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

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.