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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 18  |  Issue : 2  |  Page : 100-107

Determinants of personal hygiene practices: comparison of street food vendors and canteen food handlers in commercial City of Northwestern Nigeria


1 Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Community Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano State, Nigeria
3 World Health Organization, Jigawa State Field Office, Kano, Nigeria
4 Department of Microbiology, Bayero University, Kano, Nigeria

Date of Submission20-Jun-2021
Date of Decision30-Jun-2021
Date of Acceptance04-Jul-2021
Date of Web Publication10-Dec-2021

Correspondence Address:
Dr. Usman M Ibrahim
Department of Community Medicine, Aminu Kano Teaching Hospital, PMB 3452 Kano State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_30_21

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  Abstract 


Background: Increasing consumption of vended foods may pose a significant public health threat associated with food-borne illnesses. Context: Increasing consumption of vended foods may pose a significant public health threat associated with food borne illnesses. Aim: To assess and compare the determinants of personal hygiene practices among street food vendors and canteen food handlers in a commercial city of northwestern Nigeria. Settings and design: Using interviewer-administered questionnaire, comparative cross-sectional design was used Materials and Methods: As much as 310 (in each group) street food vendors and canteen food handlers, selected using a multistage sampling technique. Data analysis used: The data was analyzed using SPSS Version 22.0 Results: The proportion of street food vendors practicing correct personal hygiene measures were 214 (70.2%), compared with 213 (74.0%) canteen food handlers, respectively. There was a significant association between street food vendor's sex, ethnicity, educational status, hepatitis A or typhoid vaccination status, and the correct practice of personal hygiene (P < 0.05). Sex was found to be an independent predictor of personal hygiene practice (adjusted odds ratio = 4.7, 95% confidence interval = 1.3–16.7) among street food vendors with female street food vendors being five times more likely to observe correct personal hygiene practice than their male counterparts. Conclusions: Personal hygiene practice was found to be good among both street food vendors and canteen food handlers. However, there is a need for improvement if food-borne diseases are to be controlled; therefore, the government should ensure training and enforcement of all regulations to improve the personal hygiene practice thereby reducing the burden of food-borne illnesses.

Keywords: Food vendors, Kano, personal hygiene, practice


How to cite this article:
Ibrahim UM, Jibo AM, Gadanya MA, Musa A, Tsiga Ahmed FI, Jalo RI, Audu S, Danzomo AA, Abdullahi S, Bashir U, Umar ML. Determinants of personal hygiene practices: comparison of street food vendors and canteen food handlers in commercial City of Northwestern Nigeria. Niger J Basic Clin Sci 2021;18:100-7

How to cite this URL:
Ibrahim UM, Jibo AM, Gadanya MA, Musa A, Tsiga Ahmed FI, Jalo RI, Audu S, Danzomo AA, Abdullahi S, Bashir U, Umar ML. Determinants of personal hygiene practices: comparison of street food vendors and canteen food handlers in commercial City of Northwestern Nigeria. Niger J Basic Clin Sci [serial online] 2021 [cited 2022 Dec 9];18:100-7. Available from: https://www.njbcs.net/text.asp?2021/18/2/100/332190




  Introduction Top


Unsafe food consumption causes many acute and lifelong diseases, ranging from diarrheal diseases to various forms of noncommunicable diseases, with more than 200 diseases being spread through the consumption of contaminated food.[1],[2] Everyone, including farmers and growers, manufacturers and processors, food handlers and consumers, has the responsibility to ensure that food is safe and suitable for consumption.[3] Personal and environmental hygiene facilities should be available in food canteens to ensure that an appropriate degree of personal and environmental hygiene is maintained to avoid food contamination.[1],[2],[3],[4],[5],[6],[7]

Foods sold outside the home, either street vended or in the canteens, are a significant source of inexpensive and convenient foods for both urban and rural populations globally.[7] However, it faces the increased risk of contamination by physical, chemical, or biological agents, potentially due to poor personal hygiene among food handlers; therefore, it poses concerns in terms of food safety and hygiene.[7] A relationship was reported between consumption of foods outside home and various diseases, either from lack of knowledge about hygiene and food safety practices of food vendors or detection of infective bacteria in vended food samples.[7] Food-borne diseases not only adversely affect people's health and well-being but also have negative socioeconomic consequences for individuals, families, communities, businesses, and countries.[6]

