J Egypt Public Health Assoc
Vol. 84 No. 1 & 2, 2009
Food Safety Knowledge and Practices among
Women Working in Alexandria University, Egypt
Mohamed Fawzi*, Mona E. Shama**
*
Department of Nutrition, High Institute of Public Health, Alexandria University
** Department of Health Administration and Behavioral Sciences,
High Institute of Public Health, Alexandria University
ABSTRACT
Ensuring food safety at the household level is well accepted and
an understanding of the status of the food handling knowledge and
practices is needed. Food safety knowledge and practices of 270
women working in six faculties and institutions of Alexandria
University were assessed using a questionnaire including data on
personal characteristics, previous attack of prominent food poisoning,
and four parameters of food safety knowledge and practices. The
highest percentage of food poisoning cases (46.8%) was belonging to
staff members and 39.7% were in the age group <10 years. Half of the
cases resulted from eating outside home compared to 16.7% from
eating at home. The mean score percentage of the total safety
Knowledge of the sample was 67.4 compared to 72.0 for their safety
practices. The highest Knowledge score was in personal hygiene
(73.8) while the highest practice score was in cooking (77.5). The
lowest Knowledge score was in food preparation (59.8) whereas the
lowest practice was in purchasing and storage (62.7). The highest
mean scores percentages of the total food safety knowledge and its
four associated parameters were among staff members with
significant differences among different jobs except in food
preparation. The highest scores of the total food safety practices and
their parameters were among clerks except in practicing safe
purchasing and storage where the highest mean score was among staff
Corresponding Author:
Dr. Mohamed Fawzi
Department of Nutrition, High Institute of Public Health,
Alexandria University
e.mail: mohamedfawzi_hiph@yahoo.com
J Egypt Public Health Assoc
Vol. 84 No. 1 & 2, 2009
members (66.5± 12.8) with significant differences among jobs except in
practicing personal hygiene. Conclusion and recommendations: The
study showed inadequate safety Knowledge and practices among all job
categories. The inconsistencies between Knowledge and practices
emphasize the need for implementing repeated food safety education
programs.
Key words: Food safety knowledge, food safety practices, food poisoning, personal
hygiene.
INTRODUCTION
The incidence of foodborne diseases is rising in developing
countries, as well as in the developed world.(1) Although their
global incidence is difficult to estimate, it has been reported that
in 2000 alone 2.1 million people died of diarrheal diseases. A
great
proportion
of
these
cases
contamination of food and drinking
can
be
water.(2)
attributed
to
Food prepared at
home has been identified as a major source of food poisoning.(3)
In response to the increasing number of foodborne illnesses,
governments all over the world are intensifying their efforts to
improve food safety.(2) Food safety is defined as the degree of
confidence that food will not cause harm to the consumer when
it is prepared, served and eaten according to its intended use.(4)
Although the public is increasingly concerned about foodrelated risks, the rise in food poisoning cases suggests that
people still make decisions of food consumption that are less
ideal from the safety perspective.(5) The percentage of food
poisoning cases arising from food preparation practices at home
may be especially under-represented in outbreak statistics.(6)
Common mistakes identified include serving contaminated raw
food, cooking/heating food inadequately, having infected persons
handle implicated food and practice poor hygiene.(7) Two studies
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conducted at the Alexandria Poison Center reported that home
was the place of eating the incriminated food in 60.7% and 85%
of the microbial food poisoning cases admitted during 1995 and
1998; respectively.(8,9)
The role of food handlers, usually mothers, in ensuring food
safety
at
the
household
level
is
well
accepted
and
an
understanding of the status of their food handling knowledge
and practices is needed.(10) A study in Turkey (2007), reported
that consumers have inadequate knowledge about measures
needed to prevent foodborne illness in the home.(11) Given that it
is currently impossible for food producers to ensure a pathogenfree food supply, home food preparers need to take many
precautions to minimize pathogenic contamination because they
are the final line of defense against foodborne illnesses.(10) There
are no regulations for the preparation, handling, and storage of
food at home.(11) An effective risk communication to inform
consumers of the possible health risks of foodborne diseases and
encourage safer food handling practices at home is probably the
best way to ensure food safety at the consumer end of the food
chain.(12) Obtaining enough information on the knowledge and
practices of a target group is essential for the development of
effective health education programs. The aim of this study was to
assess food safety knowledge and practices among women
working in Alexandria University.
