Objective: The availability of iodized salt in households remains low in Bangladesh, which calls for improving the salt iodization quality and its coverage. The present study assessed the socio-economic disparity in Bangladesh to characterize the availability of iodized salt at household level.
Design: Associations between different socio-economic factors and availability of iodized salt at household level were explored using Bayesian mixed-effects logistic models after adjusting the district- and cluster-level random effects.
Setting: Bangladesh Multiple Indicator Cluster Survey (MICS), 2012-13.ParticipantsHouseholds (sample size, n 50981).
Results: Results showed that 73·15 % of household salt samples were iodized to some extent although iodization level varied. According to the regression model, houses with young (adjusted odds ratio of posterior mean (OR) = 1·31; 95 % credible interval (CI) 1·09, 1·64) and educated (OR = 3·66; 95 % CI 3·25, 4·23) household heads had significantly higher likelihood of availability of iodized salt. In addition, iodized salt was less likely be found in poor and rural households, as urban households were 2·88 times (95 % CI 2·41, 3·34) more likely have iodized salt. Moreover, the regional locations of the households were an important component that contributed to the local iodized salt coverage. As per the district-wise distribution, the north-west part of Bangladesh and Cox's Bazar in the far south seemed to lack household-level iodized salt.
Conclusions: Our findings suggest that iodized salt intervention should be promoted considering the area variations, which could potentially help policy makers to design interventions in the context of Bangladesh.
Keywords: Bangladesh; Bayesian mixed model; District-level variation; Salt iodization; Socio-economic status.