The hands of any food handler, for example, should be washed properly and dried thoroughly before handling food and after handling raw foods, as well as at any other time when there might be a risk of spreading disease causing organisms,[4] and achieving improved personal hygiene and food safety, quality and nutrition, requires high-level political and policy commitment.[5] A significant proportion of food vendors were reported, for example, to be involved in smoking during work and do not wash their hands in between handling food and money, although some often use soap and water after using the toilet,[8],[9],[10],[11],[12] some food handlers do not either have an apron and do not cover their hair during the cooking process.[9] Similarly, food handlers were found not to regularly wash their hands before a meal, and untrimmed fingernails were reported to be independent predictors of intestinal parasitic infection among the food handlers.[10] Furthermore, the effectiveness of hygiene practices significantly depends on the registration status of the food vendor or the establishment[11] and training on food safety.[12] These poor personal hygiene practices expose about 2.5 billion people involved in eating street food daily to the risk of food-borne diseases[13] and explain the global high prevalence of food-borne disease (25%)[14]; this poses a potential threat to national and international public health safety and economic development.[15],[16]

The retail food sector is progressively increasing in Nigeria, including in Kano, with a significant number of street and canteen food vendors serving a good number of traders within Kano and those coming to Kano for commercial and other related activities. The two categories of food vendors are involved in food handling and operate on a daily basis serving a good number of Nigerian population and are likely to differ in terms of their personal hygiene practices with food sold in the open by street food vendors who are unlikely to observe recommended personal hygiene.

Legislations on compliance with personal hygiene are poorly implemented in developing countries, including Nigeria, and documented evidence on comparative analysis of personal hygiene practices among the street food vendors and canteen food handlers is generally lacking despite the increasing number and peculiarities of the two groups in areas of food preparation, serving, food consumption, and respective vending sites. The situation is perhaps worst among street food vendors who operate freely without any regulation.

Empirical evidence suggests that the key challenges facing the enhancement of safety guidelines in Nigeria include lack of awareness of the socioeconomic importance of food safety, paucity of data and information on the incidence of food-borne disease outbreaks, lack of understanding of food safety and quality standards as outlined in an international agreement, inability to enforce compliance with international standards on global best practices, inadequate infrastructure and resources to support scientific risk analysis and upgrading of food safety regulatory systems, insufficient food supply chain, and poor traceability system.[17],[18] This study aims to assess and compare personal hygiene practices among canteen and street food vendors, and the findings can help in addressing the identified barriers by the stakeholders.


  Materials and Methods Top


This was a comparative cross-sectional study design conducted in Kano. Kano State is one of the northern states in Nigeria, with a projected total population of 13,605,021 in 2019 based on a growth rate of 3.1% per annum.[19] Kano is referred to as the center of commerce in Nigeria due to long flourished marketing activities, and there is the existence of about 40 major markets of different varieties of commodities spread across the metropolis, operating daily between 9 a.m. and as late as 10 p.m.[20] Several food canteens and street food vendors are present in clusters around the different parts of the market areas and serve as the key source of food supply with different degrees of hygiene for the busy traders.

The Health Research Ethics Committee of the Kano StateMinistry of Health with approval number MOH/OFF/797/ T1/733 dated 5th June,2018 and Aminu Kano Teaching Hospital with approval number NHREC/21/08/2008/AKTH/EC/2260 dated 4th July, 2018 provided ethical clearance for the study. Permission to conduct the study was sought from the Kano State Ministry for Local Government and the Primary Health Care departments of the selected Local Government Areas (LGAs). Written informed consent was obtained from all the respondents selected for participation in this study using consent forms. Consent was sought after all the necessary information about the study had been explained in simple terms to the respondents. For respondents who could not read, the forms were explained to them in detail, after which they provided consent by thumbprinting in front of a witness. All provisions of the Helsinki Declaration were ensured during the study.

All street food vendors and canteen food handlers in the Kano metropolis, both registered and unregistered, who have been in the food vending business for a minimum of 6 months were included, whereas canteen staff involved in administrative activities of food vending were excluded.

The sample size was determined using the formula for comparing the two proportions.[21] With Z α =1.96, Z1− β = The probability of Type II error (β) of Power at 80% =0.84; P1 = Proportion of street food vendors in Kano with good food safety practices = 93.2% =0.932.[22] P2 = Proportion of canteen food handlers in Sokoto with good food safety practices = 86.3% = 0.863.[23] Using a nonresponse rate of 10% from the previous study,[24],[25] n = 310 per group were studied. A multistage sampling technique was used to study the eligible food vendors.

Stage 1: Selection of major markets in Kano metropolis

A list of all the major markets in the Kano metropolis was obtained.[18],[20] Major markets were selected because of the possibility of having a large number of street and canteen food vendors with significant patronage by people in the market. Using the list, 10 markets were randomly selected by simple random sampling using the balloting technique from the list of 40 major markets.

