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The objective of this study was to investigate the factors associated with the optimal use of antenatal care (ANC) during pregnancy. A facility-based cross-sectional survey was conducted between February and August 2014 among nursing mothers (n = 578) attending postnatal and child welfare clinics in three districts in Northern Ghana, representing urban, peri-urban, and rural zones. The developed questionnaire aided the collection of information on maternal demographic characteristics, health status, household assets, and ANC attendance. Binary logistic regression was modeled to estimate the association between optimal ANC use and mothers' characteristics. Approximately 81% of the respondents had ≥4 ANC visits during pregnancy, and coverage was over 99%. Mothers who had any formal education (adjusted odds ratio [AOR] = 1.7, 95% confidence interval [CI] = 1.0-2.8, P = 0.040) lived in middle class socioeconomic households (AOR = 2.6, 95%CI = 1.4-4.8, P = 0.003) and resided in urban areas (AOR = 2.0, 95%CI = 1.2-3.3, P = 0.006) were significantly more likely to report the optimal ANC use. Mothers' education, socioeconomic status, and proximity to a health facility were positively associated with the optimal ANC use. Education of females and policy initiatives aimed at improving the rural-urban divide are essential to optimize the use of ANC. [ABSTRACT FROM AUTHOR]

Consumption of adequately iodized salt (AIS) ≥15 ppm is one of the criteria for measuring progress towards universal salt iodization (USI) and sustainable elimination of iodine deficiency disorders. After a series of behavior change interventions aimed at increasing utilization of AIS, this survey was conducted to evaluate extent of achievement of USI. Cross-sectional survey was conducted in 1961 households and 350 markets to estimate the iodine levels of salt consumed or sold. Three degrees of iodization were estimated from fine, coarse and granular texture salt using MBI rapid field test kits. Differences in iodization levels were determined using Bonferroni test in STATA. Determinants for household utilization of AIS were identified using regression analysis and reported as odds ratio (OR). Availability of AIS in households (24.5%) and markets (30.9%) was far below the 90% recommendation. No differences were observed in urban (26.8%) and rural (24.1%) households. Households that used fine-texture salt (OR: 40.13; CI: 30.1–53.4) or stored salt in original packs (OR: 8.02; CI: 6.01–10.70) were more likely to consume AIS. Across districts, highest household availability of AIS was 51.7% while the least was 7.5%. The district with the highest market availability of AIS was 85.7% while the least was 8.3%. Almost 32% of the traders were aware that selling non-iodized salt was unauthorized but out of this, only 12% sold AIS. Health promotion strategies should emphasize appropriate handling and storage of salt throughout the supply chain. To ensure adequate salt fortification with iodine, improved surveillance of factories and mining sites is recommended. [ABSTRACT FROM PUBLISHER]