Photo Credit Goes Here
SFFF Cambodia Taskforce and Stakeholder Meeting
Siem Reap, 24-25 October 2019
A household survey:
pork consumption practices and perception of
food safety in Phnom Penh
&
Does food safety concern affect diet: a mixed-
method results from Cambodia

Photo Credit Goes Here
•Objectives
Methodology
•Results
Discussions and conclusions

OBJECTIVES
• To determine pork consumption practices in
Phnom Penh.
• To understand the perception of food safety risks
and how it relates to food purchasing decisions and
consumption.

MATERIALS AND METHODS
Site selection
oIncluding criterions:
- Administrative districts belong to
Phnom Penh
oExcluding criterions:
- Density <1,500 and >30,000
people/km2
- Primarily high income households,
high official residential areas or
business centers
Figure 1: Study sites

Sample size and household Identification
– Random points of 200 households
– Re-loaded all random points on the tablets
– Each household identified with GPS
– Enumerators walked to the point using map in tablet
– 50 extra-points in case of missing no respondent found
(public institution, water body)

Session 1: General information on the household
Session 2: Animal sourced food (ASF) consumption patterns
Session 3: Food handling, water and sanitation
Session 4: Knowledge and perceptions food safety hazards
Session 5: Household income and expenditure
Session 6: Health and cost of illness
Questionnaire structure

Developed by
researchers from
ILRI and CelAgrid
Uploaded into
tablets using Open
Data Kit (ODK)
Trained
enumerators
Pretested
Generated final
version
Questionnaire completion

Results

Pork consumption behavior
74.3 %
69.8 %
74.8 %
• 200 HH (99%) consuming pork
- Eaten raw pork: 1%
- Most common types eaten: Fried pork, Boiled in
soup, Dried pork
- Time of purchasing raw pork: morning (84.7%),
early morning (10.9%)
- Time of keeping raw pork: <2h before preparation
(99.5%)
- Raw pork storage: room temperature (76.5%),
refrigerated (17%)
•Water
• Soap
• Brush
• Knife

Pork consumption behavior
Figure 6: Place to buy raw pork

Perception on safe/clean pork sources

Food safety concern
Food safety issue Level of concern (%)
No concern Some concern Very concerned Don’t know
Preservatives 3.5 48.0 47.0 1.5
Antibiotics 1.5 38.1 44.6 15.8
Feed additives 3.0 28.2 57.4 11.4
Pesticides 2.5 24.8 51.0 21.8
Bacteria 1.0 39.6 41.1* 18.3
Cancer causing chemicals 1.5 38.1 48.0 12.4
GMOs 2.0 42.6 8.4 47.0
Contaminated air 7.4 73.3 17.8 1.5
Imported food 3.5 21.8 72.8 2.0* Only 1/202 heard about Salmonella as a problem in food

People’s consideration when buying pork

Household income and expenditure (%)

Health and Cost of Illness (COI)
• 81 (41.3%) HH member got sickness in last 2 weeks
• Most symptoms: diarrhea, abdominal pain, vomiting
Figure 9: Most health facility visited (n=46)

CONCLUSIONS
• Limited knowledge of food safety and foodborne health risks.
• Food safety is a concerns of consumers.
• Mobile and street vendor are main sources of purchasing pork but was
considered as less clean and less safe
• Preference is driven by cleanness, convenience/accessibility, food safety
is less important.
• Raw pork consumption is not recorded but dried and fermented pork
still remaining
• Poor hygienic practice: using same knife/cutting board, wash with water
only and knife
• >80% of total pork consumption is at home by >50% people

Photo Credit Goes Here
Does food safety concern affect diet: a
mixed-method results from Cambodia
Overall aims
1. Explore food safety perception among mothers of young
children
2. Assess the linkage of food safety perception with diet and
dietary behavior

Explore food practices, food safety perception and the decision
making related to diet and nutrition
Research Objectives
H1: Negative perception of food safety
and food environment is linked to poor diet
quality
PART 1: QUALITATIVE STUDY

