Factors associated with caregivers' food safety knowledge, behavior, perception of food safety control, and the nutrition status of under-5 children in Nigeria

Background: Household-level food safety practices may have a long-term outcome on the nutrition and health status of under-five children. This study explores the relationships between caregivers' self-reported food safety knowledge, behavior, perception of food safety control, and their young child's (< 5 years) nutrition status.

Methods: In a cross-sectional study design, 664 caregivers from five Local Government Areas (LGAs) in Ibadan, Nigeria were surveyed using an interviewer-administered questionnaire on their food safety knowledge, behavior and perceived food safety control. Anthropometric measurements of the household's index child (aged 6-59 months) were also taken. Variables for food safety knowledge and behavior score were selected using principal component analyses. The nutritional status of the children (Z-scores for weight-for-height (WAZ), height-for-age (HAZ), and weight-for-age (WHZ)) were calculated. Description statistics were run on all variables and logistic regression models examined associations between the three food safety constructs and the children's nutritional status. Covariates such as LGAs, caregiver's age, household size, wealth index, child's gender, and age were adjusted.

Results: High-level of food safety knowledge, behavior and lots of perceived control on food safety issues were reported by 77.7%, 76.7%, and 81.1% of the caregivers. Using WAZ, HAZ and WHZ that are ≤ -2, acute malnutrition (6.0%), chronic malnutrition (42.5%), and underweight (22.0%), respectively were prevalent among the children. Perceived food safety control was the only food safety construct associated with acute malnutrition. Wealth index, caregivers' age, number of under 5 at home, child age, and gender were associated with acute malnutrition. Caregiver's age, child's age, and gender were associated with chronic malnutrition. Furthermore, caregiver's age, education and child's age were associated with a child being underweight. The significance level was at P < 0.05.

Conclusion: Factors associated with food safety and children's nutritional outcomes are multi-faceted in nature. Future studies should explore access to resources and other intermediate factors that may explain the linkage between childhood malnutrition and caregivers' food safety awareness, knowledge, and behavior. Public health and food safety initiatives to bridge the gap between perceived food safety control and actual food safety behavior/practices.