This study aimed to evaluate the food hygiene practices and factors associated with them among street food vendors in Addis Ketema Sub City, Addis Ababa. The prevalence of good food hygiene practices among the street food vendors was found to be 33.2% (95% CI: 28.2, 38.3). Factors significantly associated with good hygiene practices included food handling training, knowledge, uninterrupted water supply, visits from health professionals, and more than one year of work experience.
This result is consistent with the findings from a study conducted in Gedeo Zone, Southern Ethiopia, which reported a prevalence of 31.5% (18). However, it is lower than the prevalence reported in previous studies conducted in different parts of Ethiopia, such as 53% in Dessie (19), 49.1% in Gondar city (20), and 51.4% in Gojam (21). This difference could be attributed to variations in the study period and food safety regulations. For example, in Gondar town, more than half (56%) of street food vendors are licensed, and 62% of vendors in Dessie town undergo regular medical checkups. These factors may contribute to better food hygiene practices.
Additionally, this finding is lower than those reported in studies conducted outside of Ethiopia, such as in Benin City, Nigeria (84%) (22), Alexandria, Egypt (67%) (10), Santo, Brazil (41.5%) (23), Myanmar (41.5%) (24), Bangladesh (46.4%) (25), and Poland (63%) (26). This variance could be attributed to differences in interventions across nations, study periods and settings, availability of infrastructure, and variations in the sociodemographic and socioeconomic characteristics of vendors. For instance, in Alexandria, more than half (53%) of street food vendors have access to running water at their vending sites. In Myanmar, participants were solely selected from registered street food vendors, and 27% of them had received higher education in college, with the majority earning a monthly income of $266USD. These factors may contribute to a higher level of food hygiene practices compared to the study area.
However, this finding is higher than those of studies conducted in Shashamene (27%) (14) and Tharaka Nithi County, Kenya (12%) (25), potentially attributable to differences in the study period, study design, and sample size.
This study identified work experience as a factor associated with the hygienic practices of street food vendors. This observation is in line with the findings of studies conducted in Dessie, Ethiopia (19), Kiambu County, Kenya (28), and Zanzibar (29). However, it contrasts with the results of a study conducted in northern Kuching city, Malaysia (37), which found that good hygienic practices were more prevalent among street food vendors with a shorter duration of food vending. This discrepancy may be attributed to the notion that the length of time spent in the street food vending business may positively correlate with the vendor's accumulation of food hygiene and safety knowledge over time. Consequently, vendors who have been in the business for an extended period are generally expected to possess better food hygiene and safety knowledge, although this is not always the case.
An uninterrupted water supply emerged as a crucial factor independently associated with maintaining good food hygiene practices. Street food vendors with continuous access to water exhibit better hygiene practices compared to those experiencing interruptions in their water supply. This finding is consistent with studies conducted in the Gedeo Zone, Southern Ethiopia (30), and Florianopolis, Brazil (31). Water plays a critical role as a raw material in various street food vending operations, including drinking, washing, cleaning, and other essential tasks. Street vendors commonly utilize water to cleanse utensils, including those previously used to serve food, which may have undergone multiple washes. The absence of clean and suitable water poses challenges in maintaining hygienic food preparation practices, thereby increasing the risk of food contamination. An inadequate supply of water can significantly hinder vendors' ability to adhere to proper hygiene practices. Therefore, ensuring the provision of adequate and continuous water supply to street food vendors is essential to promote good hygiene practices and ensure consumer safety.
This study also found that street vendors who underwent formal training in food handling demonstrated better food hygiene practices compared to those who learned through observation. This finding is consistent with studies conducted in Dessie, Ethiopia (19), Gondar city in Northwest Ethiopia (20), Can Tho city, Vietnam (17), Nigeria (32), and North Dayi District, Ghana (33). However, it contrasts with a study conducted in Benin City (22), which found no association between training in food safety and the hygienic status of vending premises. This variance may be attributed to the fact that appropriately trained food handlers are equipped to take necessary precautions to prevent malpractice during food handling. Therefore, it is essential for street food vendors to receive proper training in basic food handling principles and personal hygiene rules to enhance their hygienic practices. This finding underscores the significance of training food handlers in basic food handling principles to notably improve the hygienic practices of street food vendors. They should also be linked to training programs such as the World Health Organization’s (WHO) Five Keys criteria, which are recognized guidelines for establishing and upholding safer and more hygienic food practices (34).
This study indicated that street food vendors with a strong understanding of food handling practices tended to exhibit better food hygiene practices compared to those with limited knowledge. This observation aligns with findings from studies conducted in Shashemene Oromia (14), Gondar city in Northwest Ethiopia (20), and Myanmar (24). Street food vendors are typically expected to possess significant knowledge and skills regarding the hygienic handling of food. It stands to reason that food handlers with a solid understanding of proper practices are more likely to engage in them. Therefore, this finding underscores the importance of equipping street food vendors with comprehensive knowledge on safe food handling, which can be achieved through formal food handling training and health education provided during visits by health professionals.
The present study found a significant association between food hygiene practices and regular inspections. Street food vendors who had inspections by health professionals were more likely to demonstrate good food hygiene practices compared to those who did not receive such inspections. This finding is consistent with studies conducted in Gedeo Zone, Southern Ethiopia (30), and Kiambu County, Kenya (28). The presence of supportive visits by health professionals can enhance the food handling practices of street food vendors by providing routine practical assistance and feedback on their handling practices. The absence of supervision and support from health professionals creates opportunities for vendors to sell unhygienically prepared food (28). This highlights the importance of health workers conducting regular inspections of vendors and providing professional guidance to improve food hygiene practices.
Limitation of the study
Direct observation of food vendors by data collectors may have influenced the food hygiene practices of street food vendors. To mitigate these limitations, food vendors were not informed before the observation began, although consent was obtained on previous days before the observation on a different day. Additionally, causal conclusions were not drawn from associations between variables since this was a cross-sectional study. Moreover, qualitative evaluation of food safety based on microbial analysis could enhance the current study.