Assessment of food safety knowledge, attitude and

hygiene practices amongst food vendors on the

University of Cape Coast Campus and its
surrounding communities
Emmanuel Ankomah-Appiah (  [email protected] )
Department of Health, Physical Education and Recreation, University of Cape Coast, Ghana
https://orcid.org/0000-0002-0328-5852
Kwo e Elizabeth
Department of Technical and Vocational Education, College of Education, University of Cape Coast,
Ghana https://orcid.org/0009-0001-0467-0912
Sophia Ohene Darko
Department of Technical and Vocational Education, College of Education, University of Cape Coast,
Ghana https://orcid.org/0000-0001-8339-2166
Francis Abrokwah
Department of Biochemistry, University of Cape Coast, Ghana https://orcid.org/0000-0003-2427-7082

Research Article

Keywords: Food Safety, Consumer Knowledge, Attitude, Hygiene Practices

Posted Date: March 27th, 2023

DOI: https://doi.org/10.21203/rs.3.rs-2727837/v1

License:   This work is licensed under a Creative Commons Attribution 4.0 International License.
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Abstract
The primary goal of this study was to assess vendors' food safety knowledge, attitude, and hygiene
practices at the University of Cape Coast. This study was carried out using a descriptive survey. Purposive
sampling was used to choose eighty-four (84) food vendors from around the University of Cape Coast. To
collect information from respondents, a series of well-structured and self-developed questionnaires were
used. Descriptive statistics were used to analyse the data (frequencies and percentages). Generally, it was
observed that the food vendors had positive attitudes towards safe food preparation as they gave
positive responses to statements such as "I wash my hands with soap to prevent any contamination, "I
wash and rinse cutting boards, knives and plates used for raw meat before using them for other foods".
Similarly, food vendors' knowledge of food safety was found to be above average (85%). Finally, the
analysis revealed that food vendors were very aware of hygienic practices during food vending and thus
knowledgeable in hygiene practices issues. It is recommended among other things that more education
should be given on food safety practices so that the few who are not doing things right can do so. A lack
of knowledge militates against the appropriate practice.

Background
The sale of street food is regarded as a signi cant contributor to the economies of many developing
countries. As a result of rapid urbanization, many people now eat outside the home, increasing the
importance of food establishments(Feldman et al., 2015). Because of the availability of jobs and readily
available cooked meals at relatively low prices, the food chain industry has grown to be a signi cant
contributor to the economies of many nations(Wuliyeng, 2013). Nonetheless, despite its importance,
many people have expressed concerns about the cleanliness, quality, and safety of street food.
Consumption of street food has been linked to food poisoning and other food-borne illnesses(Wuliyeng,
2013). This is because the majority of street food vendors are unaware of the basic food safety
requirements, exposing these foods to a variety of unsafe abuses throughout the food manufacturing
process(Annan-Prah et al., 2011). According to decades of scienti c research on food safety and
sanitation, street food vendors are a weak link in food safety supervision(FAO, 2018; Fellows & Hilmi,
2011). Concerns about the quality and safety of street food have grown over time(Wuliyeng, 2013).
Because of the unsanitary conditions in which some food vendors prepare, sell, or serve their food, street
food is sometimes thought to be of low quality(Annan-Prah et al., 2011). According to the Centers for
Disease Control and Prevention (CDC), (2010), food hygiene procedures include protecting supplies from
microbiological, chemical, and physical hazards that may arise during the processes of food preparation,
handling, and serving. Customers' health is jeopardised due to a lack of wholesome food production, and
sadly, the majority of street food is becoming one of the most common hazards linked to the rise in
outbreaks of food-borne illnesses in developing countries. Having meals away from home, according
to Gangi, Mustilli, & Varrone, (2018), increases your risk of contracting a foodborne illness. According to
other studies by Akabanda, Hlortsi, & Owusu-Kwarteng, (2017), the majority of foodborne illness
outbreaks occur in food service establishments. It is assumed that when large quantities of food are

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prepared, they will be handled by many people, increasing the risk of nal product
contamination(Akabanda et al., 2017).

