Closing the Gap: Why We Need to Understand Street Food Hygiene in Low-Resource Settings

Street food feeds millions of people every day. It’s cheap, convenient, and in many low and middle-income countries (LMICs), it’s often the most accessible source of a hot meal. But that same accessibility comes with a hidden cost: street-vended food is also a major, and poorly understood, route for foodborne illness.

A global health problem hiding in plain sight

Foodborne illness affects hundreds of millions of people worldwide every year, with the burden falling disproportionately on LMICs, where street food is both popular and largely unregulated. Studies across multiple countries found alarming rates of contamination in street-vended food: samples testing positive for E. coli, Salmonella, and Shigella at levels that pose real risks to public health. These aren’t isolated findings; they point to a systemic issue in how food is prepared, handled, stored and served outside the formal food system.

The reasons are complex. Vendors often work without reliable access to clean water or sanitation. Regulatory oversight is patchy or absent, and the COVID-19 pandemic accelerated growth in informal food vending as people sought new sources of income, even as it simultaneously disrupted the food safety training and infrastructure many vendors relied on.

The problem: we know street food is risky, but not why, or what actually works

This is the gap this review is designed to fill. Plenty of individual studies have looked at specific street food safety interventions, training programmes, educational campaigns, and hygiene certifications in specific countries. But no one has pulled that evidence together into a single, systematic picture. There is currently no existing scoping review that maps the determinants of street food hygiene behaviour across LMICs, and no synthesis of which interventions actually change behaviour or reduce contamination, for vendors or consumers.

The last point matters more than it might seem at first. Most of the existing research and most interventions focus on vendors. But street food safety is a two-sided equation: what a consumer does with the food after it’s handed to them, and how they store it? When do they eat it? Do they reheat it? This also shapes their risk of illness. The evidence on consumer-focused interventions is even thinner than the evidence on vendor training.

Without a clear map of the field, funders, policymakers, and public health practitioners are left designing interventions based on assumptions and precedent rather than evidence. That’s not a sustainable way to protect public health at scale.

What the review sets out to do

The research team is using a well-established scoping review methodology to answer three connected questions:

• What actually drives food hygiene behaviour among street food vendors? Rather than just cataloguing what vendors do wrong, the review digs into why, using the Behaviour-Centred Design framework to capture the full range of influences, from individual knowledge and motivation to the physical environment and social norms vendors operate within.
• Do interventions aimed at vendors actually reduce microbial contamination? The team is systematically reviewing intervention studies to see which approaches move the needle, not just on stated knowledge or attitudes, but on measurable hygiene outcomes.
• Do interventions aimed at consumers improve safe food handling? This is the most under-explored piece of the puzzle, and the review is treating it as a distinct objective in its own right.

Why this matters for the field

At the time the protocol was published, the research team had already screened close to 20,000 records down to a working set of studies for full synthesis, a scale that reflects just how fragmented and dispersed the existing evidence base is. Bringing it together into one coherent map will help identify where the evidence is strong enough to act on, and where genuine gaps remain that future research needs to address.

For us at RGHI, this project sits squarely at the intersection of what we care about most: turning fragmented, hard-to-access research into a clear evidence base that can actually shape better hygiene outcomes for the people who need it most. Street food vendors and the millions of people who rely on them every day deserve interventions grounded in what works, not just what’s convenient to implement.

Read the full protocol: Kamal A, Nurul Huda TM, Simi SM, et al. Determinants of Street Food Hygiene Practices and the Effectiveness of Interventions for Vendors and Consumers in Low- and Middle-Income Countries: Protocol for a Scoping Review. JMIR Res Protoc 2026;15:e68633. https://www.researchprotocols.org/2026/1/e68633