Social and environmental determinants of safe food handling among refugees in Kyangwali refugee settlement in Uganda

Abstract

World over, food safety is a growing concern that has left all planning authorities concerned about the mitigation measures because of the foodborne illnesses that have a significant global burden on mortality and morbidity especially on refugees. Poor food handling increases the risk of food borne diseases among refugees leading to high economic treatment burden. Despite food borne disease outbreaks in refugee settlements and hosting communities in Uganda, research about the probable causes remains scarce. The study was done to assess knowledge of refugees about safe food handling (SFH), identify the practices regarding food handling, and identify the environmental determinants of SFH. I investigated the determinants of Safe Food Handling (SFH) among refugees in a remote Kyangwali refugee settlement in Hoima District Midwestern Uganda. The study used an analytical cross-sectional design involving mixed methods. A total of 428 participants residing in Mararatu A and B responded to the questionnaires, plus 10 key informants whose responses were captured using an interview guide. An observation checklist was used to supplement the interviews. Data was coded and entered using Microsoft excel package 2010 and exported to Stata version 14 SE for analysis. Analysis of variables at univariate level was done using descriptive statistics. At bivariate and multi variate levels, data was analyzed using binary logistic regression to determine factors that were associated with SFH. Qualitative data was categorized and analyzed thematically while observation data was treated as frequencies of observation. Prevalence of SFH was found to be low at (13.7%). Most refugees were above 30 years (Mean=34.1 SD=15.1 IQR 12-88). Factors that were independently and significantly associated with SFH; Washing hands with soap and water (AOR: 5.9; CI 2.6-13.53, p= 0.001), disposal of solid waste in the open environment AOR: 0.16 CI 0.17-0.78, p= 0.01). Conclusion: The study found a low level of safe food handling among refugees in Kyangwali Refugee settlement. This was mainly attributed to the environmental factors, which affected personal practices. There is need for increased awareness campaigns on safe food handling among refugees to minimize the possible occurrence of foodborne diseases. Public health interventions should focus on hygiene promotion and behavioral change communication to influence food handling practices.