Household and market survey on availability of adequately iodized salt in the Volta region, Ghana

Abstract

Consumption of adequately iodized salt (AIS) ≥15 ppm is one of the criteria for measuring progress towards universal salt iodization (USI) and sustainable elimination of iodine deficiency disorders. After a series of behavior change interventions aimed at increasing utilization of AIS, this survey was conducted to evaluate extent of achievement of USI. Cross-sectional survey was conducted in 1961 households and 350 markets to estimate the iodine levels of salt consumed or sold. Three degrees of iodization were estimated from fine, coarse and granular texture salt using MBI rapid field test kits. Differences in iodization levels were determined using Bonferroni test in STATA. Determinants for household utilization of AIS were identified using regression analysis and reported as odds ratio (OR). Availability of AIS in households (24.5%) and markets (30.9%) was far below the 90% recommendation. No differences were observed in urban (26.8%) and rural (24.1%) households. Households that used fine-texture salt (OR: 40.13; CI: 30.1–53.4) or stored salt in original packs (OR: 8.02; CI: 6.01–10.70) were more likely to consume AIS. Across districts, highest household availability of AIS was 51.7% while the least was 7.5%. The district with the highest market availability of AIS was 85.7% while the least was 8.3%. Almost 32% of the traders were aware that selling non-iodized salt was unauthorized but out of this, only 12% sold AIS. Health promotion strategies should emphasize appropriate handling and storage of salt throughout the supply chain. To ensure adequate salt fortification with iodine, improved surveillance of factories and mining sites is recommended.

Keywords:

• iodized salt
• universal salt iodization
• household salt
• retail salt
• iodine deficiency disorders

Acknowledgment

We acknowledge Prosper Evadzi at the Institute for Coastal Research, Helmholtz-Zentrum Geesthacht, Germany, for converting some of the data into geographic information. Thanks to the Ghana Health Service Volta Regional Health Directorate especially the Director, staff of the Nutrition Unit, as well as the District Nutrition Officers and Community Health Nurses who assisted with data collection.