Food handler's level of COVID-19 prevention practice and preparedness of food and drinking establishments to combat the pandemic in Eastern Ethiopia

Abstract

BackgroundFood and drinking establishments are potential hotspots for the spread of coronavirus. Food handler's have a higher risk of contracting the disease and transmitting it to others. The aim of this study was to assess the food handler's level of preventive practices toward COVID-19 and the preparedness of food and drinking establishments to tackle the pandemic in Eastern Ethiopia.MethodsThe cross-sectional study design was conducted from September 1 to 30, 2020. A stratified sampling technique was used to select 276 licensed public food and drinking establishments and a simple random sampling technique was employed to select 422 food handlers from the selected establishments. A face-to-face interview and checklist-based observation were used to collect data. The collected data were entered into Epidata 3.1 and exported to STATA version 16 for analysis. Binary logistic regression analysis were conducted to identify factors associated with COVID-19 preventive practice. Statistical significance was declared at p < 0.05.ResultsAbout 406 food handler's participated in this study, making the response rate 96.2%. The study showed that 38.4% of study participants (95% CI: 33.5, 43.1) had good preventive practices for COVID-19. Only 10.5% of food and drinking establishments fulfilled all requirements to prevent COVID-19 transmission. Being male [AOR = 0.61, 95% CI(0.61, (0.39, 0.93)], attending secondary education [AOR = 2.20, (95% CI: 1.37, 3.53)], having a favorable attitude toward COVID-19 [AOR = 1.89, (95% CI: 1.22, 2.95)], and having good knowledge about COVID-19 [AOR = 1.78, (95% CI: 1.13, 2.81)] were significantly associated with the level of COVID-19 preventive practices.ConclusionThe level of good COVID-19 preventive practice was found to be low among the food handler's. Only one in ten food and drink establishments fulfilled the national guideline for preventing COVID-19 transmission. Being male, attending secondary education, having knowledge about COVID-19, and having a favorable attitude toward COVID-19 were significantly associated with good COVID-19 preventive practices. A vibrant guideline on prevention practices should be in place at all establishments, and compliance should be monitored. Local health office experts should take comprehensive measures to make all food and drinking establishments accountable for practicing all preventive measures.

What motivates food workers to adhere with WHO guidelines to combat the COVID-19? A social cognitive theory perspective

“…Two possible reasons for the inconsistency are that the knowledge measurement items differ, and the other is that Ferreira et al ( 13 ) study only targeted food workers in public school food services, who, since food safety in schools is of great concern, may have more training. Moreover, knowledge was also identified as a significant promoter of worker adherence to hygiene practices, which is consistent with the outcome of many previous studies, such as Habte et al ( 5 ), Akabanda et al ( 10 ), Sani and Siow ( 12 ). It should be noted, however, that while knowledge has a significant positive effect, the effect magnitude is not strong that is significantly lower than the self-efficacy and risk perception ones in the cognitive dimension, implying that the knowledge–behavior gap still remains among food workers ( 33 ).…”

“…Our survey revealed that near half of the knowledge of hygiene practices is poorly understood by food workers, which implies that the knowledge of food handling possessed by professionals who handle food is significantly inadequate. This result is similar to the results of Habte et al ( 5 ) survey on food handlers’ knowledge in Ethiopia (mean correct rate = 58.4%) and Olaimat et al ( 32 ) survey on food handlers’ knowledge in Jordan, but lower than the results of Ferreira et al ( 13 ) survey on food workers in Brazil (mean correct rate = 72.2%). Two possible reasons for the inconsistency are that the knowledge measurement items differ, and the other is that Ferreira et al ( 13 ) study only targeted food workers in public school food services, who, since food safety in schools is of great concern, may have more training.…”

“…Binary logistic regression with a stepwise-backward approach was employed to uncover the drivers that had significant effects on food workers’ adherence to WHO-initiated hygiene practices. Factors with p < 0.25 in bivariate logistic regression were entered in multivariate logistic regression ( 5 ). Crude (COR) and adjusted odds ratios (AOR) along with 95% CI were calculated to evaluate the effect strength.…”

“…Relevant studies after the outbreak, however, are limited, especially the lack of studies on Chinese food workers. Existing research is mostly focused on the effects of knowledge, attitudes, and demographic variables ( 5 , 13 , 14 ). However, many studies have confirmed that while knowledge and attitude exert influence on behavior formation, it has also been determined that individuals with knowledge and positive attitudes do not necessarily act accordingly, i.e., there exists knowledge–behavior gap and attitude-behavior gap ( 15 , 16 ).…”

“…But anything that surrounds food, like food packaging, utensils, and tabletop, may still be a vehicle or petri dish for the spread of the virus (2). It has been accepted that improper handling of food may lead to infection with the virus (3)(4)(5). Food service establishments have become the worst-hit by the transmission of the virus (6).…”