MATERIAL AND METHODS
The present cross sectional study was conducted on 270
females working in Alexandria University and having the
responsibility of food preparation at their homes. They were
recruited
from
six
faculties
and
institutions
affiliated
to
Alexandria university namely; High Institute of Public Health and
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Medical Research Institute in addition to the Faculties of
Pharmacy, Sports, Education, and Science. Faculties and
institutions were chosen according to personal communication
with a staff member who could facilitate data collection.
Data was collected through distributing 45 questionnaires in
each faculty/institution (15 for each of staff, clerks and workers).
The questionnaire included the following four sections: personal
characteristics (educational level, number and age of their family
members), previous attack of a prominent food poisoning (its
cause, number of victims and their age), food safety knowledge
(32 questions) and food safety practices (35 questions). A
prominent food poisoning was that associated with severe
vomiting and/or hospitalization of the victim. Questions in each
section of the food safety knowledge and practices were included
under four main parameters; food purchasing and storage,
preparation, cooking and personal hygiene
The questionnaire was pilot tested on 20 women and
amended for clarity with the addition of some answer options.
Although the questionnaire was intended to be self administered,
some illiterate workers needed help in filling it.
All questions were of the multiple choice type. Each knowledge
question has only one right answer and scored by giving one for the
right answer and zero for the wrong as well as to “don’t know”
answer. Questions related to food safety practices included a set of
positive and negative sentences. Thirty three practice questions had
3 responses and scored from 0 to 2 while the remaining two
questions had four responses and scored from 0 to 3 with higher
scores for better practices. The score of each parameter was
calculated by summing the scores of its questions and the total score
of the whole food safety knowledge and practice was calculated by
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summing the scores of its four parameters. All knowledge and
practice scores were transformed into percentages. Croncbach alpha
coefficient of internal consistency was used to estimate the reliability
of the questionnaire. Alpha coefficient was 0.798.
Statistical Analysis
Data was statistically analyzed using SPSS program version
14.0. The cutoff point for statistical significance was P value < 0.05
and all tests were two-sided. Data was tabulated and presented in
the form of arithmetic mean and standard deviation for score
percentage of the total food safety knowledge and practices and
their parameters.
As some parameters were not normally distributed, non
parametric tests (Kruskal-Wallis and Mann Whitney) were used
as tests of significance. Kruskal-Wallis test was used to compare
score percentages of knowledge and practices among different
jobs and Mann Whitney test was used to test the relation
between knowledge and practice score percentages, and food
poisoning. Because many of the cross-tabulations had cells with
expected count less than 5, Monte Carlo proportion was used to
compare the percentages of food poisoning cases as well as right
answers among different jobs.(13)
RESULTS
A total sample of 270 female women working in Alexandria
University (90 of each of staff members, clerks and workers)
participated in this study. Their average age was 42.5 ± 10.6 years,
with one third of them in the age group 40-<50 years. They served
910 family members about half of them (50.2%) were in the age
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group 10-29 years and 17.6% were with less than 10 years. They
reported 126 cases of food poisoning. The highest percentage of
cases was belonging to staff (46.8%) while the lowest (23%) was
belonging to clerks, with statistically significant differences
among different jobs. The highest percentage of food poisoning
cases was in the age group <10 years (39.7%). Half of the cases
occurred as a result of eating outside home, while 16.7%
occurred as a result of eating at home.
Table (1) shows food safety knowledge and practices related
to food purchasing and storage among women working in
Alexandria University. The percentages of the right knowledge
ranged from 25.6% in “food poisoning microorganisms can't be
destroyed in the freezers" to 90.7% in the question "growth of
food poisoning microorganisms is faster at room temperature
than in refrigerator". The highest percentages of the right
practices was in "firstly purchased foods are consumed first"
(88.5%), followed by "reading expiry date before purchasing"
(77%), while the lowest were in purchasing iced fish and not
purchasing
farmers'
kariesh
cheese
(27.8%
and
29.3%;
respectively). There were significant differences among different
jobs regarding practicing safe purchasing and storage except in
purchasing iced fresh fish and avoiding storage of cooked food
hot in chillers.
