Food and Public Health 2015, 5(3): 70-76 DOI: 10.5923/j.fph.20150503.02 Assessing Iodized Salt Use in Rural Northern Ghana: A Mixed Method Approach Dennis Chirawurah, Stephen Apanga * , Jerome Addah Department of community health and family medicine, School of Medicine and Health Sciences University for Development Studies, Tamale, Ghana Abstract Iodine deficiency disorders are a major public health concern affecting an estimated 2 billion people worldwide. As part of efforts to achieve the Universal Salt Iodization goal, the Government of Ghana launched the Universal Salt Iodization program backed by an act of parliament to oversee the attainment of this goal. Notwithstanding these efforts, iodine consumption amongst households and individuals is generally low in the Northern region especially in the Gushegu district. We therefore assessed the current iodine coverage and utilization in households and also determined the causes of low iodine use in this district. A mixed method approach of both quantitative and qualitative designs was employed. A quantitative descriptive cross sectional survey was first used to assess current iodized salt coverage, utilization and causes of low iodized salt use in households. The second design was a qualitative Focus Group Discussions and Key Informant Interviews conducted to give an in-depth inside of the causes of low iodized salt use. Rapid salt testing to determine iodine levels was conducted in all the households. In total, 100 household cooks were interviewed whiles 4 focus group discussions and 7 key informant interviews were conducted. Household iodized salt utilization and coverage was around 20%. Approximately 54% received education on iodized salt whiles 97% were unaware of the law on salt iodization. Reasons for the low use of iodized salt included; high cost and non-availability of the iodized salt, not received any education on the importance of iodized salt and ignorance of the law on iodization of salt. Iodized salt coverage and use in households and knowledge levels of the importance iodized salt is low in this district. High cost and unavailability of iodized salt coupled with ignorance of the law amongst others are responsible for the low use of iodized salt in this district. Keywords Iodized salt, Northern Ghana, Gushegu, Mixed method approach 1. Introduction Iodine is a trace element and an essential micronutrient that is often required in small amounts for the normal physiological function of the human body. Iodine has been found to be a key component of the thyroid hormones which are necessary for a number of metabolic and enzymatic processes such as control of the body’s metabolic rate; growth and development; and neuron function and development [1]. Iodine deficiency disorders (IDD) which results from insufficient intake of iodine is a major public health concern affecting an estimated 2 billion people worldwide in over 50 countries [2, 3]. IDD include a wide spectrum of disorders such as abortions, stillbirths, congenital abnormalities, cretinism, goitre and impaired mental function, squinting, dwarfism, mutism and increased infant mortality [3-7]. The vulnerable groups particularly at risk of developing IDD include pregnant women, infants, children and some cases * Corresponding author: apangastephen@hotmail.com (Stephen Apanga) Published online at http://journal.sapub.org/fph Copyright © 2015 Scientific & Academic Publishing. All Rights Reserved the developing foetus is also affected in the womb [7, 8]. It is estimated that about 120,000 children born each year in Ghana are at risk of developing intellectual impairment as a result of iodine deficiency. Approximately 15,600 accounting for 13% of these babies are severely impaired and are unable to develop properly, resulting in an average of 22 million dollars loss in productivity each year in Ghana. Majority of these affected children are also held back by reduced intelligence and mental disorders which tend to have enormous consequences on the Ghanaian educational system and also serve as a negative implication of iodine deficiency [7, 9]. Iodations of all salt known as Universal salt iodization (USI) for both human and animal consumption, is the major global strategy of choice for feasible and effective control of iodine deficiency. Iodization levels are usually measured based on estimated consumption of salt, with an estimated individual average consumption of around 10 g of salt per day in countries where most of the salt in the diet comes from table salt, used for cooking and at the table. It is recommended by the WHO, United Nations Children’s Fund (UNICEF) and International Council for Control of Iodine Deficiency Disorders (ICCIDD) that, 20 mg to 40 mg of iodine per kg salt be added to food products