• Design: In-depth interviews followed by PhotoVoice
– Photovoice: mothers to take photos of food preparation and family meals and
then participate in a follow-up interviews about the photos.
• Inclusion criteria: Mother of a child under 5 years old, living in 7 selected
districts surrounding Phnom Penh
– If the grandmother was the one primarily responsible for the child’s nutrition,
the grandmother was interviewed
• Topics: food purchasing decision, meal composition, food safety, gender
equity, nutrition
• Interviews were analyzed in MAXQDA, a software designed to interpret
themes from qualitative interviews
– Inductive themes: ones that we expected to find before the study
– Deductive themes: ones that emerge from the interviews
Methods

Chemicals affecting health:
"I’m afraid that it will affect the baby
because of those chemicals in the
vegetables. It is okay for us to eat
them but the baby in the womb cannot
handle all those chemicals.”
Caught fish as safe: “If we had
vast plain land, we would dig a pond
and raise fish by ourselves. It’s easy
eating and doesn’t have chemicals. But
there is no land. I can only afford this
house.”
Chemicals affecting food: “Because
nowadays there are many chemical-injected
meats. A few days ago, I bought half
kilogram of pork. It smelled very bad...I
then tried to marinate it and dried it under
the sun; however, it still had bad smell.”
Results: Major
themes

Cleaning Strategies: "Blanch to get rid of
that stuff. I even clean it for three or four times. I
soak it to eliminate the contaminated substances. I
am afraid that they are exposed or are injected
with chemicals. I’m afraid that it would cause
diarrhea when eating.”
Purchasing Strategies: “I buy the better-
looking ones. For vegetables, if they don’t look
good, I don’t buy them ... But on the goodness, if
they look too good, I don’t buy it either. If there’s
some caterpillar or something, we can wash them
more. Those don’t have as many chemicals.”
Home grown as safe: "I want
to show that natural vegetables are
hygienic and good for health. We
should plant those vegetables such as
banana tree, ivy gourd....by ourselves
are better than buying from the
market."

Examine the linkage between perception of food environment
and food safety with diet.
• Food environment: food availability, accessibility & convenience.
• US literature has linked food environment with obesity epidemic
• Perception of food environment and food safety is closely linked.
Research Objectives
H1: Negative perception of food safety
and food environment is linked to poor diet
quality
PART 2: Quantitative STUDY

• Design: a cross-sectional survey
• Participants: mothers of children 6 – 24 months old living within 1km
perimeter from the wet markets in selected districts.
– A child was selected from each household
• Sample size: 100 women-child pair in Phnom Penh & 105 in Siem Riep.
• Data collected:
– Demographics, wealth and household food insecurity
– Mother’s intake frequency (meat/ fruits & vegetable - FV)
– Child’s intake frequency (meat/FV)
– Food environment perception (meat/FV)
Methods: study design

Foodquality
Methods: FV perception questions

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CONCLUSIONS FROM BOTH STUDIES

QUALITATIVE STUDY
• Chemicals contamination is of a larger concern than foodborne pathogen
contaminations
• Women resort to growing or catching their own food
QUANTITATIVE STUDY
• More unfavorable perception of food environment and food safety in Siem Riep
• Fruits and vegetables: unfavorable perception is linked to less frequent intake in both
mothers and children.
• Meat: unfavorable perception, city of residence, wealth and food insecurity are linked to
less frequent intake in both mothers and children.
• Meat is a high value produce
• Mothers living in Siem Riep have lower intake, but children living in Siem Riep have
higher intake. Future research should examine complementary feeding practice

PROGRAM IMPLICATIONS
• We should address the belief about chemicals and not just
microbials (Salmonella, and it may not handle the trust of the
consumers.
• By improving the perception of food perception, we might see
the increase in maternal and child intake.

Acknowledgements
• Chhay Ty, CelAgrid
• Pok Samkol, CelAgrid
• Hung Nguyen, ILRI
• SonPov
• Sokchea
• Ratha
• Nai
• Delia Grace
• NIPH (Dr. Chrovan)
• Funding support: Feed the Future Grant
(USAID)
Photo by Sokchea Huy