Barriers to adopting good hygiene and food safety practices in the urban irrigated vegetable value chain in Accra, Ghana

<p dir="ltr">Urban farmers in low- and middle-income countries (LMICs) often irrigate crops with water contaminated by untreated wastewater due to inadequate sanitation infrastructure. The supply of such vegetables gives urban dwellers access to affordable, nutritious diets, but poses significant health risks, as consuming raw contaminated vegetables is a major pathway for contracting enteric, respiratory, and parasitic diseases. The World Health Organization (WHO) recommends a multiple-barrier approach to reduce these risks, combining safe practices from farm to fork to protect public health. Despite evidence showing the cost-effectiveness of low-cost safe irrigation, handling, and washing practices, increasing stakeholder adoption remains challenging. No behavioural analysis has yet examined the factors influencing the success or failure of interventions to change hygiene and food safety practices in urban irrigated vegetable value chains in LMICs.</p><p dir="ltr">This research analyses how institutional and psychosocial factors influence stakeholders' adoption of safe practices in urban irrigated vegetable value chains liable to faecal contamination, with a focus on Accra, Ghana. It applies the COM-B behavioural framework (Capability + Opportunity + Motivation = Behaviour) to understand barriers to the adoption of hygiene and food safety from farm to fork. The research employs an multi-method design conducted in three sequential phases: (1) interviews and observational fieldwork to identify stakeholders, their key practices and institutional influences as; (2) facilitated multi-stakeholder dialogues to examine institutional factors; and (3) an exploratory sequential mixed-method phase in which semi-structured interviews informing the design of a structured quantitative questionnaire to assess psychosocial factors influencing behaviour adoption. This approach systematically explores capability, opportunity, and motivation factors at both stakeholder and institutional levels.</p><p dir="ltr">The research reveals that sectoral silos and top-down approaches prevent the identification of capability, opportunity, and motivation barriers that hinder the adoption of safe practices. Institutional barriers, such as water company policies, hinder farmers' opportunities to access safe water resources. Psychosocial factors, including personal values and perceived social approval, significantly influence street food vendors' motivation to adopt safer vegetable washing practices. It is argued that food safety is a public good requiring government responsibility, where authorities must address stakeholders' capability, opportunity, and motivation needs rather than simply delegating responsibility onto them without providing the necessary support. This research thus makes an original contribution by demonstrating the benefits of integrating behavioural science with participatory approaches to enhance the WHO's multiple-barrier strategy and by extending the COM-B framework to analyse institutional behaviour.</p>