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The results of the food safety knowledge and practices
related to food preparation are shown in table (2). The
percentages of the right knowledge ranged from 43% in
recognizing thawing frozen foods at room temperature as a
possible cause of food poisoning to 68.1% in linking the use of
the same cutting boards between raw and cooked food, and food
poisoning. Differences among different jobs were significant only
in appreciating that thawing frozen food at room temperature
can cause food poisoning; with staff members showing the
highest percentage of right answers (51.1%). The majority of the
sample used not to refreeze the thawed frozen foods (87%) and to
use separate or properly cleaned cutting boards between raw and
cooked foods (81.5%). On the other hand, only 4.4% were usually
soaking salad vegetables in water with potassium permanganate
and 10.4% were thawing food during cooking. The percentages of
correct practices differed significantly among different job
categories in “washing salad vegetables" and "using separate or
properly cleaned cutting boards between raw and cooked food"
with clerks showing the highest percentages.
Table (3) illustrates food safety knowledge and practices
related to food cooking. The majority of the studied women
mentioned that inadequately boiled milk can cause food
poisoning (85.2%) and it is safer to cook for one day (81.5%). On
the other hand, about half of them recognized raw or half cooked
food of animal origin, and inadequately reheated cooked food as
causes
of
food
poisoning
(54.4
and
53.3%
respectively).
Significant differences were found across job categories except in
questions of "it is safer to cook food quantities sufficient for one
day" and " prepared food should not kept for >4 hrs outside the
chillers".
Regarding
safe
cooking
practices,
the
highest
percentages were in storing cooked and leftover food
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in the chillers for ≤ 3days (95.6%) followed by adequate reheating
of liquid food (90.4%) and reheating of a portion sufficient for a
meal (81.9%). The lowest percentages were in checking adequacy
of food cooking by examining internal and external color changes
(11.5%) followed by adequate reheating of solid food (33.7%).
Table (4) shows that all women recognized the importance of
proper hand washing for preparing safe food, and the majority
mentioned that hands should be free of wounds (94.4%), with
short and clean nails (95.6%), and cooked food should not be
tasted by fingers or placing unclean spoons (81.9%); while the
lowest (33.7%), appreciated the role of apparently health persons
as
a
source
of
food
contamination.
Significantly
higher
percentage of staff members recognized that diseased persons
and
apparently
healthy
persons
are
sources
of
food
contamination with food poisoning microorganisms. Concerning
practicing personal hygiene, all women used to wash their hands
after visiting the toilet and 88.5% used to wash hands before
food preparation though only 20% used to wash with warm
water and soap. The used method of hand drying, and washing
of faucets’ handles differed significantly among jobs.
The highest mean score percentages of the total food safety
knowledge and its four associated parameters were among staff
members with significant differences among different jobs except
in food preparation. On the other hand, the highest score
percentages
of
the
parameters
were
total food
among clerks
safety practices and their
except
in
practicing
safe
purchasing and storage where the highest percentage was among
staff members (66.5± 12.8) with significant differences among
jobs except in practicing personal hygiene (Table 5).
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Table (5): Food Safety Knowledge and Practices among Women
Working in Alexandria University
Food
safety
Knowledge
Practices
Staff
Clerks
Workers
Total
Mean±SD
Mean±SD
Mean±SD
Mean±SD
Purchasing and storage
69.8±15.8
66.3±13.1
57.1±15.4
64.4±15.7
37.308*
Preparation
66.1±33.2
58.1±33.7
55.3±35.8
59.8±34.4
4.791
Cooking
76.0±24.6
70.2±24.8
63.8±24.9
70.0±25.2
11.992*
Personal hygiene
79.8±16.5
72.5±16.5
69.3±16.4
73.8±17.0
19.703*
Total
73.1±14.8
67.6±12.6
61.3±14.7
67.4±14.8
31.060*
Purchasing and storage
66.5±12.8
63.1±15.0
58.6±15.4
62.7±14.7
13.747*
Preparation
70.7±13.9
72.0±13.2
64.2±14.6
69.0±14.3
13.004*
Cooking
78.7±11.8
79.9±12.3
73.9±13.6
77.5±12.8
10.866*
Personal hygiene
70.8±11.0
73.0±11.2
69.9±14.0
71.3±12.2
3.088
Total
73.3±7.6
74.0±8.8
68.5±9.9
72.0±9.1
20.125*
Parameters
KW#
# Kruskal Wallis test among different jobs
*p<0.05
Table (6) shows food safety knowledge and practices of
women in relation to food poisoning. The mean score percentages
of the total food safety knowledge and practices among women
reporting no food poisoning were higher than those reporting
food poisoning except in case of staff members where similar
scores (73.1) were found. Differences in the total mean score
percentage of food safety knowledge or practices of different jobs
in relation to food poisoning were all insignificant except in
workers’ knowledge.
