Food handling practices and associated factors among housemaids and food establishment workers: a comparative cross-sectional study from Ethiopia

Food handling practices are essential for preventing foodborne diseases and protecting public health. However, evidence comparing food handling practices and their associated factors among housemaids working in households and food handlers working in food establishments in Ethiopia remains limited. Therefore, this study aimed to compare food handling practices and identify factors associated with good food handling practices among housemaids working in households and food handlers working in food establishments in Dessie City, Ethiopia. A community-based comparative cross-sectional study was conducted among 846 participants (423 housemaids working in households and 423 food handlers working in food establishments) in Dessie City, Ethiopia, from February to April 2021. Data were collected using interviewer-administered questionnaires and observational checklists. Binary logistic regression analyses were performed to identify factors associated with good food handling practices. Variables with p < 0.25 in the bivariable analysis were entered into the multivariable model, and variables with p < 0.05 were considered statistically significant. The proportion of participants with good food handling practices was higher among food handlers working in food establishments (62.6%; 95% CI: 58.0–67.2) than among housemaids working in households (47.0%; 95% CI: 42.2–51.8). Food safety knowledge, attitude toward food handling practices, and selected environmental characteristics were also assessed. Overall, food handlers working in food establishments demonstrated higher levels of food safety knowledge than housemaids working in households. Similarly, positive attitudes toward food handling practices were more common among food handlers. Environmental characteristics, including the availability of a three-compartment dishwashing system and the absence of vectors and rodents, also differed between the two study groups. Detailed distributions of these variables are presented in the Supplementary Tables. Among housemaids, work experience > 4 years (AOR 3.37; 95% CI: 1.57–7.26) and positive attitude toward food handling practices (AOR 2.26; 95% CI: 1.39–4.14) were associated with good food handling practices. Among food handlers working in food establishments, a three-compartment dishwashing system (AOR 2.27; 95% CI: 1.43–3.61), absence of vectors/rodents (AOR 3.32; 95% CI: 1.63–6.77), and good food safety knowledge (AOR 2.15; 95% CI: 1.31–3.53) were associated with good food handling practices. In the pooled analysis, a three-compartment dishwashing system, absence of vectors/rodents, and positive attitude toward food handling practices remained significantly associated with good food handling practices. Good food handling practices were higher among food handlers working in food establishments than among housemaids working in households. Work experience, food safety knowledge, attitude toward food handling practices, the availability of a three-compartment dishwashing system, and the absence of vectors and rodents were factors associated with good food handling practices. These findings suggest that strengthening food safety education, improving workplace sanitation, and promoting positive food safety attitudes may contribute to improving food handling practices.