FOOD SAFETY IN SCHOOL FEEDING PROGRAMMES

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CHAPTER 4: RESEARCH METHODOLOGY

RESEARCH DESIGN

The research design for this study was a descriptive one in which both qualitative and quantitative methods were used to analyse data that was obtained from a cross-sectional survey study.

MPUMALANGA POPULATION

Mpumalanga is one of the nine provinces of South Africa (Figure 4.1). It has a population of 3 657 200 persons, which comprises 7.2% of the South African population (Statistics South Africa [Stats SA], 2012a). The province is the second smallest province, after Gauteng, in terms of area with 76 495km2 of land (Figure 4.2). The province (Figure 4.2) has a very high unemployment rate of 29.8% as of the first quarter of 2016 (Stats SA, 2016).
The province has 1 021 722 learners in 1 966 public schools, of which 74% offer free meals provided by the NSNP (DBE, 2014). While the province has three administrative districts there are four educational districts – Ehlanzeni District, Gert Sibande District, Nkangala District and (Bushbuckridge) Bohlabela (Figure 4.3). This discrepancy in the district boundaries is problematic when trying to work with other departments who plan and work in accordance with the administrative boundaries (DBE, 2013).

RESEARCH AREA

The study targeted primary and secondary schools in Mpumalanga province implementing the NSNP. The entire province has four school districts: Ehlanzeni (Rural and has 13 circuits), Nkanganga (Urban/Rural and has 20 circuits), Gert Sibande (Urban/Rural and has 18 circuits) and Bohlabela (Bushbuckridge) (Rural and has 16 circuits).

SAMPLING OF RESPONDENTS

A combination of purposeful and stratified sampling methods was used to sample schools from the four school districts in Mpumalanga. Each district was divided into four geographical region (North, South, East and West). Fifty schools with at least 12 from each geographical region with a minimum of 6 primary and 6 secondary schools that offer NSNP were selected randomly from a list of school in each geographical region in each district. Primary and Secondary schools that do not offer NSNP were removed from the list prior to sampling to avoid bias. A total sample size of 300 schools (200 primary and 100 secondary) out of 1 966 in the four districts (DBE, 2012/2013 annual report) were used for data collection.

DATA COLLECTION INSTRUMENTS

Questionnaires were the instruments used to collect data from administrative staff and food handlers of the NSNP (Appendices A and B).

The questionnaire instrument

The food safety knowledge questionnaire was designed to obtain information about food handlers’ knowledge of food poisoning, personal hygiene, cross contamination, cleaning, and temperature control. The questionnaire for the food-handlers (in Appendix B) comprised six sections: demographics, personal hygiene, kitchen hygiene, personnel training, cross contamination, time and temperature, and food safety practice. The other questionnaire, for administrators (Appendix A) comprised six sections, namely, demographics, management commitment to the NSNP, food safety policies, the food safety plan and standard operating procedures, HACCP knowledge, and the management of resources (human, infrastructure and the work environment). The questionnaires consisted mostly of questions to determine the participants’ opinions on food safety knowledge and awareness and the administrative support of the NSNP.
The questionnaires consisted of various closed questions of various point scale such as ‘agree’, ‘disagree’ and ‘not sure’ for participants and an open questions to clarify participants purposes. To reduce the response bias, the multiple choice answers included ‘‘not sure’’. In addition, the questionnaires included questions relating to the demographic characteristics of NSNP staff (education level, age, gender, number of years in service in foodservice operations, food safety training).

DATA COLLECTION FROM RESPONDENTS

Data was collected by the primary researcher using a combination of self-administered questionnaire and face to face interview, based on the preference of respondents. Research assistants (fieldworkers) were recruited and trained for the purpose of the data collection. For microbial analysis, swabs of food preparation surfaces were collected from NSNP food preparation premises and transported chilled in cooler boxes to the UNISA Science Campus laboratory for analysis. Details regarding data collection will be explained in the relevant research (Chapter 5.1 and 5.2).

MICROBIAL SURVEY

A microbiological survey was conducted in one school district facilities of primary and secondary schools implementing the NSNP in Mpumalanga province. Each school facility was tested twice monthly over the course of a three-month period for a total of six nine sampling periods per school (32 schools) with a total number of 192 samples (2×3=6; 6×32=192). Specific broth agar media were used to culture microorganisms while specialize media were used for the detection of pathogens (Manufacturer’s instruction manual was followed and the method is acceptable by regulatory authorities). Details regarding microbial analyses will be explained in the relevant research (Chapter 5.3).

