. Millions of people, including women and children, in the country have been found exposed to the poisonous metal.

It has been over 10 years since a micronutrient survey was conducted in the country.

The 2016 survey had studied the condition of drinking water, sanitation, child feeding practices, dietary diversity, vitamin A supplementation and deworming, iron supplementation, vitamin A and deworming among women, blood disorder status, nutrition status of adolescent girls, anaemia, iron deficiency, zinc deficiency, salt consumption and iodine level among the Nepalis.

Officials say that the new study will evaluate the outcomes of vitamin A supplementation and fortification programmes, which will ultimately help the government and policymakers to formulate evidence-based policies.

Vitamin A supplementation and deworming campaigns, carried out twice a year—in April and October, since 2003—are credited with eliminating night blindness among children and reducing the under-five mortality by 23 percent.

Likewise, based on the findings of the new study, officials will decide the appropriate amount of iodine to add to salt. The 2016 survey report showed that more than two-thirds—68 percent—of the population consumed iodine in excess of recommended levels, which resulted in high prevalence of hyperthyroidism.

Salt in Nepal is fortified with iodine at 50 ppm (parts per million) per kg, which is higher than the recommended dosage. The World Health Organisation, however, recommends iodine concentration at 15 to 40 ppm per kg.

Doctors suspect that the high iodine content in the salt sold in Nepal could be among the reasons for the high prevalence of several non-communicable diseases, including thyroid disorders and hypertension.

Similarly, changing dietary patterns and increased consumption of processed foods (including packaged soups) have also raised the prevalence of hypertension and cardiovascular diseases, they say.

On the other hand, lack of iodine in the diet can lead to hypothyroidism, where the thyroid glands produce too little thyroxine, leading to the development of goitres.

Officials say the government does not invest in data generation and independent studies, and most officials think it is a waste of national resources. Moreover, the data collected through government channels are also not considered credible by international agencies, as officials can manipulate them to show progress.

Hence, an independent study, such as the one to be carried out by UNICEF, is essential for reliable or internationally acceptable data, according to officials.