Food safety knowledge, attitudes and practices of restaurant food handlers in a lower-middle-income country

Knowledge, Attitude, and Practices on Food Safety among Food Handlers Working in Public Food Service Establishments in Lemi Kura Subcity, Addis Ababa, Ethiopia

Foodborne diseases, resulting from poor food handling and sanitation practices, are common public health problems globally. The primary contributing factors to potential foodborne disease outbreaks are often attributed to the poor perception and practices of food handlers regarding food safety. This study is aimed at assessing the knowledge, attitude, and practices of food handlers working in public food service establishments in Lemi Kura subcity, Addis Ababa, Ethiopia. A cross-sectional study was conducted from December 2022 to September 2023, involving 400 food handlers from 20 randomly selected public food service establishments. Data were collected using a structured interview-administered questionnaire and an observational checklist. The collected data were entered into Microsoft Excel and then transferred to SPSS version 20 for analysis. Descriptive statistics were employed to summarize the data, and Pearson's chi-square test was used to evaluate the association of sociodemographic factors with the knowledge, attitude, and practices of food handlers towards food safety. Of the 400 food handlers, 65.5% had good knowledge about food safety. All food handlers were knowledgeable that washing hand before handling food will reduce risk of poisoning, bacteria are the main cause of food poisoning, and temperature plays a big role in bacterial growth. This study also revealed that 65.3% of the food handlers had good attitude towards food safety and 55.3% of food handlers had good food handling practice. Based on the observation, 38.5% of food handlers had good food handling practice. Taking training, age, and work experience of food handlers have statistically significant (P < 0.05) association with good attitude towards food safety. Additionally, taking training, educational level, employment, and work experience of food handlers have statistically significant (P < 0.05) association with good practice towards food safety. However, there was no statistically significant association between all sociodemographic factors and knowledge about food safety. Good knowledge and attitude were also associated with good food handling practices of the respondents. Based on the observation, there was a statistically significant association between employment status and good food handling practice. In conclusion, the findings suggest the necessity for implementing formal educational and training programs aimed at positively influencing the knowledge and attitude of food handlers, subsequently improving their food handling practices.

Food handlers' lack of knowledge, and misunderstanding of safe food temperatures: An analysis using the theory of social representations

Comprehension is the ability to understand and be familiar with situations and facts. A critical factor causing foodborne diseases is the inadequate temperature during food storage and handling; food handlers often fail to understand this. Therefore, in this study, we investigated how technical language and everyday knowledge operate in the comprehension of safe food temperatures among food handlers in food services. To achieve this, data collection was carried out in two stages. In the first stage, a survey was conducted to 206 food handlers from 14 food service working in the city of São Paulo. Through this survey, we gathered information to characterize the socio-demographic profile of the sample, details about participation in training, and knowledge of technical terms related to safe food temperatures. In the second stage, individuais interviews were conducted on the same day following the questionnaire administration in each food service. A total of 29 interviews were carried out An interview script was developed containing two storylines based on the Fourth Key: "Keep food at safe temperatures," which is part of the WHO's "Five Keys to Safer Food" manual. Further, the collective subject discourse technique, which is based on the theory of social representations, was employed to analyze each interview and construct a representative collective discourse. Analysis of the results indicated that lack of knowledge about safe food temperatures is mainly a result of the misunderstanding of technical terms. The collective discourses obtained results reinforced that food handlers had diverse and erroneous information about food defrosting, and they exhibited low confidence and clarity about safe food temperatures. Overall, psychological, social, and cultural factors affect the formation of social representations that guide food handlers' decision-making.

Status of food safety knowledge, attitude, and practices of caregivers of children in northern Uganda