DATA ANALYSIS

The questionnaire responses were coded and analysed using the social science software (SPSS). Descriptive statistics, ANOVA and regression analysis were applied to food safety and quality assurance variables such as kitchen and personal hygiene, cross contamination and time and temperature control. Pearson’s chi-square test was performed to examine if there were any significant relationships between demographics, personal training, food safety knowledge, time and temperature control, cross contamination, kitchen hygiene and personal hygiene as well as food safety practices. Correlation coefficient and variance analysis was conducted on microbiological counts. Statistical significance was set at p < 0.05. Further data analysis was explored using various tables and figures such as the frequency distribution.

PILOT TEST FOR THE SURVEY STUDY

Eight NSNP schools (4 primary and 4 secondary) from each district in Mpumalanga were selected randomly for the pilot study. This ensured the accuracy of the questionnaire instruments that it measured what it is supposed to measure (Ary et al., 2002). Pilot test responses from 8 schools were not included in the final data analysis to ensure the accurate reporting.

RELIABILITY AND VALIDITY OF THE QUESTIONNAIRE

The reliability of the questionnaire instruments was tested in a pilot study with 8 schools as described by conducting duplicate interviews with the same instrument. After which necessary adjustments was made to ensure reliability. The instruments were evaluated for face and content validity by a panel of experts with experience in food safety and quality assurance. This exercise is done to ensure that the instruments are valid for their intended purpose and the contents are appropriate for measuring what it is supposed to measure (Ary et al., 2002).

Reliability of the questionnaire

Cronbach’s alpha was calculated to estimate internal consistency for each factor identified on the food safety knowledge and awareness scale as well as the quality assurance measures scale of the questionnaire. A total Cronbach’s alpha (α) was performed to identify how well each item fitted into the total scale and to verify that there were no items that would increase the alpha if they were deleted.

Validity of the questionnaire

To establish content validity, the questionnaires were piloted in 8 schools. The random sample was chosen from schools implementing the NSNP in school district of Mpumalanga province. The questionnaire and a cover letter explaining the purpose of the study was taken physically to schools which were then asked to evaluate the questionnaire using a critique form. The questionnaire was evaluated for clarity, appropriateness of content, ease of completion, and appropriateness of questionnaire length. Feedback from the pilot test was used to make revisions to the questionnaire. School participating in the pilot test not included in the study

ETHICAL ISSUES

Ethical clearance (2015/CAES/018) was granted by the College of Agriculture and Environmental Sciences (CAES), UNISA’s research ethics committee, in order to ensure that the study complied with the rules of ethics as prescribed by the Medical Research Council of South Africa Regulations 1993. A f ormal letter describing the purpose of the study was sent to the Mpumalanga Department of Basic Education requesting permission to perform the study in their schools. An Informed Consent letter describing the purpose of the study, the role of the interviewees in the study, and their right to withdraw at any time during the study was signed by the participants prior to their entry into the study. Respondents participated in this study on a voluntary basis and they signed a consent form. Confidentiality of the respondents and the schools was maintained.

ASSESSING THE FOOD SAFETY ATTITUDES AND AWARENESS OF MANAGERS OF SCHOOL FEEDING PROGRAMMES IN MPUMALANGA, SOUTH AFRICA

The managers of school feeding programmes are responsible for ensuring the safety of the food which is provided to schoolchildren, but very few studies have been conducted on the food safety knowledge and awareness of these managers. The objective of this study was to evaluate the food safety attitudes and awareness of managers of the National School Nutrition Programme (NSNP) in schools in Mpumalanga, a province of South Africa. A cross-sectional survey study was conducted in which questionnaires were used to collect data from 300 managers. The majority of schools offering NSNP meals were located in informal settlements and most were found to lack basic resources such as electricity (power supplies to the food preparation facility) and potable tap water in their kitchens. No school was found to have implemented the hazard analysis and critical control points (HACCP) programme, and only a few staff had received food safety training. Food safety implementation was worst in informal schools in rural areas due to limited resources and infrastructure. The NSNP managers in some schools – especially those located in rural settlements – were found to have little knowledge or awareness of HACCP. These results indicate an urgent need to provide NSNP managers with food safety training and resources (potable water supplies, electricity, dedicated food preparation facilities), particularly in schools in rural settlements.
Keyword: Food safety, Attitude, Awareness, Managers, School Feeding Programme