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Table (6): Food Safety Knowledge and Practices of the studied Women in
Relation to Food Poisoning
Food
safety
Job
Staff
Clerks
Knowledge
Workers
Total
Staff
Clerks
Practices
Workers
Total
Occurrence
of food
Purchasing
poisoning
& storage
Yes (n= 31 ) 69.4±16.2
No (n=59 ) 70.1±15.7
MW
0.751
Yes (n= 17 ) 60.5±17.7
No (n=73 ) 67.7±11.5
MW
0.076
Yes (n= 24 ) 51.2±16.8
No (n=66 ) 59.2±14.4
MW
0.018*
Yes (n= 72 ) 61.2±18.3
No (n=198 ) 65.6±14.5
MW
0.042*
Yes
67.0±10.9
No
66.2±13.8
MW
0.934
Yes
62.3±13.9
No
63.2±15.3
MW
0.619
Yes
59.0±16.8
No
58.5±14.9
MW
0.739
Yes
63.2±14.0
No
62.5±15.0
MW
0.972
MN: Mann Whitney test
±SD)
Parameters (Mean±
Personal
Cooking
hygiene
64.5±35.2
78.1±25.0
80.0±18.5
67.0±32.3
74.9±24.5
79.7±15.6
0.826
0.481
0.696
57.4±36.2
71.8±18.8
69.9±19.5
58.2±33.3
69.9±26.1
73.1±15.8
0.962
0.996
0.563
35.4±32.1
55.0±26.5
59.7±16.6
62.5±34.6
67.0±23.7
72.7±15.0
0.001*
0.061
0.002*
53.1±36.3
68.9±26.0
70.8±20.0
62.2±33.5
70.4±24.9
74.9±15.7
0.067
0.753
0.171
71.0±12.2
76.5±12.5
70.8±11.2
70.5±14.9
79.9±11.4
70.9±11.0
0.901
0.209
0.938
71.4±13.9
80.6±12.5
70.6±11.6
72.1±13.1
79.7±12.3
73.5±11.1
0.875
0.736
0.240
65.8±13.7
69.3±14.9
63.0±14.0
63.6±14.9
75.6±12.9
72.4±13.2
0.778
0.061
0.002*
69.4±13.2
75.0±13.9
68.1±12.7
68.8±14.7
78.4±12.3
72.4±11.8
0.924
0.083
0.007*
Preparation
Total
73.1 ± 16.7
73.1±13.8
0.595
64.5 ± 17.3
68.4±11.2
0.411
52.2 ± 15.8
64.6±12.9
0.000*
64.1 ± 18.7
68.5±13.0
0.124
72.5 ± 6.9
73.8±8.0
0.449
73.5 ± 6.8
74.1±9.2
0.714
65.5 ± 11.4
69.6±9.2
0.159
70.4 ± 9.2
72.5±9.1
0.158
*p<0.05
DISCUSSION
Consumers play a crucial role in prevention and control of
food-related diseases, since all hygiene measures involved in food
production, storage and distribution can be negated by poor food
handling practices.(14) The present study revealed that workers
had the lowest levels of both food safety knowledge and
practices. Staff members had the highest levels of knowledge
whereas clerks had the highest levels of practices in all
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parameters except in purchasing and storage. Socioeconomic
class and educational level can affect food safety knowledge and
awareness, with lower levels of knowledge related to lower
educational levels and lower socioeconomic classes.(15)
Food safety Knowledge and practice scores varied across the
four parameters. The highest Knowledge score was in personal
hygiene (73.8) while the highest practice score was in cooking
(77.5). The lowest Knowledge score was in food preparation (59.8)
whereas the lowest practice was in purchasing and storage (62.7)
(table 5). This finding can guide health education programs to
give more attention to improve knowledge defects related to the
parameters with the lowest knowledge scores.
The results also show that the mean score percentages of
food safety practices in two food safety parameters; preparation
and cooking (69.0 and 77.5; respectively) were higher than their
corresponding knowledge (59.8 and 70.0). This indicates that
some women used to do the right practices although their
knowledge was deficient. The explanation is that women may be
taught the right preparation and cooking practices from their
mothers or other relatives without having the correct knowledge.
