Promotion of food safety, hygiene and sanitation using healthy food market concept in selected rural markets of Chikwawa district, southern Malawi

Abstract

Introduction Health Food Market (HFM) concept started in 1996 by the World Health Organisation (WHO) to promote sanitation, food safety and hygiene (FSH) in rural food markets. In Malawi the concept was introduced on pilot basis at Mfera and Dembo in Chikwawa district in 2014 to improve FSH and sanitation. The concept was a component of the Healthy Setting Approach that was implemented by the Scotland Chikwawa Health Initiative (S-CHI) Project. Objectives The study attempted to ascertain HFM promotion interventions’ effect on FSH and sanitation at Dembo market (intervention market) and Bereu (control market). The study looked at the level of hygiene, sanitation, knowledge and practices of food handlers and the level of participation of market stakeholders in FSH activities before and after introducing the HFM concept. Methodology The study used an evaluative study design. Study population composed of permanent vendors selected using systematic random sampling, mobile vendors and customers selected using convenient sampling and extension workers and Heads of Departments who were selected using purposive sampling. Data collection methods included face-to-face interviews with vendors and customers, administration of questionnaires by data collectors to key informants who were extension workers and heads of departments and facilitation of focus group discussions by the researcher with local leaders, market committees and village development committees. Observations were also done on personal hygiene of food handlers, actual food hygiene and environmental sanitation using checklists. Numerical data was analyzed using descriptive statistics and categorical data was analyzed using frequencies. All tests were performed at 95% confidence level with statistical significance set at p<0.05. Findings Prior to the study, Dembo food market had no usable waste disposal pit and toilets. Food handlers had no comprehensive FSH knowledge with also inadequate participation of stakeholders in FSH development activities. FSH improved at Dembo market following implementation of HFM interventions although this was not comprehensive. Infrastructural improvements included boreholes rehabilitation (n=1); construction of two new latrines, one waste disposal pit and vii provision of eight waste bins. Increase in market cleaning and market inspection were observed, 41 % of food handlers trained in FSH with only 25.0% of applying the FSH concepts learnt. The HFM interventions assessed indicated that implementation of the HFM concept can help improve sanitation and provision of safe foods in markets despite facing continuing sustainability challenges affected by poor governance and supervision. Improvement on the establishment of sanitation facilities, training of food handlers in FSH and sanitation and participation of stakeholders in FSH activities incorporating the HFM concept can promote FSH and sanitation in food markets Conclusion The HFM interventions assessed indicated that implementation of the HFM concept can help to improve sanitation and provision of safe foods in markets. Improvement on establishment of sanitation facilities, training of food handlers in sanitation and FSH, and participation of stakeholders in FSH activities incorporating the HFM concept can promote FSH and sanitation in food markets.