Food safety is a scienti c eld that describes how to handle, prepare, and store food in a way that avoids
getting sick from it. It refers to procedures and circumstances that maintain food quality to avoid
contamination and food-borne illnesses while handling food(Akabanda et al., 2017; Asiedu et al., 2018).
Numerous studies have demonstrated the important impact that food safety plays on consumer health.
For instance, research from the World Health Organization(WHO, 2015) revealed that about two million
cases of food poisoning that are irreversible occur each year in developing countries. The WHO further
estimates that each year 600 million foodborne infections (FBDs) caused 420,000 fatalities due to
shoddy food safety and hygiene practices, the bulk of which are linked to meat-related
vulnerabilities(Brandwagt et al., 2018). In Malaysia, there were 47.8% of foodborne illnesses per 100,000
people who consumed street food(Tuglo et al., 2021).

Poor hygiene, unsanitary conditions, and highly contaminated food were discovered in a study conducted
among food truck workers in Brazil by Isoni Auad et al., (2019). FBD was more severe in Southeast Asian
and African countries(Zhao et al., 2020). According to a study conducted in China among street food
vendors, the respondents had poor behaviour patterns and little awareness of food safety(Teffo & Tabit,
2020). Over 60% of South African respondents were found to be adequately aware of food safety and
hygiene practices(Lema et al., 2020). According to Yenealem, Yallew, & Abdulmajid, (2020), less than half
of Ethiopian respondents had successful food cleanliness applications. Hospitalization costs for food-
related illnesses cost developing nations roughly US$ 110 billion yearly, which harms
production(Yenealem et al., 2020).

Food handlers (vendors) in Ghana are complicit in the transmission of dangerous germs that affect
consumers by failing to follow basic hygiene precautions(Ahmed Elhag Mohamed, 2022; Donkor et al.,
2009). Since taking contaminated food and water is the primary cause of diarrhoea, which has been
identi ed as one of the leading causes of hospitalization in Ghana and accounts for 16% of children's
deaths, it is assumed that some food vendors are partially to blame for the outbreak because some
people choose to eat outside the home due to factors like work, time, energy, schooling, etc. and the
safety of some vending cooked food is not guaranteed(Girma, 2015). Even vendors who demonstrate an
understanding of food hygiene still have trouble connecting lthy hands with the spread of diarrheal
diseases in Ghana, according to Acheampong, (2015). According to Rane, (2011), the health and safety
risks associated with street meals may be explained by street food vendors' lack of education and
improper food handling, as well as handlers' lack of awareness of the potential hazards associated with
speci c cuisines. The FAO's ve main recommendations for maintaining food safety from farm to plate
are to keep everything clean, separate raw from cooked food, prepare thoroughly, cook food at safe
temperatures, and use safe water and raw materials (FAO, 2018; Fellows & Hilmi, 2011; WHO, 2015).
These ve fundamental principles can be learned and applied to ensure the consistent safety of street
food.

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A vendor's knowledge, attitude, and food safety procedures have a signi cant impact on food
safety(Sharif et al., 2013). As a result, a vendor's improper practices signi cantly increase the risk of
customers contracting food poisoning and other food-borne illnesses.

Methodology
This cross-sectional study used a questionnaire-based survey to raise awareness among the population
of food vending shops at the University of Cape Coast. This research was carried out in August 2022. The
study population included 84 participants who prepare and sell food at Science Market, behind Atlantic
Hall, and in the Amamoma and Ayensu community markets. The participants were drawn at random
from a population of people over the age of 18. Participants in the study included students, shopkeepers,
street vendors, housewives, and others who worked with food in some capacity. Individuals with limited
education were asked questions, and their responses were recorded.

The survey questionnaire

The questionnaire took about 30 minutes to complete for each respondent. The 40-questionnaire
comprised three main categories such as "practise", "attitude" and "food safety knowledge". The
demographic section included the respondents' gender, age, occupation, education, and socioeconomic
status. Questions based on practice were emphasised to determine standard food handling methods in
daily routine. Similarly, attitude questions assessed hygienic approaches. The safety knowledge section
assessed awareness of food handling and consumption, which can lead to foodborne diseases.

Data Processing and Analysis

The eld data were analysed using a descriptive statistical technique. To ensure quality, the data were
coded and analysed using Statistical Package for Service Solution (SPSS) programme version 25. The
data was carefully cleaned to remove any outliers or extreme values that could have impacted the validity
of the conclusion.

Knowledge, Attitude and Hazard Analysis Critical Control Point (HACCP) Practice Model

To better understand or explain how human behaviour or actions are guided, as well as the relationship
between food handlers' knowledge of food safety and practice, several models from the behavioural
sciences have been projected(Rennie, 1995). However, the HACCP practice model developed by Ko served
as the foundation for this study (2013). This has been noted as a model frequently used to explain the
relationship between knowledge, attitude, and practice as shown in gure.1 (Ko, 2013).