Introduction

School feeding programmes are powerful instruments for seeking to alleviate short-term hunger and improve nutrition and the cognitive abilities of schoolchildren by providing free meals in schools (Sanfilippo et al., 2012; World Food Programme (WFP), 2013; Munthali et al., 2014). A positive correlation has been found between the academic performance of schoolchildren and the provision of free school meals in schools located in poor communities (Taras, 2005). Endemic poverty in many communities in developing countries has necessitated the implementation of school feeding programmes (Bundy et al., 2009; WFP, 2013).
The implementation of food safety measures in school feeding programmes is important, considering that many schoolchildren are deemed vulnerable due to their weaker immune systems, when compared to healthy adults (Lund & O’Brien, 2011; Nyenje & Ndip, 2013, Monakhova, 2014). Foodborne disease outbreaks are becoming a frequent occurrence in school settings (Mellou et a., 2013), due to a lack of adequate infrastructure as well as inadequate food safety knowledge on the part of employees of school feeding programmes (Kibret & Abera, 2012; Baluka et al., 2015). Foodborne disease outbreaks in school feeding programmes can be caused by inadequate food preparation and food storage facilities in food preparation establishments which do not meet hygiene standards (Lockis et al., 2011). The absence of prerequisite programmes such as production control, raw material control, pest control, good manufacturing practices (GMP), good hygiene practices (GHP) together with the absence of standard food safety programmes such as hazard analysis and critical control points (HACCP) in most food preparation facilities at schools constitute a food safety concern (Agyei-Baffour et al., 2013).
In 2012, the South African Department of Basic Education (DBE) reported that the majority of employees working for the National School Nutrition Programme (NSNP) had not received formal food safety training (Rendall-Mkosi et al., 2013). This means that many managers of NSNP food service facilities may not be knowledgeable about the establishment of food safety policies or the implementation of food safety standards (Arendt et al., 2013). Despite this, these managers are expected to commit monetary and material resources and to assume a leadership role in the implementation of food safety programmes (Mosadeghrad, 2014). These managers also have to make sure that staff undergo food safety training and oversee the consistent implementation of a comprehensive food safety programme within the food preparation facilities of school feeding programmes (Wilcock et al., 2011; Strohbehn et al., 2014).
In a school setting, where thousands of infants and children are served food daily, an outbreak of foodborne disease can lead to sickness which can result in death or the loss of school days due to illness amongst learners (Behravesh et al., 2012; WFP, 2013; Monakhova, 2014). Very few studies have been conducted on the food safety knowledge and awareness of school feeding programme managers who are responsible for ensuring the safety of the food which is provided to schoolchildren. Therefore, the objective of this study was to evaluate the food safety attitudes and awareness of NSNPs managers in schools in Mpumalanga, South Africa.

Materials and methods
The study area

The study was conducted in public primary and secondary schools that offer NSNPs in Mpumalanga, one of the nine provinces in South Africa and home to 7.2% of the South African population (Stats SA, 2012). The province has 1 966 public schools, of which 74% offer free meals provided by the NSNP (DBE, 2014).

Research design and Sampling

A cross-sectional survey study was conducted in which questionnaires were used to collect data from respondents. A total of 300 respondents were randomly selected from a list of 1 455 (74%) public schools that offer the NSNP in the province. Respondents were individuals 18 years and older, who have been designated by their respective school governing bodies to manage the NSNP in their schools.

Research instrument

The questionnaire instrument used for data collection comprised seven sections: socio-demographic details of respondents, details of NSNP food service facilities in schools, attitudes toward food safety assurance, food safety standard operating procedures (SOPs) and their implementation, empowerment of food handlers by NSNP food service managers, requisition practises and inventory management, and HACCP awareness. The questionnaire was piloted with 30 food handlers in eight schools, but these data were not included in the final sample. After the pilot study, the structure and wording of the questions were revised. The reliability and validity of the different sections of the research instrument were determined and the Cronbach’s alpha (α) for the different constructs were found to range from 0.689 to 0.821.

