Meat hygiene and safety practices among food establishments in Debre Markos Town, Ethiopia: a One Health approach, 2025

Abstract

Meat hygiene and safety are critical for preventing foodborne diseases and protecting public health. This study assessed meat hygiene and safety practices among 363 meat handlers in Debre Markos Town, Ethiopia, using a One Health framework that integrates human, animal, and environmental health determinants. Data were collected through structured interviews and direct observations across eleven key performance indicators. Overall, 60.6% of participants demonstrated good hygiene and safety practices, while 39.4% fell below recommended standards. Multivariable analysis showed that adequate handwashing, use of personal protective equipment (PPE), formal food safety training, and medical checkups every three months were strong human health predictors of good practice. Additionally, sourcing meat from licensed facilities and verification of ante-mortem inspections were significant animal health predictors, and facility sanitation was a key environmental predictor. These findings indicate that meat hygiene is shaped by interconnected human, animal, and environmental factors rather than individual effort alone. To ensure sustainable improvements, occupational health surveillance should be institutionalized, competency-based training and medical checkups every three months implemented, and supply chain traceability and facility sanitation monitoring integrated under a unified One Health approach.

Supplementary Information

The online version contains supplementary material available at 10.1038/s41598-026-49925-x.

Introduction

Food safety is a critical component of public health and a major determinant of population wellbeing worldwide. Meat and meat products provide high-quality nutrition but can also serve as vehicles for pathogenic microorganisms, chemical contaminants, and zoonotic agents. Globally, foodborne diseases affect an estimated 600 million people and cause 420,000 deaths annually, with animal-source foods contributing substantially to this burden, particularly when hygienic handling practices are inadequate. Pathogens such as Salmonella, Escherichia coli, Campylobacter, and Staphylococcus aureus are commonly associated with contaminated meat and pose elevated risks to vulnerable populations, including children, pregnant women, and immunocompromised individuals¹.

Ensuring meat safety requires interventions across the entire value chain, from animal production and slaughter to processing, transportation, and retail. Failures at any stage can lead to contamination and foodborne disease outbreaks². While high-income countries have established regulatory frameworks and surveillance systems, low and middle-income countries (LMICs) often face challenges such as weak regulatory enforcement, limited infrastructure, inadequate cold chain systems, and a predominance of informal markets, resulting in disproportionately high foodborne disease burdens³.

In Ethiopia, rapid urbanization and rising demand for meat have expanded both formal and informal food establishments. Meat retailing involves sourcing from municipal abattoirs and informal slaughter points, with variability in ante-mortem and post-mortem inspection practices. Within retail establishments, meat handlers frequently operate under suboptimal conditions, including limited access to clean water, inadequate waste management, insufficient pest control, and inconsistent use of personal protective equipment (PPE). Many handlers also lack formal food safety training and undergo medical checkups only irregularly, increasing the risk of both meat contamination and occupational exposure to zoonotic pathogens⁴.

Debre Markos town, a rapidly growing urban center in northwest Ethiopia, has experienced increased meat consumption and the expansion of food establishments, including both registered and unregistered outlets. The town’s meat supply chain encompasses licensed municipal abattoirs, informal slaughter points, and retail shops, with varying levels of veterinary inspection and sanitation practices. Despite these trends, empirical evidence assessing meat hygiene and safety practices in Debre Markos is limited, particularly from an integrated perspective that simultaneously considers human, animal, and environmental health factors. Most existing Ethiopian studies have focused either on microbial contamination or isolated behavioral factors among meat handlers, without integrating human, veterinary, and environmental health components^3,5.

Applying an integrated One Health framework allows for a holistic understanding of how human behavior, animal health systems, and environmental conditions interact to influence meat safety outcomes^6,7. This approach emphasizes safe animal sourcing, effective veterinary inspection, hygienic slaughter and handling practices, and proper environmental sanitation within food establishments and retail settings. It is particularly critical in LMICs, where informal practices often blur the boundaries between human, animal, and environmental exposures⁸.

This study aimed to assess meat hygiene and safety practices among food establishments in Debre Markos town, Ethiopia, using a One Health approach. Specifically, it examined human health factors (food safety training, medical checkups every three months, hand hygiene, and PPE use), animal health factors (meat sourcing and veterinary inspections), and environmental health factors (sanitation, waste management, water supply, and pest control). The findings provide evidence to inform integrated public health, veterinary, and environmental interventions to improve meat safety and reduce foodborne disease risks in urban Ethiopian settings and similar contexts in sub-Saharan Africa.

