Abstract

Background: A large population of school children benefit from the school feeding programs initiated by the Addis Ababa Administration. Unsafe food can cause outbreaks of foodborne diseases which may, in turn, deplete nutrition in the long run or lead to death. Proper food safety knowledge, attitude, and practices (KAP) of the kitchen workers is, therefore, essential, at which this research was aimed to investigate.

Methods: Data was collected on food safety KAP of kitchen workers in the government sponsored school feeding program from randomly selected 50 schools in all sub-cities of Addis Ababa using a structured questionnaire. Kaiser-Meyer-Olkin (KMO) measure was used to check for sample adequacies. Cronbach's-α was used to evaluate internal consistency of the questionnaire. Spearman’s sample correlation was used to assess correlations among the knowledge, attitude, and practice indices. Pearson’s Chi-square and logistic regression were applied to examine variations in food safety KAP across socioeconomic status. Confirmatory Factor Analysis was used to test if the observed variables represent the underlying constructs. Finally, structural equation model was employed to investigate the relationship among food safety knowledge, attitude and practice.

Results: A total of 462 food handlers participated in the assessment. KMO values (>0.9) for all knowledge, attitude, and practice confirmed sample adequacy. Cronbach's-α values confirmed the specific questions for knowledge, attitude and practice were acceptable (0.98, 0.97, and 0.88, respectively). The correlation between knowledge and practice was high (r = 0.8336, p<0.001). The correlation between attitude and practice was substantial (r = 0.5762, p<0.001). General food safety knowledge, attitude and practice among food handlers were 35.9%, 50.4% and 47.6%, respectively. Overall food safety-KAP among all kitchen workers was 39.6%. Higher educational status and training were sought significant for satisfactory food safety KAP (p<0.001). Food safety knowledge had significantly contributed to attitude and practice (p<0.001). Food safety practice in school kitchens was found low.

Conclusion: The food handlers lack proper knowledge, attitude and practice to serve safe meals in schools. Risk of foodborne diseases would be inevitable. We recommend appropriate food safety training to the food handlers for proper food safety measures. Monitoring and assessing food safety practices, devising an appropriate Hazard Analysis Critical Control Point (HACCP) system for food preparation in school kitchens may minimize risks of foodborne outbreaks.

Keywords: Food safety, food safety KAP, foodborne disease, school feeding