The model describes the interrelationship between knowledge, attitude, and HACCP practices among
food handlers in food service establishments and presupposes that there is a strong relationship between
knowledge, attitude, and HACCP practices. The knowledge, attitude, and practice (KAP) model is
predicated on the notion that a person's knowledge in uences their behaviour or practice and that simply
providing information will directly lead to a change in attitude and, subsequently, a behaviour change.
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Rennie came up with the idea (1995). The model's underlying premise is that practice can be altered and
that as one's knowledge grows, so will one's attitude, making one more likely to exhibit the desired
behaviour. As a result, an individual's attitudes and practices improve as their level of knowledge
increases. It has been noted that the knowledge, attitude, and practise model (KAP) is based on four
correlations between the model's key variables, such as knowledge, attitude, and behaviour. The four
(Schwartz, 1975) relationships cited by Ko, (2013). There are four different types of relationships: ones in
which knowledge and attitude in uence each other simultaneously, ones in which knowledge and attitude
independently in uence behaviour, and ones in which knowledge shared both directly and indirectly
in uence behaviour. Knowledge can in uence attitude but not directly behaviour in these relationships.

In all of the relationships mentioned, attitude was discovered to be a mediating variable between
knowledge and behaviour. The food handlers' knowledge, attitudes, and HACCP practices are all related in
some way, according to the food safety knowledge, attitude, and practice model. The model shows a
strong relationship between HACCP practice and knowledge, attitude, and practice related to food safety.
As a result, attitude is now recognised as a critical component in addition to knowledge and practice in
reducing the risk of foodborne illnesses. In this way, the attitudes of food handlers toward food safety
practices mediate the relationship between knowledge and HACCP practices.

The variables had positive interactions with one another, (Chang et al., 2005)found. The model's
assumption that knowledge is the main factor in behavioural change, however, is awed(Ehiri et al.,
1997). Additionally, the model did not consider potential problems or obstructions that might make
practice more challenging.

Conceptual Framework

The framework for the study was modi ed from Ko, (2013) knowledge, attitude, and HACCP practices
(KAP) model after many models were evaluated based on their strengths and weaknesses (see Fig.2). As
previously mentioned, the model was changed to make it more appropriate for this study. To narrow the
scope of the study, the modi cation excluded the HACCP practice. As a result, the modi ed framework
focused on food vendors' knowledge of food safety issues, vendors' food safety attitude during food
preparation, vendors' hygienic practices during food vending, as well as the conducive environment and
economic and social drivers of food safety.

Results And Findings

Demographics

Some relevant background data were sought from the respondents. These include data on gender, age,
educational level, type of dish, health certi cate possession and period for renewal. These results were
obtained after the data analysis on this information was summarised in Table 1, and Fig.3 and Fig.4
respectively. The questionnaires were distributed to 23 (27.4%) males and 61 (72.6%)
females. Respondents aged 18-25 years represented 48.8%, 18(21.4%) respondents aged 26-33 years,
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7(8.3%) people aged 34-41 years, 11(13.1%) people aged 42-49 years, and 7(8.3%) people aged 50 years
or older. For the sale of dish category, 35(41.7%) of respondents sell soups, 26(31.0%) sell rice, 10(11.9%)
sell porridge, and 13(15.5%) sell fries.

