To investigate factors associated with access to adequately iodised household salt.
A national and sub-nationally representative survey was undertaken in December 2014. The survey questionnaire was targeted to females responsible for food preparation in 16 randomly selected households from each of 123 clusters (41 per strata: urban, rural salt-producing, rural salt non-producing). In each consenting household, a sample of household salt was collected for analysis of iodine using titration.
Overall, 1566 salt samples were analysed for iodine concentration. Nationally, household coverage of salt with any iodine was 81.3% and with adequate iodine was 37.2%. Differences in coverage of adequately iodised salt were found by: urban (53.3%) and rural (19.0%) areas; whether salt was bought in a sealed (43.3%) or unsealed package (27.8%); and household poverty measured by the multi-dimensional poverty index (MPI) score, less vulnerable households (50.7%), more vulnerable (27.6%). Regression analyses showed that sealed packaging was significantly associated with adequate salt iodine across all three strata whereas, after accounting for sealed packaging, the MPI living standards dimension (one of three MPI dimensions used in the model) was significantly associated in rural non-salt producing areas only. Salt iodine was consistently low in rural salt-producing areas, possibly masking any MPI-related effect.
Results suggest that higher availability of salt in sealed packaging and, in rural areas, improved socio-economic status are associated with household use of adequately iodised salt. Revisions to the national strategy are required to address the inequity in access to quality iodised salt in Senegal.