Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

Objective Mali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1 center dot 00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali. Design Demographic and Health Survey data, multistage-stratified cluster sampling methodology. Setting Rural and urban areas of Mali. Subjects Non-pregnant women (n 6015) between the ages of 19 and 44 years. Results Nineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households' use of adequately iodized salt. Conclusions The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.