Food hygiene practices
Food preparation and storage practice
Table 1 shows the complementary food hygiene practices among mothers/ caregivers in Robe town, Southeast Ethiopia. Four hundred sixty-seven mothers, 91.9% cook food for their child separately from food of other family members, while the rest mothers reported they were given food for their children from domestic foods prepared for other family members. This study also revealed that 30.5% and 40.2% of mothers reported that prepared food is served immediately after preparation and within two hours, respectively. But, the study revealed that 29.3% mothers were storing prepared food for more than two hours, which they use to serve it two and more times. Four hundred sixty-six mothers, 87.8% store prepared food in a covered place. However, 9.6% of interviewed mothers store uncovered food in room temperature. Forty-one 8% of participated mothers store food in the refrigerator and 2% of them left it as hot in high temperature (most of them responded they left it on the stove which they used for cooking) until served (Table 1).
Reheating practice
More than half, 58% of mothers participated in the study reported they always reheat food when they want to give their child ready to eat food (cooked food) that stayed more than two hours at room temperature. Whereas 28% of the study participants discard it and 13.8% of them feed without reheat.
Hand washing at critical times
Concerning hand washing at critical times, most mothers, 81.5% washed their hands after visiting the toilet and only 32.7% of them reported they wash their hands before feeding their child. But the proportion of mothers who have practiced hand washing with soap at a critical time was lower. For instance, 17.5%, 21.3% and 32.7% of them were reported, they wash their hands with soap before eating food, before feeding baby and before preparing food, respectively (Figure 1). Most of the mothers who did not report hand washing with soap at critical times reported that they use soap other times such as; after they eat or prepare foods containing fat and oil, after touching charcoal, after the meal, morning and evening, and before religious practices (i.e. Salat).
Method of child feeding
The mothers were asked type of utensils or methods they use to feed their child. According to the result of the study, 86.6% of mothers feed with a spoon/cup, and 40.7% of them use their bare hands. From which 28.5% of mothers use both spoon and bare hand simultaneously to feed depending on types of food. For foods like bread and ‘injera’ they use their bare hands, whereas for foods like milk and semi-solids they use spoon or cups. Bottle feeding was also practiced by 35% of mothers (Figure 2).
Utensils cleaning practice
The majority of mothers, 79.7% and 55.5% use soap and hot water respectively to clean utensils used for child feeding, whereas some mothers, 20.5% used only cold water to clean utensils, while few numbers of mothers, 9% did not use soap and hot water at the same time to clean and sanitize spoons and plates used to feed their children (Table 1).
Domestic waste disposal practices
Pertaining waste disposal practices, 15% of mothers dispose of the children’s feces to open field. Few mothers responded that they do not dispose child feces in the latrine; they throw out at other places; for example, near the fence where the adults’ feet could not reach. In addition, more than half of study participants, 57% practiced open field disposal of other liquid wastes generating from the household (Table 1).
Table 1: Complementary Food hygiene practices among Mothers or Caregivers in Robe town, Southeast Ethiopia
Variables
|
Frequency
|
%
|
Hand washing practice with soap at critical times*
|
|
|
Before food preparation
|
166
|
32.7
|
Before feeding baby
|
108
|
21.3
|
Before eating food
|
89
|
17.5
|
After toilet use
|
414
|
81.5
|
After touching child stool
|
347
|
68.3
|
Do you wash your child hand before giving food?
|
|
|
Yes
|
391
|
77.0
|
No
|
117
|
23.0
|
Do you prepare food for the child separately?
|
|
|
Yes
|
467
|
91.9
|
No
|
41
|
8.1
|
Do you cook child food thoroughly?
|
|
|
Yes
|
504
|
99.2
|
No
|
4
|
0.8
|
Duration of cooked child meal lasts until served
|
|
|
Immediately after preparation
|
155
|
30.5
|
Less than 2 hours
|
204
|
40.2
|
More than 2 hours
|
149
|
29.3
|
Where you store child meal?*
|
|
|
In the refrigerator
|
41
|
8.1
|
Kept as hot
|
9
|
1.8
|
Kept in room temperature
|
458
|
90.8
|
Kept covered
|
446
|
87.8
|
What do you do leftover stayed more than 2 hrs?
|
|
|
Reheat always before feeding
|
296
|
58.3
|
Never/sometimes reheat
|
70
|
13.8
|
Discard
|
142
|
28.8
|
Which methed do you use to feed your child?*
|
|
|
Feed with spoon
|
440
|
86.6
|
Feed with a bare hand
|
207
|
40.7
|
Do you practice bottle feed?