Materials and methods

Study area

Debre Markos (Fig. 1), the administrative center of the East Gojjam Zone in Ethiopia’s Amhara Region, serves as a prominent hub for trade and commerce. Following the standard urban meat supply model in Ethiopia, the town’s value chain begins with municipal slaughterhouses, which distribute meat to retail outlets and food establishments for public consumption. However, consistent with findings from other Ethiopian urban centers, research indicates that these food establishment and the retail environments are often vulnerable to unhygienic conditions, presenting significant challenges to the safety and integrity of the meat supply chain⁹.

Fig. 1.

Geographical location of Debre Markos Town within East Gojjam Zone, Amhara Regional State, Ethiopia, 2025.

Study design and period

A facility-based cross-sectional study was conducted from January to March 2025 to assess meat hygiene and safety standards in food establishments in Debre Markos.

Source and study population

The source population comprised all retail, food establishments and meat handlers operating within the urban setting of Debre Markos. To ensure a comprehensive assessment of the local meat supply chain, this included both licensed (legally registered) and unlicensed (informal) outlets.

The study population consisted of food establishments actively operating during the data collection period and their primary meat handlers.

Inclusion and exclusion criteria

The study population comprised meat handlers aged 18 years and older who were directly involved in the primary handling of carcasses, meat cutting, or retail sales. To ensure a comprehensive representation of the local market, the study included participants from both licensed and unlicensed food establishments that were actively operating during the data collection period. Participants were further required to have a minimum of six months of professional experience to ensure that the observed hygiene behaviors reflected established routine practices rather than transitional performance.

To maintain the integrity of the data and focus on routine operational standards, specific exclusions were applied. Establishments that were temporarily closed during the data collection period were excluded. At the individual level, meat handlers who were seriously ill, physically incapacitated, or otherwise unavailable during the scheduled observation window were excluded.

Sample size determination

The sample size for this study was calculated using the single population proportion formula:

where n is the required sample size, Z is the standard normal value at 95% confidence level (1.96), p is the estimated proportion of good meat handling hygiene and safety practices (0.664) obtained from a previous study conducted in Gondar¹⁰, and d is the margin of error (0.05). Substituting these values yielded an initial sample size of 342 meat handlers.

The study included both licensed and unlicensed food establishments, and the total number of such establishments in the town was unknown due to the presence of unregistered food establishments. Because the source population could not be precisely defined, the finite population correction was not applied. To ensure adequate representation and account for potential non-response or unforeseen exclusions, a 10% contingency was added, resulting in a final sample size of 376 meat handlers.

Sampling procedure

A total of 376 participants were selected from food establishments in Debre Markos town, focusing on individuals primarily responsible for meat handling. Of the establishments included, 253 (67%) were licensed (hotels, restaurants, and butcher shops), and 123 (33%) were unlicensed or informal meat retail points.

To ensure representativeness, a comprehensive sampling frame was constructed. Registered establishments were obtained from the Debre Markos Trade and Commerce Department, while unregistered or informal retail points were identified through a preliminary field census. From this list, 376 meat handlers were selected using a lottery method. At each establishment, the individual with primary responsibility for meat preparation was chosen for participation. In establishments with multiple handlers, the person most directly involved in meat processing was selected. This strategy ensured that data were collected from those with the greatest influence on meat hygiene and safety, making the findings generalizable across the town’s meat-handling population (Fig. 2).

Fig. 2.

Sampling framework for selection of food establishment and primary meat handlers in Debre Markos Town, 2025.

Data collection methods and procedures

Data were collected using a structured interviewer-administered questionnaire and an observational checklist. The questionnaire was developed after reviewing relevant literature and adapted to the local context. It was designed to collect information on socio-demographic characteristics of primary meat handlers, food safety knowledge, attitudes, and self-reported meat handling practices in a one health approach. The questionnaire was first prepared in English and then translated into Amharic for field implementation, and back-translated to ensure consistency.

An observational checklist was used to objectively assess meat handling practices and sanitary conditions of the sampled food establishments (hotels, restaurants, and butcher shops). The checklist included items related to personal hygiene, use of protective clothing, handwashing practices, cleanliness of utensils and cutting surfaces, meat storage conditions, waste disposal, sanitation of the establishment and slaughter animals’ inspection. Observations were conducted at the time of the interview without prior notice to minimize social desirability bias.