The safety of homemade weaning foods in low- and middle-income countries is of great concern as rural households have limited access to standardized commercial weaning foods. In the Acholi subregion of Uganda, complementary foods are locally produced. However, there is limited information on the Food safety knowledge (FSK), food safety attitude (FSA), and food hygiene practices (FHP) of the caregivers. This study examined food safety knowledge, attitude, and practices of the caregivers of children 6-23 months of age in Amuru and Nwoya districts, Northern Uganda, between March 2019 and June 2019. A cross-sectional study was conducted involving 180 caregivers. Data were collected using semi-structured questionnaires and focus group discussions and analyzed using descriptive statistics, multivariate binary logistic regression, and thematic content analysis. Caregivers had sufficient FSK (74.1%) and positive FSA (68.1%). However, only 17.6% of them adhered to FHP. Frequency of food safety training (p = .041) and households with children who suffered from foodborne illness (p = .001) significantly predicted FSK. Conversely, both FSK and FSA were significantly predicted by gender roles in decision-making on household income (p = .006) and households with older children (p = .041). A significant positive correlation was observed between FSK and FSA (r = .406, p = .000). However, major barriers to adherence to FHP were inadequate sanitation facilities and caregiver's workload. The overall nontranslation of sufficient FSK and positive FSA into proper FHP calls for future intervention to harness the sociodemographic factors that influence FSK and FSA and address the barriers to FHP among caregivers.

Food Safety Knowledge among Professional Food Handlers in Slovenia: The Results of a Nation-Wide Survey

The authors present and discuss the results of a nation-wide survey on food safety knowledge among professional food handlers in Slovenia. The data were collected via a telephone survey using a well-established questionnaire adapted to the Slovenian context. Altogether, 601 respondents from hotels, restaurants, catering, and confectionery units completed the questionnaire. To assess food safety knowledge among food handlers in both general and specific domains, three indexes (a General Knowledge Index, a Personal Knowledge Index, and a Temperature Knowledge Index) were created. Among them, the Temperature Knowledge Index revealed the largest gaps in knowledge. An insufficient transfer of food safety knowledge from managers and chefs to assistant chefs and kitchen assistants in establishments where more persons handle food was evident, while a course titled "Hygiene Minimum" of standardised training from the past still significantly contributes to food safety knowledge. The results suggest a need for improvement in the current system of food safety training courses for professional food handlers in Slovenia. The human factor in the food supply chain still has a significant role in ensuring food safety culture, and therefore must become a more important part of the food safety management system.

Food safety knowledge, attitude, and practice of street food vendors and associated factors in low-and middle-income countries: A Systematic review and Meta-analysis

Access to safe food is considered a basic human right, but food-borne disease presents a significant public health concern globally. The problem is exacerbated in low- and middle-income countries. Due to the rise in urbanization and the popularity of street food in low- and middle-income countries, understanding the Knowledge, Attitude, and Practice (KAP) of street food vendors is crucial to ensuring food safety. Therefore, this review was aimed to estimate the pooled proportion of KAP of street food vendors toward food safety and its associated factors in low- and middle-income countries. A comprehensive search of published studies before January 30, 2023, was identified using databases like PubMed/MEDLINE, Cochrane Library, HINARI, Science Direct, and African Journals Online, as well as other sources. The preferred reporting items for systematic reviews and meta-analysis guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. The quality of the included studies was assessed using the Joanna Briggs Institute's quality appraisal tool. A random-effects model was used to estimate the pooled proportion of KAP of street food vendors toward food safety and associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics were used to assess heterogeneity. Furthermore, sensitivity analysis and subgroup analysis was also conducted. In this study, fourteen eligible studies with a total of 2,989 study populations were included. The pooled proportions of good knowledge 62% (95% CI: 51-73), positive attitude 66% (95% CI: 47-86), and good practice 51% (95% CI: 36-65) toward food safety were found among street food vendors. Being of secondary school education (OR = 5.95, 95% CI: 4.05-7.85), having training in food safety (OR = 4.64, 95% CI: 2.62-6.67), having a higher monthly income (OR = 2.98, 95% CI: 1.06-4.9), and having good knowledge of food handling (OR = 2.26, 95% CI: 1.17-3.16) were found to be associated factors in the food safety practice of street food vendors. Based on the findings of this study, there was a significant gap in the KAP of street food vendors toward food safety. Therefore, the provision of training and strengthening health education about food safety are invaluable strategies for improving food safety.

