Hygiene Practices Among Food Vendors in Educational Institutions in Lower Manya Krobo Municipality in The Eastern Region of Ghana

Abstract

Background: Food hygiene plays a critical role in safeguarding public health, particularly in school environments where students are reliant on food vendors for daily meals. In Ghana, lapses in hygiene among food vendors have been linked to foodborne illnesses and outbreaks, emphasizing the need for targeted interventions. Despite the widespread presence of food vendors in educational settings, there is limited data on their hygiene-related knowledge, attitudes, and practices (KAP), especially in the Lower Manya Krobo Municipality. This study aims to assess the levels of hygiene KAP among food vendors in educational institutions and examine the socio- demographic factors that influence these practices. Methodology: An analytical cross-sectional survey design was employed, targeting food vendors operating within public and private schools in the Lower Manya Krobo Municipality. Data were collected using a structured, interviewer-administered questionnaire based on validated KAP tools. Pre-testing of the questionnaire was conducted among schools in a town not included in the data collection. Data were analyzed using STATA version 18, employing descriptive statistics and inferential methods such as Chi-square tests and logistic regression to identify predictors of good hygiene behavior. Results: A total of 388 vendors were surveyed. Overall hygiene knowledge was high in 29.1%, moderate in 44.1%, and low in 26.8%. Hygiene attitudes were positive in 57.5%, fair in 30.6%, and poor in 11.9%. Hygiene practices were good in 34.0%, fair in 44.3%, and poor in 21.6%. Bivariate analyses showed no significant associations between socio-demographic variables and knowledge (all p > 0.05). Attitudes were associated with age (p < 0.001), sex (p = 0.039) and training (p = 0.05) but not with marital status, education, work experience, or training (p > 0.05). Practices were associated with age (p = 0.012) and marital status (p = 0.041), but not with sex, education, work experience, or training (p > 0.05). In multivariable models of formal training, vendors with tertiary education had lower odds of having received training than those with JHS (AOR = 0.418; p = 0.028); vendors with low (AOR = 0.386; p = 0.033) and moderate knowledge (AOR = 0.407; p = 0.016) also had lower odds compared with those with high knowledge. Conclusion: Food vendors in educational settings in Lower Manya Krobo Municipality exhibit generally moderate KAP, but there is a clear knowledge-to-practice gap, especially for hand hygiene and waste management. Age and marital status shape hygiene practices, and younger/single vendors appear more vulnerable to suboptimal behaviours. Improving safety requires continuous, practical hygiene training, regular supervision/inspection, and basic infrastructure (handwashing stations, covered bins) at vending points. Given the training disparities, targeted outreach should prioritize vendors with lower knowledge and ensure training access across all education levels, including those with tertiary education, to translate awareness into consistent safe practices.