Data were collected from one primary meat handler per selected food establishment. In establishments where more than one meat handler was present, the individual primarily responsible for meat handling and cutting was selected as the study participant. This ensured that there were no repetitions and that people who knew most about the handling of meat in relation to its hygiene and safety were taken into account while collecting the data. This ensured that the results were generalizable across meat handlers in the community.

Operational definitions and measurement of variables

This was the primary composite outcome variable, constructed by summing 11 performance indicators across the One Health domains (human, animal, and environmental health). Each appropriate practice was scored as “1” and each inappropriate practice as “0”, giving a total possible score ranging from 0 to 11.

The mean score of the participants was calculated and used as the cut-off point. Accordingly, participants who scored ≥ the mean value (≥ 6 out of 11) were categorized as having Good Practice, whereas those who scored < the mean value (< 6 out of 11) were categorized as having Poor Practice.

The indicators were derived from three domains:

Human Health Domain: food safety training, medical checkups, use of personal protective equipment, and handwashing practices.

Animal Health Domain: sourcing meat from licensed abattoirs and verification of inspection certification.

Environmental Health Domain: sanitation status, waste management systems, pest control, and availability of potable water.

All components were combined into a single composite variable representing overall meat hygiene and safety practice^11–13.

Independent variables

Human health–related variables

Food Safety Training: Defined as whether the meat handler had received any formal or informal training on food safety or meat hygiene within the last two years. Measured as Yes/No¹⁴.

Medical Checkup: Defined as whether the meat handler had undergone a routine medical examination at least once every three months as required by local food safety regulations. Measured as Yes/No¹⁵.

Use of Personal Protective Equipment (PPE): Defined as the consistent use of protective clothing (apron, gloves, hair cover, and boots) during meat handling and processing. Measured through observation and self-report. Classified as appropriate use if all required PPE were worn during observation¹⁶.

Handwashing Practice: Defined as washing hands with water and soap before meat handling, after toilet use, after handling waste or dirty materials and measured as adequate if all critical times were practiced; otherwise, inadequate¹⁷.

Animal health–related variables

Source of Meat: Defined as whether meat was obtained from a licensed slaughterhouse approved by veterinary authorities. Measured as formal (licensed) or informal (unlicensed) source¹⁸.

Ante-Mortem Inspection: Defined as confirmation that animals were examined by a qualified veterinary professional before slaughter to assess fitness for human consumption. Measured as Yes/No based on records and handler report¹⁹.

Post-Mortem Inspection: Defined as whether slaughtered carcasses were examined after slaughter for signs of disease or contamination by authorized inspectors. Measured as Yes/No¹⁹.

Environmental health–related variables

Sanitation of food establishments: refers to the systematic application of cleaning, disinfection, waste management, personal hygiene, and environmental control measures in places where meat is stored, handled, processed, prepared, or served, in order to prevent contamination and ensure that meat is safe for human consumption²⁰.

Waste Management Practices: Defined as the proper collection, storage, and disposal of meat waste (bones, offal) in covered containers and approved disposal systems. Measured as proper or improper based on observation²¹.

Pest Control Practice: Defined as the implementation of measures to prevent flies, rodents, and other pests, such as screened windows, covered waste containers, and regular cleaning. Measured as Yes/No²¹.

Availability of Clean Water: Defined as access to a continuous supply of safe, clean water for handwashing, cleaning utensils, and premises sanitation. Measured as available or not available at the time of observation²².

Data quality assurance

To ensure high-quality data, structured questionnaires and observational checklists were developed based on relevant literature and reviewed by environmental health experts to establish content validity^11–13. Data collectors and supervisors underwent two days of training on study objectives, data collection procedures, interview techniques, ethical considerations, and proper completion of the tools. A pretest was conducted on 5% of the sample in food establishments in Finote Selam Town, a socio-demographically comparable area to Debre Markos Town, and the tools were refined for clarity, sequencing, and reliability.

During data collection, supervisors monitored data collectors daily, checking questionnaires for completeness, consistency, and accuracy. Missing or unclear information was corrected immediately or, when necessary, by revisiting participants. Data entry was performed using Epi-Data version 4.6 with programmed checks, double entry, and validation to minimize errors. Prior to analysis, data cleaning was conducted to address inconsistencies, outliers, and missing values.