Vendors’ Food Safety Attitude

Table 2 shows the results of an analysis of vendors' food safety attitudes during food preparation. The
respondents had positive attitudes toward food preparation. As a consequence, most of the respondents
78(92.9%) agreed with the statement, "I wash my hands with soap to prevent any contamination".
Similarly, they stated that "they wash and rinse cutting boards, knives, and plates used for raw meat
before using them for other foods" with a frequency of 63(75%) and a strong agreement of 13(15.5%).
Cross-contamination could then be said to occur at a very low or never rate. Again, 26 (31.0%) strongly
agree and 56 (66.7%) agree that they clean their cooking utensils regularly. Despite this, a small
percentage of respondents do not practise the following well. Twelve (12) respondents, or 14.3%, disagree
that they ensure that leftovers are stored properly. Twenty (20) people, or 23.8%, said they do not wear
head caps/aprons during food preparation, although the majority of 64 (76.2%) said they do. Also, while
12(14.3%) stated that they do not wash their hands with soap and warm water before beginning,
72(86.7%) agreed. When coughing or sneezing, 72(85.7%) agree that they cover their mouth, while
12(14.3%) disagree. When cooking, 19% (21.7%) said they do not remove their jewellery, while the
majority (75.4%) said they do. 11 people (13.1%) disagree with the statement "I cover my cut with a
bandage and wear gloves." However, the majority of 73 (86.9%) agree, indicating a positive attitude
toward food safety. More than half of the respondents demonstrated good knowledge in areas such as
the need to wear protective clothing such as aprons/overcoats and gloves while cooking. Food handlers
are expected to be well-versed in the use of protective clothing, which acts as a barrier between bare
hands and the food being handled(Asli, 2022; Brown, 2021; Fellows & Hilmi, 2011). As a result,
respondents' knowledge of the need for these hair restraints exceeds the recommended level. Overall,
75.4% of respondents understood the importance and urgency of wearing hair restraints during food
preparation and service, which is a good sign for ensuring food safety. Regarding hand washing and
mouth covering when coughing or sneezing, it was discovered to be consistent with the observations
made by(Ackah et al., 2011; Apanga et al., 2014; Mapelu & Onyango, 2018), that most respondents had a
very good attitude on the need to wash hands after visiting the toilet, blowing nose, counting money, and
sneezing into handkerchiefs before and during food preparation and service. Their responses regarding
the wearing of jewellery during food preparation and service indicate that they agree with the suggestion
made by (Abdullah, 2015) and (Qoura & Ali, 2016) that food handlers should not wear rings and other
jewellery during food preparation and service because they can harbour germs that can cause foodborne
illness. Wearing jewellery could be a source of foreign matter contamination, potentially introducing
bacteria, pathogens and other foreign objects into the food and rendering it unsafe for consumption.

Food Safety Knowledge

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Twelve (12) measurement items were used to evaluate the level of knowledge the food vendors
possessed regarding food safety, and the results are shown in Table 3. In total, 85% of the respondents
correctly answered the knowledge questions about food safety. This observation demonstrates their
familiarity with matters related to food safety. The majority of respondents (95,2%) demonstrated a high
level of knowledge concerning the statement that "I know that food can be contaminated with any
mistakes I make." As a result, 89.2% of the respondents were aware that kitchen towels and dirty work
surfaces are signi cant sources of cross-contamination and vehicles for contamination (Mba-Jonas et
al., 2018). In addition, 63.0% of respondents were aware that a government organisation was keeping an
eye on them. The signi cance of a medical exam as a requirement for employment in the food industry
was noted to be known to more than half of the respondents (63%) and other relevant subjects. Their
knowledge of medical conditions suggests that a sizable portion of them were aware of the public health
requirements requiring everyone working in the food industry to undergo regular checkups and medical
examinations (Ackah et al., 2011; Ifeadike et al., 2014). The respondent understood that food handlers
should not handle food if they are ill or exhibiting symptoms. Furthermore, 25 (29.8%) said they did not
remove their jewellery when working with food, while 59 (70.2%) said they did. I keep leftover food in the
fridge or freezer for the next day and received 61 (72.6%) 'YES' responses and 23 (27.4% 'NO' responses. I
mostly attend food hygiene health education programs, of which 48 (57.1%) are "YES" and 36 (42.9%) are
"NO." 72.6 per cent of those polled were aware that leftover food can be refrigerated and that freezing can
prevent the growth of some microorganisms in food. This means that a sizable proportion of
respondents (27.4%) were unaware that some microorganisms are only inactivated under cold or freezing
conditions and will reactivate when conditions improve. Similarly, nearly half (42.9%) of respondents
were unaware of the importance of participating in food safety educational programs. Finally, 70(83.3%)
responded 'YES' to the statement, my vending point is close to an open gutter, but 14(16.7%) responded
'NO,' as shown in Table 3. Almost all of the respondents are knowledgeable about food safety. As a result,
following the KAP model(Ko, 2013), the respondents were expected to exhibit good food safety practices,
given that no one demonstrated low or poor knowledge of food safety issues. The KAP model assumes
that an individual's behaviour or practice is determined by his or her knowledge, and that simply providing
information to an individual can result in a change in attitudes and practice. As a result, their high
knowledge levels may have an impact on their food safety practices.

