Beyond the market: Food safety knowledge and practices among female household food handlers in the domestic kitchen.

Food safety within the household remains a critical yet often overlooked component of public health, particularly in developing countries where food preparation is largely managed at the domestic level. Despite high levels of formal education in urban populations, knowledge does not consistently translate into safe food-handling behaviour. This study assessed food safety knowledge, perceptions, and practices among female household food handlers in the Ho Municipality of the Volta Region, Ghana. A community-based cross-sectional design was employed, involving 386 female household food handlers aged 18 years and above, selected through a combined purposive and systematic sampling procedure from households in Ho Municipality. Data were collected using a semi-structured questionnaire administered through face-to-face interviews. Knowledge was assessed across five items; participants who answered three or more correctly were classified as having good knowledge. Descriptive statistics, chi-square tests, and ordinal logistic regression were used to analyse data (SPSS version 22; p ≤ 0.05). The findings revealed generally high awareness of food safety: 81.9% reported practising personal hygiene during food preparation, and 86.5% recognised that poor hygiene contributes to food contamination. However, this awareness did not consistently translate into safe practices. Only 22.5% reported that they regularly wash foodstuffs before usage, and 42.2% wash their hands before cooking. Risky behaviours were common, including tasting food with bare hands (43.8%) and using the same ladle throughout cooking (31.1%). Additionally, 60.1% were unaware of the correct freezer temperature (-18°C). Educational level was the only factor significantly associated with food safety knowledge (p = 0.001) and remained the sole independent predictor after logistic regression adjustment (adjusted OR 3.66, 95% CI 1.72-7.79, p = 0.001 for tertiary versus primary-educated respondents). A clear gap exists between food safety knowledge and practice among female household food handlers in Ho Municipality. Targeted, practical, and culturally appropriate interventions that promote behaviour change, rather than awareness alone, are needed to reduce preventable food-borne illness, particularly among children.