Hazard analysis and critical control points for foods consumed by children aged 6–24 months in Maputo, Mozambique

Background: Diarrhoeal disease remains a significant cause of mortality among children under five years of age in many countries. Food consumed by young children in high-burden settings is often contaminated, thereby exposing children to foodborne risks. Better understanding food preparation, feeding, and storage practices of foods consumed by children aged 6–24 months can support efforts to reduce diarrhoeal disease. A hazard analysis and critical control point (HACCP) approach was used to determine critical control points (CCPs) that might reduce risk of food contamination among households with a child aged 6–24 months in the Polana Caniço neighbourhood of Maputo, Mozambique.Methods: 110 structured observations of food hygiene practices, including child food handling, preparation, cooking, feeding, and storage in the household were conducted. These observations were used to identify key hazards and critical control points for the microbial contamination of foods among households with a child under the age of two. Food flow diagrams were also developed for the main food groups.Results: Based on a systematic assessment of food hygiene behaviours, we identified the following key practices to target: cleaning of utensils for child feeding, caregiver handwashing with soap before feeding, heating liquids to boiling when added to food, storing cooked food in containers, and thoroughly cooking foods and reheating leftovers that are fed to the child.Conclusion: Our study highlights key hazards and potential control points for reducing foodborne health risks for children 6–24 month in an urban setting in Mozambique. These findings can support future research to assess the relative importance of the identified hazards and critical control points. The results can be also used by policy and operational actors to design household or community level interventions to reduce foodborne health risks.