Perception and attitudes of street food vendors toward the healthiness of meals prepared and sold in Dodoma

Consumption of street meals among urban dwellers has become inevitable, especially in low- and middle-income countries. It has been linked to higher incidence of dietary-related diseases. Vendors' perceptions and attitudes toward the healthiness of meals can influence nutritional quality of the offered meals. Therefore, the study aimed to assess perceptions and attitudes of vendors toward healthy and unhealthy meals as well as the healthiness of meals they prepare and sell. A cross-sectional study was carried out among 384 street food vendors. Face-to-face interviews were conducted using semistructured questionnaire. Pearson Chi-square test and logistic regression analysis were used in comparing and testing for the association of perceptions and attitudes to vendors' characteristics. Street food vendors that took part in this study demonstrated good perceptions based on what they perceived to be healthy meals (58.33%) and positive attitudes (95.57%) toward preparation and provision of healthy meals. Perceptions were associated with sex (p = .007), education level (p = .002), and investment cost (p = .000). Results from logistic regression showed that better perceptions of healthy meals were associated with being female (OR = 2.46, p-value < .031), having higher education (OR = 11.88, p-value < .042), and vending experience of 1-5 years and more than 5 years (OR = 3.17, 2.95, p-value < .019, .039, respectively) while having moderate investment cost showed significant lower chances of having better perceptions (OR = 0.33, p-value < .001). Attitudes were associated with sex (p = .002), age (p = .002), marital status (p = .013), education (p = .009), and vending experience (p = .008). Female vendors, having 25 years of age and above, living with partners, with tertiary education, and having vending experience of more than 1 year had shown to have more positive attitudes toward healthy meals. Generally, street food vendors had good perceptions and attitudes toward healthy meals. This implies possible room for change and adoption of better ways of preparing meals. These findings could be used as a stepping stone in improving nutritional and healthy quality of street meals. Increased efforts are needed on the inclusion of nutritional aspects of healthy meals as they were merely considered by vendors. Future interventions on these vendors should focus more on male vendors, vendors with little vending experience, and little education as they had shown to have relatively poorer attitudes and perceptions compared to other groups.

Hygiene practices of food of animal origin operators in primary schools in the Mono Department of Benin. A cross-sectional study

Food of animal origin is an important source of proteins for human beings. However, they are subject to microbial contamination. It is essential to ensure the safety of food products intended for school children regarding their vulnerability to food poisoning. Good sanitary quality of these products requires the respect of good practices during their processing and distribution. This study aims to evaluate the conditions of processing and sale of food of animal origin to school children in public schools, with or without canteens, in the Department of Mono in southern Benin. In the Department of Mono in the Republic of Benin, 137 operators were interviewed in public schools, with one operator per school, using a questionnaire created on the Epicollect5 platform. The interview showed that the operators involved in the processing and sale of food to school children were women. Most of these operators had primary education and did not undergo a medical examination. They transported food of animal origin mixed with other types of food. Frying and cooking were used to prepare or process the food. Direct observation revealed that food is produced in an unhealthy environment. The operators did not wear gloves during food processing but some wore aprons. All the operators washed their hands with soap and water (tap or well water) after using the toilet. There was not an adequate handwashing facility. The majority of operators used wooden cutting boards. Overall, food operators especially in schools without a canteen do not follow good hygiene and manufacturing practices in the kitchen. To guarantee food safety for school children, training should be organized to make operators aware of good hygiene and manufacturing practices in kitchens.

A systematic review of the knowledge, attitude, and practices (KAP) of food safety among street food handlers

Foodborne diseases are commonly reported from various food establishments; however, little information has been obtained on this topic from the street food industry. Therefore, the present systematic review aimed to provide an overview of the knowledge, attitude, and practices (KAP) of food safety among street food handlers to highlight relevant gaps in the safety and quality of food handling. Articles included in the present systematic review were extracted from several electronic databases based on the PRISMA protocol and CASP checklist. By applying inclusion criteria, twelve peer-reviewed studies from 2010 to 2020 were included in the present systematic review. Results revealed that the food safety KAP level among street food handlers varied across the study settings. It was also found that training plays an essential role in improving food safety practices. KAP assessment is essential as an initial diagnosis to guide and prioritise appropriate strategies based on the food safety aspect that requires the most attention. It also provides a decision-making basis for food safety authorities to develop relevant policies, and organise food safety training.

