Policy of universal salt iodization in Bangladesh: do coastal people benefit?

Iodine deficiency disorders (IDD) are a serious public-health problem in Bangladesh and in other countries. Use of iodized salt has been promoted to solve the problem. A study was conducted in eight unions of Chakaria upazila in the Cox's Bazar district of Bangladesh during 1997-1998 to determine the prevalence of use of iodized salt, explore the reasons behind nonuse, and identify the socioeconomic correlates of its use. A quantitative survey was conducted to collect information from 21,190 households on socioeconomic status, demographic characteristics, and the kind of salt used. In-depth interviews and focus-group discussions were also conducted to understand the situation further. The results revealed that only 1.9% of the households used iodized salt. Strong barriers that limit their use of iodized salt included the wide availability of coarse salt, lack of knowledge about the link between iodized salt and IDD, and the high cost of iodized salt. Households in the salt-producing localities and those that are economically disadvantaged tend to use iodized salt less than others. Understanding of the prevalent situation will allow the policy-makers to take measures to improve the situation in the salt-producing areas.