TABLE OF CONTENT

Title Page                                                                                                         i

Approval                                                                                                                ii

Certification                                                                                                   iii

Dedication                                                                                                                    iv

Acknowledgement                                                                                                   v

Table of Contents                                                                                             vi

List of Tables                                                                                                    ix

List of figures                                                                                                       x

Abstract                                                                                                               xi

CHAPTER ONE: INTRODUCTION

Background of the Study                                                                                     1

Statement of Problem                                                                                         4

Purpose of the Study                                                                                              5

Objectives of the Study                                                                                  5

Research Questions                                                                                              5

Research Hypotheses                                                                                      6

Significance of the Study                                                                                       6

Scope of the Study                                                                                              7

Operational Definition of Terms                                                                           7

CHAPTER TWO: LITERATURE REVIEW

Theoretical Review                                                                                                 32

Conceptual Review                                                                                              34

Empirical Review                                                                                            35

Summary of Literature Review                                                                        46

CHAPTER THREE: RESEARCH METHOD

Research Design                                                                                                47

Area of Study                                                                                                          47

Population of Study                                                                                     48

Sample                                                                                                    48

Inclusion Criteria                                                                                      48

Sampling Procedure                                                                                   49

Instrument for Data Collection                                                                         49

Validity of Instrument                                                                                             50

Reliability of Instrument                                                                                   50

Ethical Consideration                                                                                       50

Procedure for Data Collection                                                                       50

Method of Data Analysis                                                                              51

CHAPTER FOUR: PRESENTATION OF RESULTS

Data Presentation and analysis                                                                     52

Summary of Major Findings                                                                           63

CHAPTER FIVE: DISCUSSION OF FINDINGS

Discussion of findings                                                                                       65

Implication of the findings                                                                               68

Limitations of the study                                                                                       69

Summary                                                                                                                70

Conclusion                                                                                                      71

Recommendations                                                                                         71

Suggestions for further studies                                                                 72

References                                                                                                          73

Appendix I Names of restaurants in the two selected towns in Nnewi Urban                      85

Appendix ii Selection of sample size using the minimum sample size formula                      87

Appendix iii Calculation of proportion of restaurants                                                           88

Appendix iv Instrument for data collection                                                                           89                                                                                                       

LIST OF TABLES

Table 1:          Recommended minimum internal temperature of food                                  30

Table 2:          Socio-demographic data of the respondents                                                  52

Table 3:          Knowledge of food safety by food handlers                                                 53

Table 4a:        Food safety practices in food preservation (questionnaire items)                  55

Table 4b:        Food safety practices in food preservation (checklist items)                          56

Table 5a:        Food safety practices in food preparation (questionnaire items)                    57

Table 5b:        Food safety practices in food preparation (checklist items)                           58

Table 6a:        Food safety practices in food serving (questionnaire items)                          60

Table 6b:        Food safety practices in food serving (checklist items)                                  61

Table 7:          Overall practice of food safety                                                                       61

Table 8:          Relationship between age and knowledge of food safety                             62

Table 9:          Relationship between educational level and food safety practice                  62

Table 10:        Relationship between length of service and food safety practice                  63

LIST OF FIGURES

Figure 1:         Theory of Reasoned action to explain food handlers knowledge and

practice of food safety.                                                                                   33

ABSTRACT

Food borne disease remains a major public Health problem across the globe. The high incidence of food borne illness has led to an increase in global concern about food safety. The purpose of this was to assess food safety, knowledge and practices among food handlers in restaurants in Nnewi Urban. The researcher utilized a cross sectional descriptive survey design and a convenient sampling method was used to reach one hundred and eighty (180) food handlers from two randomly selected towns in Nnewi Urban. A validated questionnaire and checklist constructed by the researcher were used to collect data. Information obtained from the questionnaire and checklists were subjected to descriptive statistics and chi-square test of association at 0.05 level of significance. Analysis of data was done with the SPSS version 20.0. Findings revealed that majority (77.9%) of respondents had good knowledge of food safety. Above average (58.6%) were observed to have good food safety practices. There was no relationship between age of respondents and knowledge of food safety (p = .693). There was no relationship between educational level and food safety practices (p = .404).Length of service of respondents was significantly related to their practice of food safety (p = .015).Based on these findings, it was recommended that Health and Environmental Authorities should improve on the implementation of existing food hygiene laws. Nurses, Public health officers and Health educators; should intensify efforts to correct poor food safety practices. The government and related health agencies should provide the necessary logistics to ensure that all restaurants / food handlers are registered especially in rural areas.