Peanut Butter Food Safety Concerns—Prevalence, Mitigation and Control of Salmonella spp., and Aflatoxins in Peanut Butter

Peanut butter has a very large and continuously increasing global market. The food safety risks associated with its consumption are also likely to have impacts on a correspondingly large global population. In terms of prevalence and potential magnitude of impact, contamination by Salmonella spp., and aflatoxins, are the major food safety risks associated with peanut butter consumption. The inherent nature of the Salmonella spp., coupled with the unique chemical composition and structure of peanut butter, present serious technical challenges when inactivating Salmonella spp. in contaminated peanut butter. Thermal treatment, microwave, radiofrequency, irradiation, and high-pressure processing all are of limited efficacy in inactivating Salmonella spp. in contaminated peanut butter. The removal of aflatoxins in contaminated peanut butter is equally problematic and for all practical purposes almost impossible at the moment. Adopting good manufacturing hygiene practices from farm to table and avoiding the processing of contaminated peanuts are probably some of the few practically viable strategies for minimising these peanut butter food safety risks. The purpose of this review is to highlight the nature of food safety risks associated with peanut butter and to discuss the effectiveness of the initiatives that are aimed at minimising these risks.

Self-Reported Food Safety Practices and Associated Factors Among Health Extension Model and Non-Model Households in Northeastern Ethiopia: A Comparative Cross-Sectional Study

Purpose

Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia.

Methods

A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value <0.05.

Results

The overall prevalence of food safety practices was 44.7% (95% CI: 40.5-48.4%), of which 57.8% (95% CI: 53.0-63.1%) were model and 31.6% (95% CI: 26.5-36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98-4.52), having a female household head (AOR=3.13; 95% CI: 2.13-4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54-3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43-3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices.

Conclusion

The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices.

Food safety and sanitation challenges of public university students in a developing country

Inadequate catering facilities in Kenyan public universities compel students to handle and prepare their own food, in environments not designated for food preparation such as rooms in hostels. This study investigated the level of food safety and sanitation knowledge, attitude, and practice, among students in an effort to prevent food-borne diseases. A cross-sectional study was conducted among 535 students from two public universities in Kenya. Data were obtained through a piloted, structured questionnaire in line with Food and Agriculture Organization (FAO) guidelines, administered to students from seven different departments. Eighty percent of the students had adequate levels of food safety and hygiene knowledge, while 70% had a positive attitude toward food safety and sanitation. An average of 74% engaged in inadequate food safety and hygiene practices, with majority citing lack of equipment as a major contributor. ANOVA results revealed significant correlation between the gender and knowledge and practice of food safety and sanitation (F = 30.328, ρ = 0.000) and (F = 18.177,ρ = 0.000), respectively. Binary logistic regression showed that knowledge (β = 3.677, p < .000) fostered the practice of food safety and sanitation more in comparison with attitude (β = 2.244, p < .000). Kenyan universities should consider introducing food safety courses that emphasize Food Safety Management System (FSMS) and Hazard Analysis Critical Control Point (HACCP) practices and procedures especially to non-science-based courses, in addition to providing students with proper cooking and food handling facilities.

Food Safety Knowledge, Handling Practices and Associated Factors Among Food Handlers Working in Food Establishments in Debre Markos Town, Northwest Ethiopia, 2020: Institution-Based Cross-Sectional Study

Purpose

Foodborne illness is a major public health problem worldwide. The supply of safe and healthy food is crucial to prevent foodborne illness. However, evidence regarding food safety knowledge and handling practice is limited in Ethiopia. Therefore, this study aimed to assess food safety knowledge, handling practice, and its associated factors among food handlers in Debre Markos Town, North West Ethiopia.

Patients and Methods

An institutional-based cross-sectional study was conducted on 408 randomly selected food handlers at Debre-Markos town. A structured questionnaire and an observational checklist were used to collect relevant data. The main outcome of interest was food safety and handling practice. Multivariable logistic regression analysis was used to identify the factors significantly associated with food safety knowledge and food handling practice. Data were analyzed using SPSS version 25.

Results

In this study, only 34.1% of food handlers had good food safety knowledge and nearly 54% of food handlers had good food handling practice. Level of education (AOR = 0.23 (0.14–0.57)), training on food safety (AOR = 5.13 (3.57–7.82)), and favorable attitudes towards food safety (AOR=2.54 (1.52–4.25)) were the factors associated with knowledge of food safety. Similarly, training (AOR=2.05, 95% CI=1.31–3.19), a good level of knowledge (AOR: 1.68, 95% CI: 1.40, 3.17), and work experience (AOR = 1.24, 95% CI: 1.10–2.81) were positively associated with good food handling practice.

