Food-handling practices, nutrition and food safety knowledge, and attitudes of staff at early childhood development centres in the City of Cape Town, South Africa

Abstract

Background
Early childhood development (ECD) centres offer an ideal setting to reach vulnerable children below
five years and provide an environment for developing healthy eating behaviours
Objective
To describe the food provisioning environment, nutrition and food safety knowledge, and attitudes
of staff at ECD centres in Cape Town.
Methods
Forty-six randomly selected ECD centres participated in the cross-sectional study. An observational
audit was conducted of the food provisioning environment and food-handling practices. Staff (N=162)
completed a self-administered questionnaire assessing nutrition and food safety knowledge and
attitudes.
Results
Managers were responsible for compiling the menus in 89.1% of centres. The format of the menus
varied considerably. Twenty-three per cent (n=11) of the centres had a separate eating area. Six
(13.1%) lacked cooling facilities, and three (6.5%) had a freezer. Cooked leftover food was stored
correctly in 14.3% (n =7) of the ECD centres where this observation was made. The personal hygiene
score was 86.5%. Hands were not washed regularly (n=16; 34.7%). One third (32.6%, 51/156) of the
staff had received nutrition-related training. The staff's nutrition knowledge score was 69.9% (SD
10.15). The lowest knowledge scores related to food safety such as how to defrost meat (30.8%).
There was a statistically significant difference in the level of education and the knowledge score
(p < 0.01). ECD centre staff (86.2%, n=138) displayed a positive attitude towards their role in
promoting healthy eating habits.
Conclusion
There is a substantial opportunity to improve the food-provisioning environment at ECD centres in
the City of Cape Town. Despite the availability of nutrition guidelines for ECD centres,
implementation remained poor. Regular training and monitoring should be a priority to ensure
implementation and adherence to food provision guidelines. Insights from this study provide
stakeholders with guidance on how to improve the food-provisioning
environment at ECD centres in a multi-sectoral manner.