Action Research to Improve Food Establishments in Accordance with the Ministry of Public Health’s SAN and SAN Plus Food Sanitation Standards in Somdet Subdistrict, Somdet District, Kalasin Province

Abstract

     This action research aimed to examine and develop a process for improving food establishments in accordance with the SAN and SAN Plus food sanitation standards; compare food establishment assessment results, food sanitation knowledge, and coliform bacterial contamination before and after implementation; and investigate supporting factors, problems, barriers, and success factors. The PAOR cycle, comprising planning, action, observation, and reflection, was applied. The participants included 37 food establishments, 21 food business operators, 16 food handlers, and 18 stakeholders representing relevant organizations and sectors. The research instruments consisted of the SAN and SAN Plus food sanitation standard assessment forms, a demographic questionnaire, food sanitation knowledge tests, a coliform bacterial contamination record form, and focus group discussion guidelines. Quantitative data were analyzed using frequency, percentage, mean, standard deviation, and paired-samples t-test, while qualitative data were analyzed using content analysis.

     The results showed that, following implementation of the PAOR cycle, the proportion of food establishments meeting the SAN standard increased from 26.0% to 61.5%, and six establishments met the SAN Plus standard. The mean knowledge score among food business operators increased from 78.4% (SD=9.8) to 91.2% (SD=7.3), while the mean knowledge score among food handlers increased from 60.3% (SD=13.5) to 83.9% (SD=10.2). In both groups, post-development knowledge scores were significantly higher than pre-development scores (p<.001). The proportion of samples contaminated with coliform bacteria decreased from 60.0% to 20.0%, representing a statistically significant difference from the pre-development level (p=.017). The qualitative analysis identified six major findings: gaps between knowledge and actual practice; limitations in infrastructure and resources; the use of health examination and food safety surveillance results to encourage change; the division of responsibilities among network partners; continuous monitoring and consultation; and cooperation between food establishments and local support systems.