CHAPTER ONE

INTRODUCTION

Background to the Study

Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food is any substance that can be taken through ingestion to supply nutrient and energy for growth and development. Food has direct influence on health and it is therefore pertinent to keep food free from contamination, (Daniyan & Nwokwu, 2011). Food handlers play important role in ensuring food production and storage, (Abdalla & Suliman, 2009).

Food safety is an area of public health action to protect consumer from the risks of food poisoning and food borne diseases, acute or chronic. Unsafe food can lead to a range of health problems: diarrhoeal disease, viral disease (the first Ebola cases were linked to contaminated bush meat); reproductive and developmental problems, cancers. Food safety is thus a prerequisite for food security (WHO, 2015). Unsafe food can contain harmful bacteria, viruses, parasites or chemical substances, and cause more than 200 diseases ranging from diarrhea to cancers (WHO 2015).

New threats to food safety are constantly emerging, changes in food production, distribution and consumption (globalization of food trade, mass catering and street food); changes in the environment; new and emerging bacteria and toxins; antimicrobial resistance – all increase the risk that food becomes contaminated (WHO, 2015). Increase in travel and trade enhance the likelihood that contamination can spread. The World Health Organization helps and encourages countries to prevent, detect and respond to food borne disease outbreaks- in line with the codex alimentarius, a collection of international food standards, guidelines and codes of practice covering all the main foods (WHO, 2015). Access to sufficient amounts of safe and nutritious food is the key to sustaining life and promoting good health. Food borne and water borne diarrhoeal diseases kill an estimated 2 million people annually, including many children (WHO, 2015). Food safety, nutrition and food security are inextricably linked. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, the elderly and the sick (WHO, 2015).

Food safety requires much more than a clean premises (Adewunmi, Ajayi, & Omotoso, 2014). The knowledge of food handlers’ practices is the key to addressing the trend of increasing food-borne diseases (Adweunmi et al, 2014). Food poisoning and other food borne diseases could occur in restaurants located in places such as schools, hostel, hospitals and market places where food and drinks are served or sold to groups by food handlers (Adweunmi et al, 2014). The high incidence of food borne illness has led to an increase in global concern about food safety (Van Tonder, 2007). In the UK alone it is estimated that there are a million cases of food borne disease each year, resulting in 200,000 hospital admissions and 500 deaths (Food Standards Agency, 2011). Similarly, in the US, one in six of the population is thought to suffer from food borne disease annually with 3000 deaths attributed to this cause (Painter, Hockstra & Tauxe, 2013). While there are no known estimates of the global economic burden from food borne disease, in the UK it is reported to be I.8 billion pounds per annum (Food Standards Agency, 2013).  Individuals aged over 60 years, pregnant women, children under five years and others with a compromised immune system are thought to be particularly vulnerable to the effects of food borne disease.  Several food-borne disease outbreaks have been reported to be associated with poor personal hygiene of people handling food stuffs (ACMSC, 2009).

Food borne diseases are increasing in both developed and developing countries. Diarrhoea diseases, mostly caused by food borne microbial pathogens, are leading causes of illness and death in developing countries, killing an estimated 1.9 million people annually at the global level (Adewunmmi et al, 2014). Food contamination may occur at any point during its journey production, processing, distributing, and preparation (Green 2006). Infection can also be acquired through contaminated unwashed fingers, insects, circulation of bank notes and wind during dry weathers (Isara, 2009). Street food have been designated important sources of affordable food, but often do not meet proper hygiene standards, in large part because of weak regulatory systems, lack of good financial resources to invest in safer equipment, and lack of education for food handlers. The food may satisfy immediate needs, but pays little attention to food safety (Santosh, Nogueira, & Patara, 2008).

However, in developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food, water, nails and fingers contaminated with faeces. Accordingly, food handlers with poor personal hygiene could be potential sources of infections by these micro-organism (Ifeadike, Ironkwe, Adogu, Nnebue, Emelumadu, Nwabueze & Ubajaka, 2014). 

In recent years, changing lifestyle, breakdown of joint family system and increase in number of working women has led to consumption of ready-to-eat foods from restaurants (Santosh et al, 2008). These have resulted in more school children, university students, and workers depending on restaurants for breakfast and midday food, thus the whole community is involved. The implication is that people in the community are exposed to hazards of purchasing food from restaurants that may harbour dangerous pathogens or have the potentials of spreading infection to a large number of populations. Food handlers in restaurants are required to follow health standards of handling food and keeping their cooking areas clean and bacteria free. An adequate supply of safe, wholesome and healthy food is essential to the health and well being of humans (e-How, 2011).

Statement of Problem