Food safety knowledge, attitudes and self-reported practices of food handlers in institutional foodservice in Accra, Ghana

The aim of this study was to evaluate the food safety knowledge, attitude and practices (KAP) of food handlers from institutional food service establishments that serve hospitals, boarding senior high schools and prisons in Accra, Ghana. A total of 278 food handlers (56.8% of hospital, 30.9% of schools and 12.3% of prison food service) participated in the cross-sectional study. Data was collected by face-to-face interviews, and responses were scored to determine the level of food safety KAP. Respondents who scored ≥70% of the maximum possible score were adjudged to have sufficient knowledge and practices and positive attitudes. Results showed that respondents generally had insufficient food safety knowledge and practices with means scores of 20.99 ± 7.64 (46%) and 9.35 ± 5.62 (52%) respectively. Attitudes towards food safety were generally negative but with a comparatively higher mean score of 12.64 ± 3.06 (63%). Areas of most concern were 1) Lack of knowledge of sources of contamination/cross-contamination and appropriate holding temperatures for food. 2) Poor practices included multiple freeze-thaw cycles for frozen food and 3) Infrequent hand washing during food preparation after coughing or sneezing. There is the need for continuous risk based training to educate and effect behavioral changes among food handlers. This process will encourage positive attitudes towards food safety and consequently promote good food safety practices.