Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys

Abstract

Background: Household coverage with iodized salt was assessed in 10 countries that implemented Universal Salt Iodization (USI).Objective: The objective of this paper was to summarize household coverage data for iodized salt, including the relation between coverage and residence type and socioeconomic status (SES).Methods: A review was conducted of results from cross-sectional multistage household cluster surveys with the use of stratified probability proportional to size design in Bangladesh, Ethiopia, Ghana, India, Indonesia, Niger, the Philippines, Senegal, Tanzania, and Uganda. Salt iodine content was assessed with quantitative methods in all cases. The primary indicator of coverage was percentage of households that used adequately iodized salt, with an additional indicator for salt with some added iodine. Indicators of risk were SES and residence type. We used 95% CIs to determine significant differences in coverage.Results: National household coverage of adequately iodized salt varied from 6.2% in Niger to 97.0% in Uganda. For salt with some added iodine, coverage varied from 52.4% in the Philippines to 99.5% in Uganda. Coverage with adequately iodized salt was significantly higher in urban than in rural households in Bangladesh (68.9% compared with 44.3%, respectively), India (86.4% compared with 69.8%, respectively), Indonesia (59.3% compared with 51.4%, respectively), the Philippines (31.5% compared with 20.2%, respectively), Senegal (53.3% compared with 19.0%, respectively), and Tanzania (89.2% compared with 57.6%, respectively). In 7 of 8 countries with data, household coverage of adequately iodized salt was significantly higher in high- than in low-SES households in Bangladesh (58.8% compared with 39.7%, respectively), Ghana (36.2% compared with 21.5%, respectively), India (80.6% compared with 70.5%, respectively), Indonesia (59.9% compared with 45.6%, respectively), the Philippines (39.4% compared with 17.3%, respectively), Senegal (50.7% compared with 27.6%, respectively) and Tanzania (80.9% compared with 51.3%, respectively).Conclusions: Uganda has achieved USI. In other countries, access to iodized salt is inequitable. Quality control and regulatory enforcement of salt iodization remain challenging. Notable progress toward USI has been made in Ethiopia and India. Assessing progress toward USI only through household salt does not account for potentially iodized salt consumed through processed foods.

Socio-demographic correlates of availability of adequate iodine in household salt: a community-based cross-sectional study

“…The estimated proportion of households with an adequate level of iodine in Arba Minch town, 52.8%, was higher compared to the sub-national estimate for SNNPR, 13.7% [7], and also compared to a study in Wolaita zone, 37.7% [9]. Our sample, however, was restricted to households located in an urban area, and different studies reported a higher level of iodine content in urban than rural areas [9,[13][14][15]. Consistent with our finding, a study in southwest Ethiopia, Dera district, reported that 57.4% of households had an adequately iodized salt (≥ 15 ppm) [16].…”

Supplementation during pregnancy with small‐quantity lipid‐based nutrient supplements or multiple micronutrients, compared with iron and folic acid, increases women's urinary iodine concentration in semiurban Ghana: A randomized controlled trial

“…The large percentage of households consuming inadequately iodized salt observed in previous national surveys (GSS, 2011, GSS et al, 2015, and supported by findings from this study, suggests that those challenges remain to some degree, despite attempts at resolving them (Nyumuah et al, 2012), and as a result, much of the salt produced in Ghana is still not iodized. Women know that noniodized salt is cheaper and more accessible, compared with the usually factory-processed, fine-textured, and branded iodized salt (Agbozo, Dera, Gloverb, & Ellahi, 2016;Avinash & Prabha Adhikari, 2002;Knowles et al, 2017).…”

Related Factors with School Age Children’s Iodine Status in Indonesia

“…Penggunaan garam beriodium tentunya berkontribusi terhadap status iodium anak. Suatu survei di beberapa negara menunjukkan bahwa rumah tangga dengan status sosial ekonomi tinggi secara signifikan lebih banyak menggunakan garam cukup iodium dibandingkan iodium rendah (Knowles et al, 2017).…”