Abstract
Background: In South Africa, food is a fundamental human right. One of the initiatives from the South African government is the implementation of the NSNP to fulfil this human right. This program affords government primary and secondary school meals to enhance learners' learning capacity. However, the program is not immune to the problem of foodborne illnesses. Unsafe food handling practices associated with inadequate food safety knowledge and poor attitude of food handlers are deemed as some of the root causes of foodborne disease outbreaks in food handling premises. The prevalence of foodborne illnesses in schools is associated with cross-contamination during food preparation and can disturb the learning program.
Aim: The overall aim of the study was to assess the knowledge, awareness, attitude, and practices on food safety amongst the food handlers that are part of the NSNP in the City of Mbombela
Methods: This cross-sectional study collected data from 317 food handlers from randomly selected public schools using a standard questionnaire. The study's estimated sample size was calculated using EPINFO (version). STATA version 15 was used to analyze data using frequency distributions, and logistic regression models.
Results: The results demonstrated that over 90.0% of the food handlers were females older than 30 years of age. Only (56.8%) attained a secondary education level and just less than 50% of the food handlers either had no formal education or only attained primary education level. Up to 60.9% had no prior experience in food hygiene and safety, and more than 70.0% did not receive in-service training in food safety, kitchen operations, equipment cleaning techniques, clean as you go principle, stock management, first in first out principle, personal hygiene, chemical safety, and pest control. There was a general lack of knowledge on HACCP; however, most indicated a key interest in being trained on HACCP. There were still food handlers who do not know food safety
ii
aspects such as the importance of always washing hands before food preparation, using the correct and appropriate chemicals for washing hands and dishes, and that it is not safe to serve food contaminated with flies and cockroaches for human consumption.
More than 80% of the food handlers recognized the significance of the NSNP and over 90% were aware of the importance of nutrition for children’s mental and physical development, the importance of food safety training, causes of food poising, signs and symptoms of food poisoning and that meat should be brought from approved sources. However, up to 15% of food handlers were not aware of the above-mentioned food safety-related aspects, while 17% of the food handlers reported that they encountered food poisoning outbreaks in the schools where they are currently employed. When the food handlers were asked about their frequency of washing hands before handling food and wearing hairnets and jewellery during food preparation, up to20% portrayed a lack of awareness while the remaining 80% followed good hand washing practices. There is still a lack of infrastructure such as (kitchens), potable running water, handwashing facilities, waste management systems and pest control measures. Non-compliance with food preparation facilities is a huge concern as it influences practices and food handlers' perspectives on food safety. It further has implications for maintaining or adhering to food safety measures.
Conclusion: Even though general knowledge and awareness of food handlers was indicated to be at a satisfactory level by the results of this study, there are still a lot of gaps that need to filled for the purpose of NSNP to be fully realised. These were exposed through the poor practices of food handlers which were reported in the study as well as the infrastructure challenges. Government needs to intensify efforts to enhance appropriate food safety at public schools through implementation of hygiene and safety programs. Provision of suitable infrastructure for food preparation should be accelerated. Schools should be equipped with basic services such as
iii
adequate potable running water, waste management, electricity for cooking and maintain the cold chain of the food products. Training of food handlers on food safety needs to be prioritized and conducted before newly recruited food handlers commence with the job. The Department of Education need to coordinate collaboration with different stakeholders who are key in the food industry to ensure that food safety trainings are inclusive and food handlers are fully capacitated and monitored regularly. Food handlers need to realise that their roles and responsibilities in food safety have health implications and are bidding. As much as it seems like the NSNP is the responsibility of the Department of Education as the custodians, district and metropolitan municipalities have a huge role to play in the prevention and control of food poisoning outbreaks emanating from learning institutions and they need to actively play their role.
It is recommended that information from this study be used by policy-makers, law enforcement authorities, schools, and other stakeholders to develop strategies, policies, and training material that will strengthen food safety measures and curb food poisoning outbreaks in public schools. Furthermore, the results of this study may assist the Department of Education in better planning and subsequently channelling resources where they are needed most.
Key Words: Knowledge; Awareness; Attitude; Practices; Food handlers; Food hygiene; Food safety.