Utilization of adequately iodized salt and iodine status of pregnant women attending antenatal care in Hargeisa, Somaliland: facility based cross-sectional analysis

Iodine deficiency during pregnancy can cause irreversible impairment in the fetus’s brain structure and function. There is a paucity of data on adequately iodized salt utilization and iodine status of pregnant women in Somaliland. This study was done to assess the utilization of adequately iodized salt and iodine status of the pregnant women attending Antenatal Care (ANC) in Hargeisa, Somaliland. Health-facility based cross-sectional study was done in April 2020. A total of 317 pregnant women were recruited. Respondent were sampled following two stages. First, five health facilities were selected by lottery method, and sampling frame was made. Respondents were selected by using simple random sampling technique. Edible salt was collected from participants’ households. The morning urine sample was collected from 150 sub-samples. Data was analyzed using Statistical Software Package for Social Science (SPSS) version 20. Binary and multivariable logistic regression analysis was done. At 95% confidence interval, a variable with p-value < 0.05 in multivariable analysis was declared statistically significant. the result revealed that 36.9% of participants were not utilized adequately iodized salt and 63.1% were consumed either adequately or more than adequately iodized salt. The median urine iodine concentration (mUIC) was 155.7 µg/L (IQR = 80.6–320.3 µg/L), and 48.7% of the participants had insufficient iodine status. The odds of the insufficient iodine status was 9.5 (AOR = 9.5; 95% CI: 3.4, 26.2) times higher among women who were utilized non-improved drinking water. The odds of insufficient iodine was 0.3 (AOR = 0.3; 95%CI: 0.1, 0.8) times lower among those who were consumed egg at least four times per week. The odds of insufficient iodine status was 2.9 (AOR = 2.9; 95%CI: 1.3, 6.3) times higher among women utilizing inadequately iodized salt compared to their counterparts. the utilization of adequately iodized salt among pregnant women was suboptimal. Pregnant women in this study have optimal iodine status. Drinking non-improved water, consuming eggs less than four times per week, and utilizing inadequately iodized salt were identified determinants of insufficient iodine status; and should take due attention.