On the other hand, the Knowledge score percentage in the other
two parameters; purchasing and storage, and personal hygiene
(64.4
and
73.8;
respectively)
were
higher
than
their
corresponding practices (62.7 and 71.3). This indicates that
some women may have the correct knowledge but failed to do the
correct practices probably due to lack of facilities as in case of
lack of warm water for proper hand washing, or lack of other
alternatives as in case preparing the food while ill and
purchasing non refrigerated food of animal origin. Another study
reported that the vast majority of consumers (95%) were engaged
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in less than ideal hygiene practices due to lack of knowledge or
failure to implement known food safety procedures.(16)
Food poisoning among families of the studied women:
Although everyone is susceptible to food poisoning, infants
and young children, pregnant women, the immunocompromised,
and
the
elderly
are
more
likely
to
experience
severe
consequences.(17) The present study revealed that 17.6% of the
910 served family members were in the vulnerable age group less
than 10 years. A total of 126 food poisoning cases occurred
among women and their family members (n=1180) comprising
10.7% with the highest proportion of cases (39.7%) in the age
group less than 10 years. Other studies reported that this age
group was the highest admitted to Alexandria Poison Center from
1990-1994 (1748 cases representing 26.1%) and from August
1997 till July 1998 (166 cases; 36.7%).(8,9)
Unexpectedly, about half of the reported food poisoning
cases (46.8%) were belonging to staff members, though they
represent the highest social and educational level of the three job
categories and they had the best mean food safety knowledge
scores. The most reasonable explanation that could be given to
this finding is that eating outside home was the main cause of
food poisoning among this group. Any one is liable to be a victim
of food poisoning, since most causative microorganisms do not
alter food sensory properties i.e. its taste, odor, color...etc.(18) It is
worth mentioning that all women mentioned that they suffered
several episodes of mild food poisoning.
Outside home was the place of eating the incriminated
food reported by half the women while only 16.7% were in home.
However, in a review of the consumer's food safety KAP (2004) it
was found that many consumers were unaware that at least 60%
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of food poisoning originates in the home believing that the
responsibility
lies
instead
with
restaurants
and
food
manufactures.(19)
Food safety knowledge among women (n=72) to whom food
poisoning cases (n= 126) were belonging was slightly lower than
the
other
198 women
with
significant
difference in
the
purchasing and storage parameter. Also they reported worse food
safety practices in cooking and personal hygiene that were
significant in personal hygiene indicating its importance in
prevention of food poisoning.
Knowledge and practices related to food purchasing and
storage:
Concerning purchasing and storage, the knowledge score
percentage of the total sample (64.4) was slightly higher than the
corresponding practice score (62.7) with significant difference
among different jobs. This can be attributed to observed
variations between their knowledge and practices regarding
purchasing of unrefrigerated raw or frozen food of animal origin
and purchasing iced fresh fish. Most of the sample recognized
that displaying raw food unrefrigerated can contribute to food
poisoning (77.4%), though only 58.1% used to purchase
refrigerated food. Also, most of them (72.6%) mentioned that
fresh fish not stored in ice is risky, though only 27.8% used to
purchase the iced fish. This can be attributed to a common belief
that fish sellers usually put ice on fish remained unsold from the
previous day and the addition of ice means they are stale.
Knowledge and practices related to food preparation:
The mean score percentage of safe preparation practices was
higher among women than their knowledge score (69 and 59.8;
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respectively) with significant differences among different jobs in
their practices. This can be attributed to noticeable differences
between their knowledge and practices concerning thawing of
frozen food, refreezing of thawed frozen food and using of cutting
boards. For example, the majority of women (87%) used not to
refreeze the thawed frozen food but properly cook them to be
used in another day, yet only 63.7% recognized thawing and
refreezing as a cause of food poisoning.
