Hygiene practices among food vendors in urban, semi-urban, and rural Ghanaian settings: an ethnographic qualitative study

Background Street food vending is an important source of affordable meals and livelihood in Ghana; however, poor hygiene practices among vendors remain a major contributor to foodborne diseases. Despite this public health concern, qualitative evidence from smaller towns and peri-urban communities in Ghana remains limited. This study explored the hygiene practices, knowledge, attitudes, and regulatory experiences of food vendors in Asamankese, Adabraka, and Kpando Gabi. Methods A descriptive qualitative research design was employed using structured in-depth interviews and field observations. Twenty food vendors were selected through convenience sampling across the three study sites. Data were analyzed using reflexive thematic analysis. Results Four major themes emerged from the analysis: personal hygiene practices, environmental and food handling hygiene, knowledge and perceptions of food hygiene, and enforcement of food safety regulations. Although many vendors reported engaging in routine hygiene practices such as bathing, cleaning vending areas, and washing utensils before work, field observations revealed inconsistencies between reported and actual practices, particularly regarding hand hygiene and the handling of food and money simultaneously. The use of Personal Protective Equipment was inconsistent across study sites. Vendors generally associate food hygiene with visible cleanliness and customer attraction rather than microbial contamination risks. Regulatory inspections were irregular and focused mainly on blood testing and health card renewal, with limited assessment of actual vending conditions. Conclusion Improving food hygiene among street food vendors requires more than awareness creation alone. Consistent regulatory enforcement, improved sanitation infrastructure, and practical, context-specific hygiene training are necessary to strengthen food safety practices in informal food vending settings in Ghana.