Salt use behaviours of Ghanaians and South Africans: A comparative study of knowledge, attitudes and practices

Salt consumption is high in Africa and the continent also shares the greatest burden of hypertension. This study examines salt-related knowledge, attitude and self-reported behaviours (KAB) amongst adults from two African countries-Ghana and South Africa-which have distributed different public health messages related to salt. KAB was assessed in the multinational longitudinal World Health Organisation (WHO) study on global AGEing and adult health (WHO-SAGE) Wave 2 (2014-2015). Respondents were randomly selected across both countries-Ghana (n = 6746; mean age 58 years old; SD 17; 41% men; 31% hypertensive) and South Africa (n = 3776, mean age 54 years old; SD 17; 32% men; 45% hypertensive). South Africans were more likely than Ghanaians to add salt to food at the table (OR 4.80, CI 4.071-5.611, p < 0.001) but less likely to add salt to food during cooking (OR 0.16, CI 0.130-0.197, p < 0.001). South Africans were also less likely to take action to control their salt intake (OR 0.436, CI 0.379-0.488, p < 0.001). Considering the various salt reduction initiatives of South Africa that have been largely absent in Ghana, this study supports additional efforts to raise consumer awareness on discretionary salt use and behaviour change in both countries.