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At a glance: Ghana

'Smart salt' reduces iodine deficiency in Ghana

© UNICEF Ghana/2012/Logan
Gertrude Azasim with her grandson, Joseph Opoku, at the chop bar where she sells iodized salt in Bolgatanga, Ghana. Behind her are her granddaughters Claudine, Josephine, Claudia and Grace.

By Madeleine Logan

BOLGATANGA, Ghana, 26 January 2012 – Joseph Opoku pointed to a plastic container in the local restaurant, called a chop bar, belonging to his grandmother, Gertrude Azasim. “That is the smartest salt in Ghana,” he said.

Joseph, 14, is one of a growing number of children in Bolgatanga, capital of the Upper East Region of Ghana, educated about the benefits of iodized salt.

Iodine deficiency is the most common cause of preventable brain damage in the world. It also increases risk of infant mortality and miscarriage, and can cause goitre, an enlarged thyroid gland. This deficiency is easily and effectively prevented with the use of iodized salt use, but Ghana has persistently low iodized salt consumption.

In response, UNICEF is supporting a campaign to achieve universal salt iodization in the region. The campaign, led by the Ghana Health Service and supported by salt traders, chop bar owners, students and parents, has had a profound effect in Bolgatanga. In 2009, the municipal health service found only 24 per cent of tested households had adequate levels of iodized salt; by 2011, that number had risen to 63 per cent.

Educating the community

Municipal Health Director Joyce Bagina is leading the effort to promote salt iodization in Bolgatanga. In November 2010, she created a salt iodization committee that, with UNICEF support, conducted a radio campaign to teach the community – and especially parents – about the benefits of iodine. The committee also armed salt traders with iodine testing kits.

Patience Ayamga, assistant leader of the Bolgatanga Salt Traders Association, used to have no idea that the salt she heaped on her wooden table every day could prevent brain damage and mental impairment. She has since become a powerful advocate for the cause, persuading doubtful sellers to buy iodized salt and store it properly.

“Before the program started, I used to pour all my salt on the table in the sun. Now I package it in plastic bags to stop the iodine from evaporating. We ask our customers to put it in a container with a lid when they get home,” she said.

© UNICEF/NYHQ2007-2715/Noorani
UNICEF supports salt iodization efforts around the world. Salt is tested for the presence of iodine during an inspection by UNICEF staff at a company in Egypt.

She also makes sure traders know what’s in their product. “We were also given test kits, and if there was no iodine in the salt we wouldn’t buy it from the suppliers,” she said. “In the beginning, some salt didn’t have iodine. Now all salt does.”

Influencing public sentiment

Chop bar owners like Ms. Azasim were also crucial to the success of the campaign. Feeding thousands of Bolgatanga residents every day, chop bars were in a key position to influence public sentiment and increase iodine consumption.

Ms. Azasim, a former nurse, quickly realized the food industry could affect the health of the entire community. “We use iodized salt in all our dishes,” she said. “Those who come here to eat, we educate them about iodine. We tell them it develops the brain and prevents goitre. ”

Her six grandchildren – three pairs of twins including Joseph – grew up eating iodized salt. They can all recite the benefits of iodine, and not just because of their grandmother’s work.  Children have been at the centre of the iodization campaign, with awareness-raising activities in schools and child welfare clinics throughout the city.

Key to success

Achieving universal salt iodization throughout Ghana remains a challenge due to weak law enforcement; limited availability of potassium iodate, the compound used to iodize salt; and the large number of small-scale salt producers, estimated between 5000–10,000, who are difficult to monitor.

But the Bolgatanga program has been a great success thanks to its focus on educating consumers, who demand iodized salt from suppliers. The community’s refusal to buy salt without iodine gave producers a commercial incentive to change.

And Joseph, for one, is happy more children are consuming iodized salt. “They will be the brightest person that they can be,” he said.



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