Food safety practices, nutrition knowledge and menu adequacy at non-registered Early Childhood Development (ECD) centres in the Ntuzuma Area, Durban, South Africa

Abstract

Globally, millions of children are deprived of their right to good nutrition which contributes to child development and nurturing while eliminating preventable diseases that could affect them at their early age. According to the World Health Organisation (WHO), food safety has become a health priority over the years with more than 95% of deaths reported globally due to diarrhoea and dehydration and 40% of these being young children. Food safety is the responsibility of every person who is involved in food handling. In general, food handlers’ mistakes include serving contaminated food, inadequate cooking, heating or reheating of food and allowing the consumption of food from unsafe sources. Children spend more than 50% of their day at an Early Childhood Development (ECD) centre therefore centres need to provide adequate meals and snacks in order to provide for the basic nutritional needs of these children. Nutrition remains an essential element of a child’s health care and nutrients are important for optimum growth, which is why regular small healthy meals for young children should include fruit and vegetables, whole grain and cereals, meat and meat alternatives (fish, legumes). The aim of this study was to investigate the food safety and hygiene practices, and evaluate the current nutrition knowledge of food handlers and also assess the nutritional adequacy of the menus at nonregistered ECD centres. This study also aimed to observe the food handling and hygiene practices of the food handlers and also determine the menu adequacy of meals served to the young children in these non-registered ECD centres. The designing of the research is one of the important steps in conducting a research as it helps structure research questions and objectives that have been outlined to provide a solution. This cross sectional study was of a quantitative nature and data was collected through structured research measuring tools that have been tested for their validity and reliability, and ensuring accuracy in measurements. A list of non-registered ECD centres (n=10) based in the Ntuzuma area was provided to the researcher by the Department of Social Development’s (DSD) Durban office. It must be stated that this list consisted of ECD centres that were not registered with DSD at the time of the study but were in the process of complying with the regulations and requirements stated by DSD, to assist in the sampling process. All ten of the centres were approached by the researcher and they all agreed to participate. Questionnaires and the observation checklist were then piloted in a sample group to establish suitability and adapted if necessary in one ECD centre while the remaining ECD centres formed part of the study (n=9). Eleven participants in total, two of whom were food handlers who assisted the managers when they were not available and nine who were both managers and food handlers formed part of the study. The researcher also conducted a plate waste study to determine the consumption patterns during meal times. Food finder version 2019 software was used to analyse the menu adequacy in each ECD centre by comparing it to the DRIs for children younger than five years old. Data collected from this study showed that food handlers were more knowledgeable on certain aspects of food safety as the majority of the food handlers knew that raw and cooked food needed to be placed separately during storage to prevent cross contamination. The vast majority of the centres had adequate space and utensils for cooking but insufficient chopping boards. Furthermore, simple hygiene practices such as washing of hands after a visit to the toilet and before food preparation were demonstrated by most of the food handlers. However, there was no antibacterial soap available for hand washing and no designated hand washing stations. Knowledge on temperature control was poorly demonstrated as all cooked foods should be kept very hot before serving; however, the food handlers kept their food warm by leaving it in pots on the stove with the lid tightly secured during the holding stage. The data gathered from this study was that food handlers at all the non-registered ECD centres needed to attend intensive formal training on food safety and hygiene practices on all the different aspects of food safety Nutrition knowledge questionnaire showed that majority of the FHs were able to correctly answer most of the questions relating to the South African Food Based Dietary Guidelines. However, it was disappointing that most of the food handlers were not aware that an average of 8 glasses of water a day are recommended to be drunk. The dietary analysis indicated that there was a low consumption of fruits and vegetables and dairy products as most meals lacked essential macro and micronutrients, contributing to the poor nutritional status of the young children. The microbial analysis revealed that the occurrence of Staphylococcus aureus and Escherichia coli was visible on the hands of the food handlers, the chopping boards and the preparation surface areas in each centre before washing but no growth was observed after washing, indicating that the cleaning process was effective. The overall observation assessment suggested that food safety compliance was not implemented. This indicates that thorough food safety and hygiene training is urgently needed. This study aimed to determine the food safety, hygiene practices and nutrition knowledge of all the food handlers, while analysing and assessing the nutrition adequacy of the menus offered to the children in these non-registered ECD centres, and lastly, to observe the food safety practices of food handlers and analyse the food workspaces for bacterial count. More research at non-registered ECD centres in other provinces is crucial in order to compare the results to the results obtained in this study. It is also recommended that other government stakeholders such as the Department of Social Development and the Department of Health be engaged in order to supplement existing knowledge and implement further practical improvements.