The internal consistency of the questionnaire was assessed using Cronbach’s α, with values above 0.70 indicating acceptable reliability. Inter-rater agreement for the observational checklist was evaluated using the kappa statistic (κ = 0.78), demonstrating substantial agreement. These measures collectively ensured that the collected data were reliable and valid for analysis.

Data analysis

Data were entered into Epi-Data version 4.6 and exported to SPSS version 24 for analysis. Prior to analysis, data cleaning was performed to check for completeness, consistency, and outliers. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were used to summarize the socio-demographic characteristics of primary meat handlers and their meat handling practices.

Bivariable logistic regression analysis was conducted to identify factors associated with good meat handling practices. Variables with a p-value less than 0.25 in the bivariable analysis were selected as candidate variables for multivariable logistic regression. Multivariable logistic regression was then performed to identify independent predictors of meat handling practices while controlling for potential confounders.

The strength of associations was reported using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Statistical significance was set at a p-value < 0.05.

The Hosmer–Lemeshow goodness-of-fit test was used to assess the fit of the final multivariable logistic regression model. The test yielded a chi-square value of 8.45 with a p-value = 0.39, indicating that the model adequately fits the data (a p-value > 0.05 indicates good fit).

Multicollinearity among the independent variables was assessed using variance inflation factors (VIFs). All independent variables had VIF values ranging from 1.05 to 2.31, well below the commonly accepted cutoff of VIF < 10, indicating no significant multicollinearity.

Results

Socio-demographic characteristics of respondents

A total of 376 primary meat handlers were invited to participate in this study, of which 363 provided completed surveys, representing a 96.5% response rate.

The study population had a mean age of 31.26.5 years. In terms of gender distribution, the majority of respondents were male (60.1%, = 218). Regarding educational attainment, descriptive analysis showed that 35.8% (= 130) of participants had achieved a secondary education or above, while the remainder had a primary education or below.

Regarding the status of hygiene and safety practices, the overall practice of meat handlers was divided into two categories based on the frequency and percentage distribution of the 363 participants. More than half of the participants (60.6%, n = 220) demonstrated good hygiene and safety practices, while the remaining 39.4% (n = 143) had poor practices.

In the bivariable analysis, socio-demographic factors including age ( 30 vs. < 30 years, p = 0.268) and educational level (p = 0.553) showed no statistically significant association with the quality of meat hygiene and safety practices (Table 2).

Table 2.

Bivariable logistic regression analysis of factors associated with meat hygiene and safety practice among meat handlers, Debre Markos Town, Ethiopia (One Health Framework), 2025 (n = 363).

Variable	Category	Good practice n (%)	Poor practice n (%)	Calculated COR (95% CI)	P-value
Socio-demographic
Age	30 years	110 (30.3)	80 (22.0)	0.79 (0.52–1.20)	0.268
	30 years	110 (30.3)	63 (17.4)	1.00	Ref
Educational level	Secondary & above	130 (35.8)	80 (22.0)	1.14 (0.74–1.74)	0.553
	Primary & below	90 (24.8)	63 (17.4)	1.00	Ref
Human Health
Food safety training	Yes	155 (42.7)	55 (15.2)	3.82 (2.45–5.95)	< 0.001*
	No	65 (17.9)	88 (24.2)	1.00	Ref
Medical checkup	Yes	160 (44.1)	55 (15.2)	4.27 (2.72–6.68)	< 0.001*
	No	60 (16.5)	88 (24.2)	1.00	Ref
PPE use	Appropriate	170 (46.8)	50 (13.8)	6.32 (3.97–10.08)	< 0.001*
	Inappropriate	50 (13.8)	93 (25.6)	1.00	Ref
Handwashing practice	Adequate	168 (46.3)	45 (12.4)	7.04 (4.40–11.26)	< 0.001*
	Inadequate	52 (14.3)	98 (27.0)	1.00	Ref
Animal Health
Source of meat	Licensed	180 (49.6)	62 (17.1)	5.54 (3.45–8.87)	< 0.001*
	Unlicensed	42 (11.6)	81 (22.3)	1.00	Ref
Ante-mortem insp.	Yes	170 (46.8)	63 (17.4)	4.32 (2.73–6.82)	< 0.001*
	No	50 (13.8)	80 (22.0)	1.00	Ref
Post-mortem insp.	Yes	150 (41.3)	85 (23.4)	1.46 (0.94–2.27)	0.088
	No	70 (19.3)	58 (16.0)	1.00	Ref
Environmental Health
Food establishment sanitation	Clean	170 (46.8)	53 (14.6)	5.77 (3.63–9.18)	< 0.001*
	Unclean	50 (13.8)	90 (24.8)	1.00	Ref
Waste management	Proper	145 (40.0)	75 (20.7)	1.75 (1.14–2.70)	0.010*
	Improper	75 (20.7)	68 (18.8)	1.00	Ref
Pest control practice	Yes	160 (44.1)	55 (15.2)	4.27 (2.72–6.68)	< 0.001*
	No	60 (16.5)	88 (24.2)	1.00	Ref
Clean water availability	Available	150 (41.3)	74 (20.4)	2.00 (1.29–3.08)	0.002*
	Not available	70 (19.3)	69 (19.0)	1.00	Ref

