Published in PLOS One on 2026-09-02, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Edward Ken Essuman, Afia Sakyiwaa Amponsah, Vida Gyimah Boadu, Evangeline Adu Okraku
Source: PLOS One • DOI 10.1371/journal.pone.0356599
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Food safety within the household remains a critical yet often overlooked component of public health, particularly in developing countries where food preparation is largely managed at the domestic level. Despite high levels of formal education in urban populations, knowledge does not consistently translate into safe food-handling behaviour. This study assessed food safety knowledge, perceptions, and practices among female household food handlers in the Ho Municipality of the Volta Region, Ghana. A community-based cross-sectional design was employed, involving 386 female household food handlers aged 18 years and above, selected through a combined purposive and systematic sampling procedure from households in Ho Municipality. Data were collected using a semi-structured questionnaire administered through face-to-face interviews. Knowledge was assessed across five items; participants who answered three or more correctly were classified as having good knowledge. Descriptive statistics, chi-square tests, and ordinal logistic regression were used to analyse data (SPSS version 22; p ≤ 0.05). The findings revealed generally high awareness of food safety: 81.9% reported practising personal hygiene during food preparation, and 86.5% recognised that poor hygiene contributes to food contamination. However, this awareness did not consistently translate into safe practices. Only 22.5% reported that they regularly wash foodstuffs before usage, and 42.2% wash their hands before cooking. Risky behaviours were common, including tasting food with bare hands (43.8%) and using the same ladle throughout cooking (31.1%). Additionally, 60.1% were unaware of the correct freezer temperature (−18°C). Educational level was the only factor significantly associated with food safety knowledge (p = 0.001) and remained the sole independent predictor after logistic regression adjustment (adjusted OR 3.66, 95% CI 1.72–7.79, p = 0.001 for tertiary versus primary-educated respondents). A clear gap exists between food safety knowledge and practice among female household food handlers in Ho Municipality. Targeted, practical, and culturally appropriate interventions that promote behaviour change, rather than awareness alone, are needed to reduce preventable food-borne illness, particularly among children.
Introduction
Food is a fundamental human need, essential for growth, health, and survival. In most households, particularly in developing countries, food preparation and handling are primarily undertaken by women, who often simultaneously manage multiple responsibilities, including childcare and maintaining the home environment. As individuals who are often directly responsible for food preparation and serving within the household, their knowledge, perceptions, and practices play a critical role in ensuring food safety and protecting household health, especially among children. Unlike commercial settings where food safety is regulated and monitored, the domestic kitchen relies largely on individual awareness and behaviour, making household food-handling practices important for preventing food-borne illness.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Edward Ken Essuman, Afia Sakyiwaa Amponsah, Vida Gyimah Boadu, Evangeline Adu Okraku. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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