User experiences with Food Storage in a Meatsafe (Mesh-Covered Food Storage Cabinets) in an Informal Settlement in Dhaka, Bangladesh

Background Food hygiene is a critical but often overlooked link in fecal–oral disease transmission, particularly in dense informal settlements where environmental contamination and food storage constraints heighten risk. A mesh-walled food storage cabinet, or “meatsafe,” was designed to protect food from insects, animals, and young children while allowing ventilation. A parent randomized controlled trial (RCT) in Korail, Dhaka’s largest informal settlement, documented near-universal meatsafe use but no reductions in food contamination or child diarrhea. This qualitative study explored why a widely adopted hardware solution did not achieve expected health impacts. Methods Guided by the Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH), we conducted a purposive, theory-driven study embedded within the RCT. Data collection included 21 in-depth interviews with primary caregivers, 684 structured spot checks, and message-recall assessments among 145 participants. Interview transcripts were thematically coded for barriers and organized into contextual, technological, and psychosocial dimensions. Results Multiple barriers constrained effective meatsafe use. Technological issues included unstable frames, weak latches, sharp edges, mesh gaps, and the use of rexine liners that warped with heat. Psychosocial barriers involved concerns that storing hot food would trap steam and cause spoilage, low recall of behavior-change messages, contested childcare authority, and temporary relocations to villages during certain seasons. Contextual barriers reflected shared kitchens, chronic gas shortages, overcrowding, extreme heat and humidity, rapid food spoilage, flooding, and sewage-contaminated water. A critical behavioral gap emerged: households often cooled food uncovered before placing it in the meatsafe, leaving it vulnerable to flies, rodents, and dust. Conclusions High observed use of the meatsafe without corresponding reductions in microbial contamination or child illness underscores the limits of single-technology interventions in resource-constrained urban environments. Sustainable reduction of foodborne enteric disease in informal settlements will require integrated improvements in energy, water, drainage, and pest control, alongside co-designed technologies that address users’ practical, environmental, and behavioral realities.