COR= Crude Odd Ratio, CI= Confidence Interval Ref=Reference Group.

One Health cross-domain interaction analysis

To assess the synergistic impact of the One Health framework, the multivariable model accounted for dependencies between the Human, Animal, and Environmental health domains.

The analysis revealed a significant positive relationship between Food Safety Training (Human) and Licensed Meat Sourcing (Animal) (AOR = 2.15, p = 0.009). This suggests that a handler’s likelihood of practicing good hygiene is significantly amplified when their training is supported by access to a regulated, licensed meat supply. Other cross-domain combinations, such as handwashing with sanitation or inspection with waste management, did not show statistically significant synergy (p > 0.05) (Table 1).

Table 1.

Interaction effects across One Health domains on good meat hygiene and safety practice practices (n = 363).

Interaction (Domain A × Domain B)	Adjusted OR (95% CI)	P-value	Interpretation
Human Animal Food Safety Training ×Licensed Source	2.15 (1.20–3.85)	0.009*	Significant Synergy: Training is most effective when meat is from a licensed source.
Human ×Environment Handwashing ×Food establishment	1.45 (0.80–2.62)	0.215	No significant interaction; factors act independently.
Animal ×Environment Ante-mortem Inspection ×Waste Management	1.30 (0.75–2.25)	0.350	No significant interaction; factors act independently.

Factors associated with meat hygiene and safety practice (bivariable analysis)

Bivariable logistic regression revealed that human, animal, and environmental factors were significantly linked to practice quality. In the human health domain, food safety training (COR = 3.82), regular medical checkups (COR = 4.27), appropriate PPE use (COR = 6.32), and adequate handwashing (COR = 7.04) were all strongly associated with good practices (p < 0.001).

Regarding animal health, sourcing meat from licensed facilities (COR = 5.54) and the presence of ante-mortem inspections (COR = 4.32) were significant predictors (p < 0.001). Environmental indicators, including clean food establishments (COR = 5.77), proper waste management (COR = 1.75), active pest control (COR = 4.27), and clean water availability (COR = 2.00), also showed significant associations (p < 0.05) (Table 2).

Independent predictors of practice (multivariable analysis)

After adjusting for potential confounders, several factors remained independently associated with good meat handling practices.

Human Health Domain: The strongest independent predictors were adequate handwashing (AOR = 4.20, 95% CI: 2.25–7.80, p < 0.001) and appropriate PPE use (AOR = 3.55, p < 0.001). Additionally, food safety training (AOR = 2.15, p = 0.010) and medical checkups (AOR = 1.90, p = 0.034) remained significant.

Animal Health Domain: Sourcing meat from licensed facilities nearly tripled the odds of good practice (AOR = 2.95, p = 0.001), while the presence of ante-mortem inspections remained a significant predictor (AOR = 2.05, p = 0.024).

Environmental Health Domain: Food establishment sanitation was the only environmental factor to maintain significance; handlers in clean environments were 3.2 times more likely to maintain high standards (AOR = 3.20, p = 0.001) (Table 3).

Table 3.

Multivariable logistic regression analysis of factors associated with meat hygiene and safety practice among meat handlers, Debre Markos Town, Ethiopia (One Health Framework), 2025.