Stage 2: Selection of the canteens

Census was conducted in the selected major markets to obtain the total lists of canteens. This was conducted by mapping all the streets in the markets, using the traditional names assigned to the streets; numbers were allocated to all the canteens and stalls located in each of the mapped streets from which the total number of the canteens and stalls in each of the streets were obtained. The canteens to be studied were selected by simple random sampling/balloting technique using the numbers assigned to the canteens during mapping and numbering.

Stage 3: Selection of canteen respondents

One food vendor was interviewed in each of the randomly selected canteen and was randomly selected using a simple random sampling technique by balloting after generating a list of food handlers in each of the canteens.

Stage 4: Selection of street food vendors

Mapping and numbering of all the clusters of street food vendors were done and the average number of street food vendors in each cluster of the selected markets was obtained. The sampling frame of food vendors in each of the selected clusters was generated, and the respondents were proportionately allocated. The proportionately allocated respondents were picked up using a simple random sampling technique. Randomly selected numbers were traced to study the street food vendor bearing the name. If the number of street food vendors in the cluster did not meet up the proportionately assigned numbers, the next available clusters were studied in a similar pattern until the required sample size was obtained.

A pretested, semistructured, interviewer-administered adapted questionnaire[18],[22],[23] was used to collect data from the food vendors. Twenty research assistants were recruited and trained for this study (two for each of the markets selected). The training sessions were completed within 3 days and covered the objectives of the study, ethical issues in research, communication skills, how to administer the questionnaires, and mapping and numbering of street food vendors, among others, and the (31 each) street food vendors and canteen food handlers were studied in a market outside the state capital to pretest the data collection tool.

Data were analyzed using SPSS Statistical Software Version 22.0. There were 17 questions that assessed the respondents' practice of personal hygiene. Each question assessed the personal hygiene practice status as (either ever practiced but not currently practicing or currently practicing). Each correct current practice response to questions assessing the practice of personal hygiene was given one point, whereas ever practiced positive response was given a score of half a point, the wrong response was given zero points, and the total scores were summed up. Scores of less than 9 points was considered as wrong practice, whereas scores ≥9 was considered as correct personal hygiene practice.[18] The outcome variable is personal hygiene practice, whereas the independent variables are age, sex, marital status, among others. The Chi-square test was used for comparison of proportions at ≤5% α level of significance and a probability of ≤0.05 was considered as significant for all tests of significance at bivariate level. Factors with a P ≤0.1 at bivariate level were entered into a logistic regression model to adjust for confounding.[18]


  Results Top


The response rate among street food vendors and canteen food handlers were 98.4% and 92.9%, respectively.

Sociodemographic characteristics

The mean ages (± standard deviation [SD]) of street food vendors and canteen food handlers were 24.6 ± 9.1 and 32.1 ± 10.3 years, respectively. Almost half (46.6%) of the street food vendors were in the second decade of life compared with less than one fifth (15.2%) of canteen food handlers.

About one half of street food vendors (53.0%) and one third of canteen food handlers had less than 5 years work experience in food vending, respectively, with a median work experience of 4 and 7 years, respectively. Nearly two thirds of the street food vendors (62.0%) and half of canteen food handlers (51.4%) learned food vending business from their parents, respectively. Similarly, more than one half of street food vendors (56.4%) and canteen food handlers (56.6%) often worked ≥35 hours per week in food vending business with median work duration of 35 and 42 hours, respectively.

More than half of the street food vendors (57.0%) and canteen food handlers (58.3%) were involved in both food preparation and serving. Most of the street food vendors (73.1%) earned <18,000 Naira per month, whereas one half (50.0%) of the canteen food handlers earned that amount with a median of 10,000 and 17,500 Naira, respectively. Furthermore, about one third of street food vendors (35.0%) and canteen food handlers (35.8%) were vaccinated against either hepatitis A or typhoid, respectively, as shown in [Table 1].
Table 1: Sociodemographic characteristics of respondents

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Personal hygiene practices

The scores for personal hygiene practice among street food vendors and canteen food handlers ranged from 1 to 17 and 2 to 16, respectively, with mean ± SD of 10.1 ± 2.8 and 10.5 ± 2.8, respectively. Street food vendors and canteen food handlers with correct personal hygiene were 70.2% and 74%, respectively, as shown in [Figure 1]. Handwashing using soap and water was practiced by majority of street food vendors (81.6%) and canteen food handlers (82.6%). Similarly, handwashing after touching the hair was practiced by about one third of street food vendors (30.2%) and canteen food handlers (31.3%) as shown in [Table 2].
Table 2: Correct responses to parameters used to assess personal hygiene practice of respondents