|
|
|
Yes
|
178
|
35.0
|
No
|
330
|
65.0
|
Which method you practice to clean utensils?*
|
|
|
Wash with hot water
|
282
|
55.5
|
Wash with detergent
|
405
|
79.7
|
Wash with cold water only
|
104
|
20.5
|
Do you wash raw fruits and vegetable before use?
|
|
|
Yes
|
490
|
96.5
|
No
|
18
|
3.5
|
Child’s feces disposal practice
|
|
|
Closed (in latrine)
|
434
|
85.4
|
Open field
|
74
|
14.6
|
Where you dispose other liquid wastes?
|
|
|
Closed (in the latrine or in sewage pit)
|
219
|
43.1
|
Open field
|
289
|
56.9
|
Notes: *, multiple responses
Factors associated with food hygiene practices
According to the result of the study the overall food hygiene practice of mothers was significantly associated with child age, growth monitoring follow-up, media exposure and knowledge of mothers on critical times of hand washing. Mothers of children aged 12-23 months practice 1.63 times good food hygiene than that of children aged 6-11 months of age [AOR, 1.82 95% CI (1.21, 2.73)]. Mothers whose child attend growth monitoring session practice good food hygiene than their counterpart [AOR, 2.74 95% CI (1.49, 5.06)]. The finding also identified that mothers who have media exposure practiced good food hygiene practices compared to mothers who have no media exposure [AOR, 0.73 95 CI (1.14, 2.62)]. Mothers who have knowledge on critical times of hand washing have more likely to practice better food hygienic practices than mothers who does not have knowledge on critical times of hand washing [AOR, 1.94 95% CI (1.33, 2.82)]. Educational status of mothers, occupation of fathers and marital status of mothers showed significant association in bivariable regression, but not in a multivariable regression model (Table 2).
Table 2: Bivariable and multivariable logistic regression analysis of factors on Complementary food hygiene practice among mothers of children aged 6-23 months in Robe town
Predictor variables
|
Food hygiene practices
|
COR (95% CI)
|
AOR (95% CI)
|
Good (%)
|
Poor (%)
|
Child age (in months)
|
|
|
|
|
6-11
|
72(47)
|
83(53)
|
1
|
1
|
12-23
|
207(59)
|
146(41)
|
1.63(1.12, 2.39)*
|
1.82(1.21, 2.73)*
|
Growth monitoring follow-up
|
|
|
|
|
No
|
18(29)
|
44(71)
|
1
|
1
|
Yes
|
2261(58)
|
185(42)
|
3.45(1.93, 6.16)**
|
2.74(1.49, 5.06)**
|
Mother’s educational status
|
|
|
|
|
No education
|
24(39)
|
37(61)
|
1
|
1
|
Primary education
|
130(53)
|
115(47)
|
1.74(0.98, 3.09)
|
1.31(0.69, 2.45)
|
Secondary and above
|
125(62)
|
77(38)
|
2.50(1.39, 4.50)**
|
1.42(0.69, 2.88)
|
Marital status
|
|
|
|
|
Not in union
|
5(23)
|
17(77)
|
1
|
1
|
In union
|
274(56)
|
212(44)
|
4.39(1.59, 12.10)**
|
2.54(0.86, 7.51)
|
Media exposure
|
|
|
|
|
No
|
68(45)
|
84(55)
|
1
|
1
|
Yes
|
211(59)
|
145(41)
|
1.79(1.22, 2.64)**
|
1.73(1.14, 2.62)*
|
Father’s educational status
|
|
|
|
|
No education
|
20(44)
|
25(56)
|
1
|
1
|
Primary education
|
124(52)
|
117(48)
|
1.32(0.69, 2.51)
|
0.73(0.34, 1.54)
|
Secondary and above
|
135(61)
|
87(39)
|
1.94(1.02, 3.70)*
|
0.95(0.44, 2.07)
|
Knowledge on critical times of handwashing
|
|
|
|
|
Doesn’t knows
|
111(45)
|
133(55)
|
1
|
1
|
Knows
|
168(64)
|
96(36)
|
2.09(1.47, 2.99)**
|
1.94(1.33, 2.82)**
|
Notes: **, statistically significant at p < 0.01; *, statistically significant at p < 0.05; COR, Crude odds ratio; AOR, Adjusted odds ratio; CI, Confidence interval