Hygiene Practice

Statistical analysis was performed on data to ascertain respondents' knowledge of food vending hygiene,
11 vendor hygiene practices during food sales have been applied. The distribution of scores with the
hygienic procedures used by vendors when selling food is shown in Table 4. The current general
consensus is that 97.6% of the respondents agreed with the statements about the hygiene practices of
vendors during food vending, demonstrating their familiarity with these issues. This assumption is valid
since majority of them had practical knowledge of always washing dishes/bowls in clean, soapy water
78 (92.9%), avoid using bare hands when serving food 76(90.5%), and the need to empty trash cans
regularly 77(92.7%). It is important to understand that the consequences of proper waste disposal prevent
the spread of insects and pests in the environment (Sharif et al., 2013; WHO, 2015). These results further
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the understanding of the ISO 22000 (2015) standard(Arvanitoyannis, 2009), which requires that waste
containers have appropriate lids and that liquid and solid waste be removed from food processing areas
without contaminating their surroundings or their products.

The vast majority of respondents (90%) included in the study were aware that clearing the dining table as
soon as a customer nished eating prevented ies and other insects from primarily invading the vending
area to cause contamination. Unclean work surfaces and kitchen towels are major sources of cross-
contamination and vehicles for contamination, according to this a rmation(Mba-Jonas et al., 2018). 75
of them, or 89.3%, strongly agreed that sweeping or cleaning the vending area properly more than twice a
day lowers the risk of food contamination. Additionally, relatively large statistical differences, 67 (79.8%)
agreed that customers should frequently have new hand-washing water available. Likewise, about 76
(90.5%) people agreed that cooked foods should be served extremely hot and that people shouldn't
handle food with their bare hands to prevent contamination.

Conclusion
Food vendors at the University of Cape Coast and its environs were observed to have a good food safety
attitude during food preparation. Furthermore, vendors were knowledgeable about food safety. Again, the
study discovered that food vendors consider hygiene practices when preparing food. The relationship
between food vendors' food safety knowledge, attitude, and practices was observed to be that food
vendors' food safety knowledge and attitude did not exceed their practices, implying that food safety
knowledge militates appropriate attitude and practice. According to the study, the majority of vendors
(75%) have health certi cates, but 31% have never renewed their licenses. This could lead to a lack of
food hygiene practices, implying that unsafe practices continue.

Abbreviations
(KAP) Knowledge, Attitude, and Practise Model

(HACCP) Hazard Analysis Critical Control Point

Declarations
Acknowledgement

We are grateful to the authors and food vendors in the University of Cape Coast community who made
their resources freely available to us. Moreover, we appreciate the kind efforts of reviewers and editors
who assisted our work.

Author contributions

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KE conceived the idea of the study.SOD, FA and EAA analysed the data. All authors (KE,SOD,FA,EAA)
wrote the manuscript. All authors read, edited, and approved the nal version of the manuscript.

Funding

This research did not receive any speci c grant from funding agencies in the public, commercial, or not-
for-pro t sectors.

Availability of data and materials

All resources used in this study are available, and the authors will make them available according to their
respective copyright and access policies.

Ethics approval and consent to participate.

All procedures contributing to this project comply with the ethical standards of the relevant national and
institutional human experimentation committees and the 1975 Declaration of Helsinki as amended in
2008. Access and use of resources were sought ethically and in accordance with standards for
implementation from a project work. We have sought and received ethical approval from the University of
Cape Coast Institutional Review Board. Again, we asked for and obtained the informed consent of the
managers who provided us with data on interviews.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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3 . Wuliyeng, G. T. (2013). Examining the Hygiene Practices among Street Food Vendors in Nsawam and
Adoagyiri. Master dissertation]. University of Ghana.

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37. Yenealem, D. G., Yallew, W. W., & Abdulmajid, S. (2020). Food safety practice and associated factors
among meat handlers in Gondar town: a cross-sectional study. Journal of Environmental and Public
Health, 2020.
3 . Zhao, Y., Yu, X., Xiao, Y., Cai, Z., Luo, X., & Zhang, F. (2020). Netizens’ food safety knowledge, attitude,
behaviors, and demand for science popularization by WeMedia. International Journal of
Environmental Research and Public Health, 17(3), 730.

Tables
Table 1: Background information of the respondents

Variable Sub-Scale Frequency Percentage

Gender Male 23 27.4

Female 61 72.6

Age 18 - 25 years 41 48.8

26 – 33 years 18 21.4

34 – 41 years 7 8.3

42 - 49 years 11 13.1

50 and above 7 8.3

Educational Level Primary 35 41.7

Secondary 39 46.4

Tertiary 10 11.9

Type of dish Soup dish 35 41.7

Rice dish 26 31.0

Porridge dish 10 11.9

Fries 13 15.5

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 Table 2: Vendors' Food Safety Attitudes During Food Preparation

Statement Strongly Disagree Agree Strongly

Disagree Agree

F(%) F(%)
F(%) F(%)

1. I wash my hands with soap to prevent any 2(2.4) 4(4.9) 67(79.8) 11(13.1)
contamination

2. I wash and rinse cutting boards, knives and 1(1.2) 7(8.3) 63(75) 13(15.5)
plates used for raw meat before using them
for other foods.

