Non-iodized salt consumption among women of reproductive age in sub-Saharan Africa: a population-based study

Abstract

Objective: To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age. Design: A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age. Setting: There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt. Participants: Women (n 108 318) aged 15–49 years. Results: Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23). Conclusions: The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.

Individual and community level factors associated with use of iodized salt in sub-Saharan Africa: A multilevel analysis of demographic health surveys

“…Similarly, households from high community education level had higher chance of using iodized salt compared to those households came from low community education level. The finding of this study is consistent with other studies conducted elsewhere [ 16 – 19 ]. This higher chance of using iodized salt among educated participants might be due an increased knowledge and awareness about the importance of using iodized salt [ 27 , 29 ].…”

“…Consistent with previous studies conducted in low income countries [ 16 – 19 , 30 ], in this study, wealth index is associated with use of iodized salt. Those households with middle, richer and richest wealth status had an increased chance of iodized salt utilization compared to households with poorest wealth status.…”

“…This higher chance of using iodized salt among educated participants might be due an increased knowledge and awareness about the importance of using iodized salt [27,29]. Consistent with previous studies conducted in low income countries [16][17][18][19]30], in this study, wealth index is associated with use of iodized salt. Those households with middle, richer and richest wealth status had an increased chance of iodized salt utilization compared to households with poorest wealth status.…”

“…Although this substantial progress has been made over the last several decades towards iodized salt consumption, still it is under the recommendation of the World Health Organization(at least 90% of households should consume iodized salt) [8] and hence, iodine deficiency remains a significant health problem in developing countries [15]. Some previous research works conducted revealed that the use of iodized salt is associated with wealth index [16][17][18][19], age [16,17], education status [16][17][18][19][20], community media exposure [18], knowledge of respondents on IDD and the importance of using iodized salt [20,21]. Despite the use of iodized salt is a cost-effective universal strategy to combat IDD [22], IDD is still a problem in SSA [23].…”

“…Some previous research works conducted revealed that the use of iodized salt is associated with wealth index [ 16 – 19 ], age [ 16 , 17 ], education status [ 16 – 20 ], community media exposure [ 18 ], knowledge of respondents on IDD and the importance of using iodized salt [ 20 , 21 ]. Despite the use of iodized salt is a cost-effective universal strategy to combat IDD [ 22 ], IDD is still a problem in SSA [ 23 ].…”