Iodized Salt Consumption in Sudan: Present Status and Future Directions

Abstract

Iodine Deficiency Disorders (IDD) Control Programme in Sudan adopted salt iodization as the long-term strategy in 1994. In 2000, it was found that less than 1% of households were using adequately-iodized salt. The objectives of this study were to: (i) study the coverage and variation of different geographical regions of Sudan regarding access to and use of iodized salt, (ii) explore the possible factors which influence the use of iodized salt, (iii) develop recommendations to help in the implementation of the Universal Salt Iodization (USI) strategy in Sudan. This paper is based on the Sudan Household Health Survey (SHHS) dataset. A total sample of 24,507 households was surveyed, and 18,786 cooking salt samples were tested for iodine levels with rapid salt-testing kits. Nationally, the percentage of households using adequately-iodized salt increased from less than 1% in 2000 to 14.4%, with wide variations between states. Access to iodized salt ranged from 96.9% in Central Equatoria to 0.4% in Gezira state. Population coverage with iodized salt in Sudan remains very low. The awareness and political support for USI programme is very weak. National legislation banning the sale of non-iodized salt does not exist. Utilization of the already-existing laws, like the National Standardization and Metrology Law (2008), to develop a compulsory national salt specification, will accelerate the USI in Sudan.

Factors Affecting the Presence of Adequately Iodized Salt at Home in Wolaita, Southern Ethiopia: Community Based Study

“…The result of this study is higher than the findings observed in different parts of Ethiopia: Hawassa town 0% [18], Shebe town, south west Ethiopia 19% [19], Northern Ethiopia 25% [20], Gondar 29% [10], JigJiga town, Eastern Ethiopia 26.6% [21], and Laelay Maychew District, Northern Ethiopia 33% [22] of the households have access to iodized salt. The finding from the current study is also higher than the findings observed in Sudan 14.4% [9] and Sindh and Punjab provinces of Pakistan 15% [8]. The improvement observed in the current study might be attributed to the application of more effective strategies in the production and distribution of iodized salt to enhance universal salt iodization program by the Ethiopian Ministry of Health in general and zonal health department in particular.…”

“…Other similar studies elsewhere reported the presence of an association between urban and the presence of adequately iodized salt at home [7–9, 11]. The reason may be that those who were unaware of its significance are the socially and economically disadvantaged rural population.…”

“…Similarly, Ethiopian Demographic and Health Survey shows that households in the highest wealth quintile were twice as likely to use iodized salt as compared to households in the lowest two wealth quintiles [7]. Similar survey in Sudan [9] shows that the wealthiest group of people consumes more iodized salt. And in India [11], households earning higher than 10 USD were more likely to use adequately iodized salt as compared to those who were earning lower.…”

In transition: current health challenges and priorities in Sudan

“…A 2013 publication described Sudan as having ‘made insufficient progress to achieve Millenium Development Goal 4 and having levels of child and infant mortality that are among the highest in the region and the world’ 58. The current infant mortality rate is 60 per 1000 live births and the under-5-year mortality rate is 82 deaths per 1000 live births 58 59. The neonatal mortality rate is also high, ranging from 34 to 47 per 1000 births59 with a maternal mortality rate of 311 deaths/100 000 live births 58.…”

Determinants of Iodised Salt Utilisation among Households with Children Under-Five in Ghana

“…In India, Malhotra et al [9] revealed that, religion, education of spouse of head of family, occupation and education of the family head, per capita monthly income, source of salt and quantum of salt bought at one time were not strongly linked (associated) with the use of adequately iodised salt. Also is being found by Mahfouz et al [10] that, getting iodised salt in the market or staying in an urban area by household head, having a more educated, a male and comparatively wealthy household head increased the probability of utilising iodised salt among households in Sudan. Further in Pakistan (Punjab and Sindh), people in the Province of Punjab and rural dwellers were found by Khan et al [11] to be less likely to use iodised salt.…”