3. I clean the cooking utensils regularly 2(2.4) 0(0) 56(66.7) 26(31.0)

4. I ensure that leftovers are preserved in an 0(0) 12(14.3) 43(51.2) 29(34.5)

appropriate place

5. I wear head caps /apron 9(10.7) 11(13.1) 43(51.2) 21(25.0)

6. I try to maintain short and clean nails 1(1.2) 13(15.5) 54(64.3) 16(19.0)

7. I try to clean the work area and surfaces 0(0) 6(7.1) 57(67.9) 21(25.0)
frequently

8. I remove my jewellery 4(4.8) 15(17.9) 29(34.5) 36(42.9)

14. I cover my mouth when coughing or sneezing 2(2.4) 10(11.9) 60(71.4) 12(14.3)

15. I wash my vegetables with salty water before 3(3.6) 11(13.1) 46(54.8) 24(28.6)
using

16. Hands washing with soap and warm water 10(11.9) 28(33.3) 35(41.7) 11(13.1)
before commencing

17. I wash my hands only after 18(21.4) 32(38.1) 26(31.0) 8(9.5)

visiting the toilet

18. I cover my cut with a bandage and use gloves 3(3.6) 8(9.5) 58(69.0) 15(17.9)

Source: Field Data

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 Table 3: Vendors' Level of Food Safety Knowledge

Statements YES NO

F(%) F(%)

1. I remove my jewellery when dealing with food 59(70.2) 25(29.8)

2. I know that food can be contaminated with any fewer mistakes I make. 80(95.2) 4(4.8)

3. I store leftover foods in the refrigerator/freezer to be used the next day 61(72.6) 23(27.4)

4. I pour leftover foods into a container and 54(64.2) 30(35.7)

cover it to be used the next day

5. I Pour leftover foods into a container and leave it open to be used the 11(13.1) 73(86.9)
next day

6. I have undergone a medical examination for purposes of food vending 63(75.0) 21(25.0)

7. I mostly attend health education programs on food hygiene 48(57.1) 36(42.9)

8. My activities are being monitored by the government agency 63(75.0) 21(25.0)

10. The person(s) preparing the food has formal training in food 50(59.5) 32(38.1)
preparation and handling

11. My vending point is close to an open gutter 14(16.7) 70(83.3)

12. Food preparation surfaces can contaminate foods 75(89.2) 9(10.7)

Source: Field Data

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 Table 4: The Vendors' Hygiene Practices During Food Vending

Statement Strongly Disagree Agree Strongly

Disagree Agree
F(%) F(%) F(%) F(%)

1. I always wash dishes/ bowls in 2(2.4) 4(4.8) 53(63.1) 25(29.8)

clean soapy water

2. I serve food with my 2(2.4) 6(7.1) 35(41.7) 41(48.8)

bare hands

3. I collect money with 0(0.0) 2(2.4) 57(67.9) 25(29.8)

bare hands and never
wash my hands before
touching the food
again

4. I cover my cut with a 14(15.7) 17(20.2) 43(51.2) 10(11.9)

bandage when serving
food

5. I cover my head with a 17(20.2) 14(16.7) 33(39.3) 20(23.8)

cap/ scarf when
serving

6. I often change hands 0(0.0) 17(20.2) 45(53.6) 22(26.2)

and wash water for
customers

7. I make sure my food is 19(22.6) 18(21.4) 22(26.2) 25(29.8)

always warm

8. I make sure my 4(4.4) 4(4.8) 58(69.0) 18(21.4)

packaging materials
are always clean

9. I clear the eating table 2(2.4) 6(7.1) 35(41.7) 41(48.8)

immediately customer
nishes eating

10. I sweep my vending 2(2.4) 7(8.3) 42(50.0) 33(39.3)

area more than twice a
day

11 I empty and clean my 0(0.0) 6(7.2) 46(55.4) 31(37.3)

dustbin always

Source: Field Data

Figures

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Figure 1

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Figure 2

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Figure 3

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Figure 4

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Supplementary Files
This is a list of supplementary les associated with this preprint. Click to download.

Highlights.docx
Questionnaire.docx

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