Variable	Category	AOR (95% CI)	P-value
Food safety training	Yes	2.15 (1.20–3.85)	0.010*
	No	1.00	Ref
Medical checkup	Yes	1.90 (1.05–3.42)	0.034*
	No	1.00	Ref
PPE use	Appropriate	3.55 (1.90–6.60)	< 0.001*
	Inappropriate	1.00	Ref
Handwashing practice	Adequate	4.20 (2.25–7.80)	< 0.001*
	Inadequate	1.00	Ref
Source of meat	Licensed	2.95 (1.60–5.45)	0.001*
	Unlicensed	1.00	Ref
Ante-mortem inspection	Yes	2.05 (1.10–3.80)	0.024*
	No	1.00	Ref
Post-mortem inspection	Yes	1.25 (0.75–2.10)	0.390
	No	1.00	Ref
Food establishment sanitation	Clean	3.20 (1.75–5.85)	0.001*
	Unclean	1.00	Ref
Waste management	Proper	1.15 (0.68–1.95)	0.605
	Improper	1.00	Ref
Pest control practice	Yes	1.55 (0.85–2.80)	0.155
	No	1.00	Ref
Clean water availability	Available	1.01 (0.23–4.67)	0.88
	Not available	1.00	Ref

AOR= Adjusted Odd Ratio, CI= Confidence Interval Ref=Reference Group.

Discussion

The findings of this study offer compelling evidence base for the One Health framework as a superior model for improving meat hygiene and safety. Rather than treating food safety as a series of isolated human behaviors, our results demonstrate that the most significant improvements occur at the synergistic intersection of human, animal, and environmental domains.

The human-animal interface: sourcing and inspection

A primary finding was that food safety training acts as a fundamental determinant of practice, with trained handlers being twice as likely to demonstrate good hygiene. This aligns with research across Ethiopia and other low-resource contexts, which consistently indicates that training enhances risk perception and behavioral compliance^3,23–25.

Within the animal health domain, the presence of ante-mortem inspections emerged as a particularly robust predictor of hygiene standards. Interestingly, while licensed sourcing showed a synergistic relationship with training, ante-mortem inspection functioned as a powerful independent factor. This suggests that rigorous veterinary oversight at the point of slaughter provides a high-impact, standalone protective layer that significantly elevates handling standards, regardless of other variables. Such inspections are essential for preventing the slaughter of diseased animals, thereby averting potential contamination of the slaughter line and ensuring that only meat fit for consumption enters the food chain¹⁸.

However, our study provides a deeper “One Health” insight regarding the necessity of a regulated supply chain: we observed a significant synergy between training and licensed meat sourcing. This indicates that while training provides theoretical knowledge, that knowledge is most effectively translated into practice when supported by a formal, regulated animal health system²⁶. While studies in Hawassa and Bishoftu found that infrastructural deficits often undermined worker knowledge²⁶, our data suggests that the combination of human training and licensed sourcing creates a stabilized interface that allows interventions to succeed. From a One Health perspective, this specific intersection creates a protective barrier stronger than the sum of its parts²⁷.

The human health sentinel: medical surveillance and PPE

Beyond professional training, regular medical checkups and PPE use emerged as powerful independent predictors:

Handlers participating in routine screenings were nearly twice as likely to maintain proper hygiene. This finding mirrors global evidence that health screenings are vital for identifying asymptomatic carriers of zoonotic pathogens like Salmonella and Shigella²⁸. In many developing contexts, medical surveillance remains a weak link²⁹; our results argue for integrating mandatory checkups into the licensing process to bolster professional accountability²⁹.

Personal protective equipment’s use was one of the strongest predictors, with compliant handlers being over three times more likely to demonstrate high standards. This aligns with evidence that protective gear prevents the direct transmission of human-derived contaminants like Staphylococcus aureus to animal products while protecting the handler from occupationally acquired zoonotic pathogens³⁰.

Environmental mediators: handwashing and sanitation

Adequate handwashing was the most influential human-related factor, with a fourfold increase in good practices among those with proper hygiene. This reinforces the role of the handler as the primary bridge at the human–animal–environment interface³¹. Similar to reports from South Africa and South Sudan, inadequate hand hygiene after contact with raw meat or money remains a leading cause of cross-contamination³².

Furthermore, establishment sanitation served as a powerful environmental predictor. Handlers in clean premises were three times more likely to follow safety protocols. This suggests that a sanitized workspace acts as a passive nudge reinforcing behavioral compliance a finding consistent with research in Addis Ababa where environmental conditions directly shaped individual handling standards³³.

Divergences and systemic challenges

Unexpectedly, waste management, pest control, and clean water availability did not show statistically significant associations in our multivariable analysis (p > 0.05). This contrasts with the Hawassa study, where waste container disinfection was a significant predictor³⁴. This lack of significance in our study may stem from a ceiling effect or lack of variability, where these environmental controls were uniformly poor across study sites³⁵.

