Understanding Patterns and Drivers of Bouillon Use in Northern Ghana to Inform Fortification Planning

OBJECTIVES: To explore the potential for bouillon as a micronutrient fortification vehicle in northern Ghana, we assessed market availability, household purchase and consumption of bouillon products, and perceptions of bouillon and salt. METHODS: We selected 28 clusters in the Tolon and Kumbungu districts of the Northern region of Ghana (7 urban, 4 semi-urban, and 3 rural clusters per district). Among 369 randomly selected households, women of reproductive age (15–49 y; WRA) were interviewed about household bouillon purchasing habits, its use in food preparation, and perceptions about the positive/negative effects of bouillon consumption. Twenty focus groups of 5–6 participants each were held in 11 clusters (10 WRA, 5 men, 5 women > 49y). We also assessed availability of bouillon products for sale from vendors in clusters (n = 11) and major markets (n = 4). RESULTS: In the survey, almost all (99%) respondents had ever cooked with bouillon, and 77% reported typically cooking with bouillon at least twice per day. Seven brands and three flavors of bouillon products were for sale. Most households (87%) reported consuming shrimp flavor without other spice most frequently. On average, households purchased bouillon cubes weekly, most from open markets (74%) or kiosks (22%). Most common reasons for bouillon use included taste (98%) and family preference (46%). Economic access was also important: 59% reported purchasing less bouillon or switching bouillon brands (28%) or flavors (11%) when they had less money available. About two-thirds of respondents perceived having bouillon in a person's diet was “good” (vs 43% for salt); reasons provided included: “gives more energy” (43%) and “makes you stronger” (41%). Among the 18% of respondents who perceived having bouillon in a person's diet was “bad”, reasons included: stomach upset (63%) and high blood pressure (39%). High blood pressure (85%) was the most common concern among the 32% perceiving salt as “bad”. Focus groups revealed seasonal variation in quantity of bouillon used. CONCLUSIONS: Bouillon consumption is common and frequent in northern Ghana, indicating good potential as a micronutrient fortification vehicle. Understanding perceptions of bouillon by different household members will inform research and program messaging. FUNDING SOURCES: Funded by a grant to the University of California, Davis from Helen Keller International.