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Figure 1: Personal hygiene practices of respondents. Χ2 = 1.06, P-Χ2 = 1.06, P = 0.3

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Street food vendors from other ethnic backgrounds significantly practiced correct personal hygiene (86.1%, P = 0.03). More so, street food vendors with a secondary level of education significantly practiced correct personal hygiene (78.8% ,P = 0.02), whereas canteen food handlers with a tertiary level of education significantly practiced correct personal hygiene as shown in [Table 3]a while non-vaccination was significantly associated (78.6%0, P=0.03) with correct personal hygiene practice among street food vendors as shown in [Table 3]b. Sex was the only significant predictor of personal hygiene practice among street food vendors as shown in [Table 4].
Table 3:

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Table 4: Predictors of personal hygiene practice among respondents

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  Discussion Top


In comparison with a previous study conducted in Kano, lower personal hygiene practice of 70.2% was found among street food vendors in our study. Most street food vendors were found to have good practices of personal hygiene 93.2%, with only 17.1% having good practice of food hygiene in a study conducted in Kano,[22] unlike what was obtained in Niger Delta, Nigeria, with up to 96.7% having good hygiene practice.[25] Similarly, studies conducted in southwestern Nigeria in both local eateries and cafeterias identified poor personal hygienic practices[26],[27] among the food handlers. The difference in finding especially looking at the study conducted in Kano among street food vendors underscores the importance of regular supervision even after enforcing the existing food safety guidelines if compliance is to be ensured. More so, emphasis on the safety practices should be made clear, because in addition to improving the safety of vended food, improving personal hygiene can improve the well-being of the immediate family of food vendors and the community at large, partly because the practices are likely replicated at the level of the family and the larger community. This can help in promoting informed adherence to personal hygiene and other food safety guidelines.

We found that nearly half and a third of canteen food handlers and street food vendors used aprons during food preparation. However, tidy attire was worn by the majority of canteen food handlers and street food vendors; the wrong method of observing hygiene after using the toilet and handwashing after touching the hair were correctly practiced by about a quarter of canteen food handlers and street food vendors, respectively. This may be explained by the fact that physical cleanliness unlike hygienic practices may not be identified by food consumers and may promote their patronage. The reverse was true for food handlers in South Africa and Kenya who were found to follow standard regulations in keeping with personal hygiene regulations among canteen food handlers.[28],[29] It, therefore, shows that existing guidelines in Kano should be reviewed and enforced appropriately and the vendors are well-informed through appropriate channels. Achieving this may need specialized and trained inspectors across the state to ensure both registration of all the food vendors and regular supervision to ensure compliance with the guidelines using a standardized and accepted checklist that should be readily available to all the food vendors. The success of intervention program may require regular training and retraining of food vendors and their inspectors, which must employ collaboration with various stakeholders including nongovernmental organizations involved in food safety promotion and food-borne diseases prevention. More so, the success of safety programs can be strengthened if the association of food vendors is involved at various stages of the program.

The finding of the relationship between female sex, being from other ethnic groups, having secondary education, not receiving hepatitis A or typhoid vaccine, and correct practice of personal hygiene among food vendors may be explained technically by various sociocultural practices and norms of the study area. For example, females are the culturally accepted group in Hausa/Fulani culture for preparing and serving food, and they are being trained from early adolescence on this social role. This may explain the finding of female sex and correct practices by our study. Similarly, other ethnic groups may practice better personal hygiene to attract customers from predominantly Hausa/Fulani community who are the majority consumers of the vended food, with those formally educated to the level of secondary school more likely to read and understand what constitutes the recommended personal hygiene guidelines, which can promote the practice and prevent the spread of food-borne diseases. Furthermore, schools at various levels in Nigeria, starting from primary school are involved in school health services programs, and personal hygiene is one of the key components. This provides an additional advantage of better awareness on basic personal hygiene guidelines and resultant negative effect of not following it as it adversely affects not only the individual but also the immediate family and other community members to the food vendors privileged to have formal education. For vaccination, those who received hepatitis A/typhoid vaccine may have a false sense of protection unlike those who did not receive the vaccine; this may limit their efforts in ensuring safe practices.


  Conclusion Top


Personal hygiene practices among street food vendors and canteen food handlers were found to be fair, with canteen food handlers having better practices, although improvement is required to reduce the burden of food-borne diseases. Therefore, the government should ensure training, supervision, and enforcement of personal hygiene guidelines.

Author's contribution

All the authors contributed equally

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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