From a One Health standpoint, these factors often function as distal determinants. Unlike premises sanitation, which handlers manage directly, waste and water infrastructure are typically managed at a municipal level. Their impact may be masked by broader infrastructural failures that are outside the handler’s immediate control. This aligns with findings in other developing contexts were systemic failures in environmental health render individual efforts less influential³⁵.

Conclusion

This study demonstrated that meat hygiene and safety practices are significantly influenced by interconnected factors related to human health, animal health, and food establishment sanitation. In the human health domain, food safety training, regular medical checkups, proper use of personal protective equipment, and adequate handwashing practices were strongly associated with good hygiene practices. In the animal health domain, sourcing meat from licensed facilities and the presence of ante-mortem inspection were identified as important predictors of safe practices. Furthermore, food establishment sanitation particularly cleanliness, proper waste management, effective pest control, and availability of clean water showed significant associations with improved meat hygiene and safety practices.

Overall, the findings highlight the importance of a comprehensive approach that simultaneously addresses handler-related behaviors, safe meat sourcing, and sanitation conditions within food establishments to improve meat safety and reduce public health risks.

Recommendations

Based on the identified factors, improving meat hygiene and safety practices requires targeted interventions across human, animal, and environmental health domains. Strengthening human health capacity is essential by expanding access to food safety training, enforcing the consistent use of personal protective equipment, and promoting proper handwashing practices within establishments. In addition, regular medical checkups should be implemented every three months to ensure early detection and exclusion of handlers with communicable conditions.

From an animal health perspective, strict enforcement of sourcing meat only from licensed facilities and ensuring the presence of ante-mortem inspection systems are critical to maintaining meat safety along the supply chain.

Improving environmental health conditions is also necessary, particularly by enhancing the cleanliness of food establishments, strengthening waste management systems, implementing effective pest control measures, and ensuring reliable access to clean water.

Overall, coordinated efforts focusing on these key factors will significantly improve meat hygiene and safety practices.

Strengths and limitations

This study’s primary strength is the application of a holistic One Health framework, which identifies the synergistic interactions between human behavior, animal health oversight, and environmental sanitation. By utilizing multivariable analysis, the research provides a statistically robust map of the independent predictors such as professional training and licensed sourcing that govern meat safety in an urban Ethiopian context.

However, the findings are subject to certain limitations. The cross-sectional design allows for the identification of significant associations but precludes the establishment of definitive causal relationships. While structured observations were used, the potential for social desirability bias remains, as handlers may have altered their routine behaviors during the assessment. Most notably, the study was constrained by the absence of microbiological validation. Due to logistical and resource limitations, laboratory analysis of meat samples, hand swabs, and environmental surfaces was not performed. Consequently, while the study provides high-quality evidence regarding the behavioral and systemic predictors of meat safety, it cannot objectively quantify the microbial load or verify the presence of specific foodborne pathogens. These findings therefore serve as a behavioral foundation, highlighting the urgent need for future longitudinal, lab-based research to correlate these systemic predictors with biological safety outcomes.

Supplementary Information

Below is the link to the electronic supplementary material.

Author contributions

BA: Conceptualized and developed the study framework, AA and AT designed the data collection checklists, performed data analysis and interpretation, and led the drafting and editing of the manuscript., TS, BS, MK, MG, and YB: Contributed to the development of the research proposal, assisted in data analysis, participated in the preparation of the final research report, and provided critical revisions to the manuscript for intellectual content. All authors have read and approved the final version of the manuscript.

Data availability

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Competing interests

The authors declare no competing interests.

Ethical considerations

Ethical clearance was obtained from the Institutional Health Research Ethics Review Committee (IHRERC) of the College of Health Sciences at Debre Markos University, with additional permission secured from the Debre Markos Town Municipality. In accordance with the ethical principles of the Declaration of Helsinki³⁶ for research involving human participants, all subjects were informed of the study’s purpose, their right to voluntary participation, and the option to withdraw at any time without consequence. To accommodate varying literacy levels while maintaining ethical rigor, written informed consent was obtained from all participants prior to data collection. To ensure anonymity and confidentiality, no personal identifiers were recorded, and all interviews and observational assessments were conducted in private areas within the butcher shop premises to protect participant privacy.