Food should never be thawed or stored on the counter, since
food poisoning microorganisms grow faster in the middle of the
temperature danger zone (21–52°C) than at any other point.(20)
Safe thawing was practiced by 40% of the studied women where
29.6% used to thaw in the chiller and 10.4% used to thaw
during cooking while the other 60% were thawing either at the
kitchen temperature, by soaking in water or under running
water. Only 43.0% of the sample mentioned that thawing frozen
food at room temperature can cause food poisoning. A study in
Trinidad (2006) reported that the practices of thawing frozen
foods varied significantly among the respondents. They were
thawing on the counter (41.6%), in cold water (28.0%), in
microwave oven (18.4%) and in the refrigerator (12.0%).(20)
The use of the same cutting boards for raw and cooked food
of animal and vegetable origin without thorough proper washing
can be one of the causes of food poisoning.(21) Though 81.5% of
the studied women reported using separate or the same properly
cleaned cutting boards between raw and cooked food of animal
origin, only 68.1% recognized that failure to do this practice can
lead to food poisoning.
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Knowledge and practices related to food cooking:
Despite Americans have become more food safety–conscious
during the past decade, they frequently engaged in risky eating
behaviors e.g. eating raw or undercooked food of animal origin.(22)
The mean score percentage of food cooking practices was higher
(77.5%) among the studied women than their knowledge (70%).
This may be attributed to discrepancies between their knowledge
and practices concerning reheating of cooked food and boiling of
raw milk.
The majority of the studied women (90.4%) used to
adequately reheat liquid food e.g. soup while only 33.7% reported
adequate reheating of solid food e.g. rice and macaroni. The link
between consumption of inadequately reheated food and food
poisoning was appreciated by 53.3% of the sample. Although
75.6% of the sample mentioned that cooked food should not be
kept outside chillers for more than 4 hours, only 58.9% used not
to leave their cooked food for longer periods in the kitchen.
Leaving cooked food for longer periods in the kitchen constitutes
a hazardous practice since food poisoning microorganisms can
grow to produce large number and/or toxins sufficient to induce
food poisoning. Keeping leftover food for several hours at the
kitchen temperature with inadequate reheating was the highest
contributing factor in microbial food poisoning outbreaks
admitted to Alexandria Poison Center from August 1997 till July
1998 (36.6%).(9) Although the role of inadequately boiled milk in
causing food poisoning was mentioned by 85.2% of the women
only 70% used to boil raw milk for 5-10 minutes after its
effervescence.
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Knowledge and practices related to personal hygiene:
Practicing personal hygiene was ranked as the first set of
behaviors in maintaining the safety of food and reducing number
of foodborne illnesses with washing hands before handling food
received
the
highest
rank.(23)
The
best
knowledge
score
percentage among the studied women (73.8) was in their
personal hygiene but their practice was with a lower score (71.3).
There was a significant difference among different jobs only in
the knowledge. This may be attributed to noticeable variations
among their knowledge and practices in the proper hand
washing and preparation of food during illness.
The safe practice of washing hands before preparing food
makes food poisoning less likely to occur. Hands should be
washed with warm water and soap for at least 20 seconds.(24)
Although all studied women agreed that hands should be
properly cleaned before starting food preparation, using warm
water and soap during hand washing, rubbing of finger tips,
between fingers and around the wrist as well as washing the
faucets’ handles were practiced by 20%, 71.1% and 46.3%;
respectively. This indicates that large numbers of the women
used not to properly clean their hands and used to contaminate
them after hand washing. A study in Slovenia (2008) reported
that 57.1% of respondents washed their hands properly with
soap and warm water, although a significant number (33.9%)
washed their hands with water only or did not wash at all
(1.6%).(1)
Not
only
persons
suffering
from
food
poisoning
can
contaminate the food, but also healthy carriers who carry
normally a lot of food poisoning microorganisms e.g. E. coli,
Staphylococcus aureus and Clostridium perfringens.(25)More than
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half of the sample (56.3%) considered diseased persons as a
source
of
food
contamination
with
food
poisoning
microorganisms and they should avoid food handling while ill
(54.4%), but only 16.7% mentioned that they always avoid food
handling during their illness since they are solely responsible for
the food preparation for their family members. Also, about only
one third of the studied women (33.7%) mentioned that
apparently healthy persons can contaminate the food with food
poisoning microorganisms.
The limitations of this study included choosing the faculties
and institutions that was based on personal communications.
Also, food safety practices were assessed through self reporting.
Self reporting usually overestimates the correct practices.
RECOMMENDATIONS
Food safety education should be launched to women and
repeated at specific intervals to ensure that learnt information is
put into the daily life practices. The information gained by this
study can be used to formulate essential messages for such
educational programs.
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