Conclusion

In this study, the level of food safety knowledge and handling practices were relatively low. Therefore, the concerned bodies should work on the identified factors to improve food handlers’ knowledge of food safety and practice level. Continuous training for food handlers should be given.

Food safety practices of food handlers at home engaged in online food businesses during COVID-19 pandemic in the Philippines

This study was conducted to assess the self-reported and observed food safety practices (FSP) of food handlers, who deliver food products that are prepared and cooked at home during the COVID-19 pandemic in the Philippines. 751 participated in the online survey who were selected using criterion sampling. A questionnaire developed by the researcher was used to gather data with Cronbach Alpha of 0.91. t-test, ANOVA, and Fleiss kappa were performed to treat data. There were no significant differences between self-reported FSP in four dimensions and demographic characteristics, except for age, where a significant difference exists between the FSP of the four age groups along food preparation (F ​= ​4.530,ρ<0.01). The FSP in the four dimensions obtained a weighted x¯ and σ of 1.72 ​± ​0.69 which is interpreted as Sometimes Practiced. The food handlers at home inadequately and inappropriately practiced the protocols in keeping the food safe to eat. The observed reports showed that the food handlers at home do not meet food safety standards as indicated in the weighted x¯ and σ in the four dimensions 1.63 ± 0.11, with a description of Sometimes Practiced. Observed practices further show very poor adherence to guidelines. Test for inter-rater reliability yielded almost perfect agreement (κ ​= ​0.81, ρ<0.05). There exists a significant difference with the FSP in personal hygiene (t ​= ​0.964, ρ<0.05), cross-contamination prevention and sanitation (t ​= ​0.815, ρ<0.05), food preparation (t ​= ​0.753, ρ<0.05), and food delivery (t ​= ​0.794, ρ<0.05). Government and non-government agencies should work together towards educating the food handlers at home on effective ways to learn about food safety concepts so they could become advocates of safer food practices.

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Online food business is growing due to restrictions brought about by the pandemic.

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Self-reported FSP of food handlers reveal compliance to food safety standards.

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Food handlers violate food safety protocols based on expert observations.

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There is significant difference between the self-reported and the observed FSP.

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Food safety training involving food handlers in online businesses is imperative.

Hand Hygiene Knowledge and Self-Reported Hand Washing Behaviors among Restaurant Kitchen Chefs in Jiangsu Province, China

Inadequate hand washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Although many studies have evaluated hand hygiene knowledge (HHK) and self-reported hand washing behaviors (HWBs) in restaurant workers in different countries, little is known about HHK and HWBs in restaurant kitchen chefs, particularly in China. In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province in China regarding their HHK and HWBs and used Chi-square tests (Fisher exact tests), pairwise comparisons, and linear regression models to analyze the responses and identify determinants of HHK and HWBs. Results reveal that less frequent hand washing after leaving work temporarily and after touching used cutlery were the main issues among restaurant kitchen chefs in Jiangsu Province. Kitchen hands had lower levels of HHK and engaged less frequently in good HWBs than the other type of chefs. Furthermore, working in a large restaurant and having worked in the restaurant industry for a longer amount of time were correlated with better HHK and HWBs. These findings suggest that close attention should be paid to the HWBs of chefs during food preparation, that kitchen hands are the key group of restaurant kitchen workers who need training in HHK, and that regulatory activities should focus on small-scale restaurants.