Data collection

Prior to data collection, permission to conduct the study was obtained from the Mpumalanga Province’s DBE and ethical clearance was granted by the ethics committee of the University of South Africa. Appointments to conduct interviews were made in advance with the relevant school principals. The questionnaires were distributed to each school NSNP manager/coordinator to complete. A consent form was signed by participants to affirm their voluntarily participation and their right to withdraw from the study if they so desired. The questionnaire of each respondent was coded to ensure anonymity.

Statistical analysis

The results were evaluated and analysed using the SPSS 20.0 software package. The data of all variables were presented as percentages. ANOVA was used to examine variations in response to food safety parameters

TABLE OF CONTENTS
DECLARATION
ACKNOWLEDGEMENTS
DEDICATION
ABSTRACT
TABLE OF CONTENTS
LIST OF TABLES
LIST OF FIGURES
CHAPTER 1: INTRODUCTION
1.1 BACKGROUND INFORMATION
1.2 PROBLEM STATEMENT
1.3 PURPOSE FOR THE STUDY
1.4 SIGNIFICANCE OF THE STUDY
1.5 ASSUMPTIONS OF THE STUDY
1.6 LIMITATIONS OF THE STUDY
1.7 LAYOUT OF THE THESIS
CHAPTER 2: LITERATURE REVIEW
2.1 INTRODUCTION
2.2 SCHOOL FEEDING PROGRAMMES
2.3 FOOD SAFETY IN SCHOOL FEEDING PROGRAMMES
2.4 HAZARDS IN FOODS
2.5 CAUSES OF FOODBORNE DISEASES
2.6 EPIDEMIOLOGY OF FOODBORNE DISEASES
2.7 THE CHALLENGES OF THE NATIONAL SCHOOL NUTRITION PROGRAMME
2.8 MICROBIAL QUALITY OF FOOD PREPARATION SURFACES
2.9 FOOD HANDLERS’ KNOWLEDGE OF FOOD SAFETY IN A NSNP
2.10 FOOD SAFETY TRAINING IN THE SCHOOL FEEDING PROGRAMME
2.11 FOODBORNE DISEASE IN SOUTH AFRICA
2.12 FOOD SAFETY LAWS IN SOUTH AFRICA
2.13 MANAGEMENT SUPPORT OF FOOD SAFETY
2.14 DEVELOPING A HAZARD ANALYSES CRITICAL CONTROL POINT (HACCP) PROGRAMME
CHAPTER 3: AIM AND OBJECTIVES
3.1 AIM
3.2 OBJECTIVES
3.3 CONCEPTUAL FRAMEWORK
CHAPTER 4: RESEARCH METHODOLOGY
4.1 RESEARCH DESIGN
4.2 MPUMALANGA POPULATION
4.3 RESEARCH AREA
4.4 SAMPLING OF RESPONDENTS
4.5 DATA COLLECTION INSTRUMENTS
4.6 DATA COLLECTION FROM RESPONDENTS
4.7 MICROBIAL SURVEY
4.8 DATA ANALYSIS
4.9 PILOT TEST FOR THE SURVEY STUDY
4.10 RELIABILITY AND VALIDITY OF THE QUESTIONNAIRE
4.11 ETHICAL ISSUES
CHAPTER 5: RESEARCH
5.1 ASSESSING THE FOOD SAFETY ATTITUDES AND AWARENESS OF MANAGERS OF SCHOOL FEEDING PROGRAMMES IN MPUMALANGA, SOUTH AFRICA
5.2 FOOD SAFETY KNOWLEDGE AND AWARENESS OF FOOD HANDLERS IN SCHOOL FEEDING PROGRAMMES IN MPUMALANGA, SOUTH AFRICA
5.3 MICROBIOLOGICAL QUALITY OF FOOD CONTACT SURFACES IN THE FOOD PREPARATION FACILITIES OF SCHOOLS INVOLVED IN SCHOOL FEEDING PROGRAMMES, MPUMALANGA, SOUTH AFRICA
CHAPTER 6: GENERAL CONCLUSION AND RECOMMENDATIONS
6.1 CONCLUSION
6.2 RECOMMENDATIONS
REFERENCES
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