Street-food vendors and food safety: Behavioural predictors of safe vegetable washing in Accra, Ghana

BackgroundIn Accra, Ghana, street food vendors soak leafy greens and other salad vegetables, eaten raw, in a basin of water to which they add salt, with the expectation that this will remove germs. While this method has long been the best available option, salt is less effective than other disinfectants. Potassium permanganate is one such disinfectant commonly used in French-speaking West Africa and other Low- and Middle-Income Countries, but its use to sanitise vegetables is virtually unknown in Ghana. This article aims to identify the factors that would induce street food vendors to use potassium permanganate instead of salt. MethodsUsing the Risk-Attitude-Norms-Abilities-Self regulation (RANAS) behaviour change approach, an exploratory sequential mixed-methods design consisting of formative interviews (N=20) and a quantitative survey of street food vendors (N=251) was conducted in 10 neighbourhoods of Accra to investigate which psychosocial factors best predict the adoption of potassium permanganate. An ordinal logistic regression analysis then determined the factors that are the most significant predictors of vendors commitment to using potassium permanganate. ResultsThe interviews and survey showed that street food vendors are aware of the health risks associated with food contaminated with germs and prioritise hygiene. However, limited and sometimes inaccurate knowledge hinders their motivation to adopt safer practices. Our study revealed that personal norms, confidence in resuming the practice after an interruption, and others approval (injunctive norms) are significant predictors of street vendors commitment to using potassium permanganate. Our findings also suggest that education, training and financial (dis-)incentives are insufficient on their own to motivate the adoption of this safe practice. ConclusionsOur results suggest that public authorities seeking to promote the use of potassium permanganate to sanitise vegetables eaten raw should integrate behaviour change strategies that leverage these predictors to enhance adoption. The article demonstrates the value of the RANAS approach for addressing food safety behaviours across urban vegetable value chains in low- and middle-income countries globally, aligning with WHO recommendations that emphasise socio-cultural dimensions alongside technical measures.