Food Safety and Sanitation Implementation Impasse on Adolescents in Kenyan High Schools

The ability to combat food-borne illnesses in food facilities and institutional catering units require sufficient knowledge on food safety and sanitation standards by food producers and consumers. The aim of the study was to investigate the food safety and sanitation knowledge of food handlers in Kenyan high schools. A cross-sectional study was carried out among 204 food handlers in 50 schools. Questions about knowledge and practice toward food safety and sanitation were asked. Respondents were the most knowledgeable on food contamination (93%), while participants were the least knowledgeable on the importance of protective attire when distributing foods to learners (50%). One-way ANOVA revealed a significant difference between gender and food handlers' behavior and practice (F = 19.886, ρ = 0.00 < 0.05) as well as between job tenure and practice of food safety and sanitation (F = 17.874, ρ = 0.00 < 0.05). Multiple regression analysis established that knowledge contributed to 44.1% of the behavior and practice of the food handlers. It is concluded that food handlers have a fair knowledge despite lack of training, motivation, and facilities to maintain quality standards. It is recommended that the Kenyan Government develop and implement guidelines through school feeding policy that would ensure that food safety and sanitation practices are implemented and utilized by Kenyan high schools.

Determinants of Hand Hygiene Practice at Critical Times among Food Handlers in Educational Institutions of the Sagnarigu Municipality of Ghana: A Cross-Sectional Study

INTRODUCTION

Food handlers' hands serve as a vehicle for potential foodborne pathogenic contamination which constitutes a public health risk. In Ghana, there are always constant reports of outbreaks of foodborne diseases in schools. However, determinants of hand hygiene practice among educational institutions food handlers are little known. The study, therefore, aimed to assess the determinants of hand hygiene practice at critical times among educational institutions' food handlers in the Sagnarigu Municipality of Ghana.

METHODS

This was a cross-sectional survey among educational institutions food handlers in the Sagnarigu Municipality. Two hundred and six food handlers were selected through convenience sampling in the educational institutions. At the same time, structured questions that were developed from previous studies were used to assess food handlers' hand hygiene practice at critical times. Data were analyzed using descriptive statistics, bivariate and multivariate logistic regression models. All variables with their respective confidence intervals (95%) and adjusted odds ratios were declared significant at P-values less than .05.

RESULTS

Hand hygiene practice at critical times among the food handlers were relatively good at a rating of 66.0% (95% CI: 59.1, 72.5%). Good hand hygiene practice at critical times was less likely among food handlers with no food safety training (AOR 0.04; 95% CI: 0.00, 0.41) and food handlers who had insufficient knowledge of hand hygiene (AOR 0.06; 95% CI 0.01, 0.25). Good hygiene practice at critical times was 99% lower in food handlers with a negative attitude as compared to food handlers with positive attitudes towards hand hygiene at critical times (AOR 0.01; 95% CI 0.00, 0.07). Only 17.0% of the food handlers demonstrated proper handwashing techniques, whereas a good number (85.4%) of the food handlers did not wash their hands after touching money.

CONCLUSION

Good hand hygiene practice at critical times was relatively good. Food safety training, knowledge of hand hygiene and attitudes towards hand hygiene were independent predictors of hand hygiene practice at critical times. Concerned stakeholders and organizations should focus on WASH interventions that seek to improve educational institutions food handlers' knowledge and attitudes towards hand hygiene, coupled with training on food safety.

Food safety knowledge, attitudes and practices of restaurant food handlers in a lower-middle-income country

Global research attention appears to be focused predominantly on self‐reported than observed food safety practices. The purpose of this study was to determine the food safety knowledge, attitudes, and self‐reported and observed practices of food handlers in 22 urban restaurants in Zimbabwe. A piloted questionnaire was used to gather qualitative data regarding socio‐demographic variables, food safety knowledge (FSK), attitudes, and self‐reported food handling practices (SRFHPs). A predesigned checklist was used to observe the food handling practices. FSK scores were significantly higher in food handlers who received basic food safety training compared to those who did not (p < .05). No differences in food safety knowledge and attitudes were noted based on the socio‐demographic characteristics of the food handlers (p > .05). A significant positive correlation was observed between FSK and attitudes (r_s = 0.371, p < .05), FSK and SRFHPs (r_s = 0.242, p < 0.05), FSK and observed food handling practices (OFHPs) (r_s = 0.254, p < .05), attitudes and SRFPs (r_s = 0.229, p < .05), and attitudes and OFHPs (r_s = 0.263, p < .05). About half of the food handlers washed their hands in sinks meant for washing cutlery, 57% did not use approved hand drying methods, and 19.8% did not adequately thaw frozen foods. Food was commonly defrosted either under room temperature or using hot water (>45°C). Results suggest a need for mandatory basic and advanced training to improve the food safety knowledge, attitudes, and practices.