Food is any nutritious substance that people or animals eat or drink or that plants absorb to maintain life and growth [1]. Food contamination occurs when foods become contaminated with another substance. It can happen In the process of production, transportation, packaging, storage, sales, and cooking process. Food can be contaminated from production to consumption. Manufacturers, shippers, processors, retailers, and grocery stores are responsible for ensuring safe food handling practices. Especially in public food facilities, grocery stores are the first responsible entity to contaminate food and serve as a biological or physical carrier for many pathogenic organisms [1]. The degree of food contamination is strongly determined by the degree of contact [2, 3].

According to the WHO (1989) assessment in Geneva, food handling personal practice plays an essential role in guaranteeing food safety throughout the food production and storage chain. Mishandling and disregard for sanitary measures on the part of food handlers may allow harmful microorganisms to enter food and, in rare cases, survive and grow in sufficient numbers to cause disease in consumers (WHO, 1989). Similarly, Asrat et al. [4] claim that food handling practices difficulties among food handlers cause 2.2 million fatalities yearly (1.9 million of which are children), while [5]discovered that unsafe food handling procedures cause 22.9 percent of diarrhea cases in Tanzania.

Evidence suggests that illness and mortality from illnesses caused by contaminated food are a persistent danger to public health in underdeveloped nations and a serious hindrance to global socioeconomic growth. Foodborne disease (FBD) outbreaks are widespread and can result in significant morbidity and death [6]. In Ethiopia, tainted food is responsible for around 70% of diarrhoeal illnesses (WHO, 2010). Approximately 10 to 20% of foodborne illness outbreaks are caused by food handler contamination and poor food handling procedures [7]. This is also a trend in Ethiopia, where eating out covered 16% of the city's food budget, according to reanalysis data from the 2011 Ethiopia Household Consumption and Expenditure Survey (EHICES) [5]. According to a 2019 report, about 7% of food is consumed outside Addis Ababa's homes (ibid). Eating food away can be a potential source of microbial exposure from food because of the long value chain that food passes through with producers, transporters, processors, retailers, distributors, and food handlers [6].

In Ethiopia, the problem of unsafe food handling practices has become more prevalent in most urban areas and has caused various foodborne diseases (FBDs). In our country, Ethiopia, the government plays an important role in regulation in the areas of food quality and safety. Consumer protection was developed with the aim of protecting consumers from economic and health risks and ensuring the proper functioning of the food market. Despite the government's efforts, the federal governments responsible for food-regulated activity frequently, report that they have faced difficulty in contacting qualified food safety professionals and have little access to state-of-the-art tools for advanced microorganisms or analytical parameters. Often, it makes it difficult for regulators to establish safety goals and activities in the food environment [7]. Given that a variety of foods are prepared in bulk, usually by a large number of people in establishments, they have a synergistic effect on the high possibility of one-time and/or recurring contamination [4]. This is due to unsanitary food preparation, inappropriate food handling, holding temperatures, and a lack of personal hygiene knowledge, which are all factors that could increase the degree of food contamination.

In the city of Addis Ababa, there is a high expansion of food establishments. But ensuring safe food handling service has been one of the major challenges and concerns for producers, consumers, and public health officials. According to studies, the main causes of poor food safety practices in food outlets include a lack of basic sanitary facilities/infrastructures, inadequate understanding and practice of hygiene and sanitation among food handlers in food service companies, and neglect of safe food handling [2,3,7]. Thus, it is essential to investigate associated factors and the overall food handling practices to reckon with the problem from the ground. In the meantime, this study tried to examine factors influencing food handling practices and the commonly used practices for food selection, storage, and disposal of waste food among the food handlers at the Yeka sub-city primary public school cafeteria.

Justification of the Study

There have been several studies conducted on the convergence of food handling practices and food safety in various parts of Ethiopia. Starting from the conclusive side, they were shown to be the pervasiveness of poor food handling practices and foodborne diseases. Also, they have shown the hideous consequences of poor hygiene practices of food processors, poor hygiene of food plants, poor waste disposal services, lack of legal permits, and environmental hygiene in Ethiopia. Nevertheless, even though several studies have been conducted on food handling practices, many of them are primarily concerned with the public food and drinking service establishments of various towns in Ethiopia, instead of public school compounds. It has shown the need for well-organized and well-immense research not only in public food and drinking establishments but also in government primary schools.

Although, in 2011 E.C there was a significant effort to cover the primary students’ daily meals (breakfast and lunch programs) in each public primary school in Ethiopia. However, concerning the primary student food programs, there is a significant problem observed related to food handling practices that would result in food poisoning and student morbidity. Children are the future posterity who should be raised with access to high-quality social services because they are the primary input for any country's development. With this in mind, this study focused on the public primary schools in the Yeka sub-city and many of the students are below 18, which mean they need critical care and are vulnerable to hazardous foodborne diseases if we are unable to take care of what we are doing in the establishments. Therefore, an examination of food handling practices and their associated factors is believed to trigger the problem in school establishments and is needed to enhance food handlers' and the school community's awareness.

Objectives of the Study

This study aimed to investigate food handling practices and associated factors among the food handlers at public primary schools in Yeka sub-city, Addis Ababa, Ethiopia. But specifically, this study answers the questions of what the food handling practices look like and explores the associated factors with food handling practices among the public schools of Yeka sub-city, Addis Ababa.

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