Food Safety Knowledge, Attitude, and Practices (KAP) of Urban Consumers in Low-Income and Lower-Middle-Income Countries (LLMICs): A Scoping Review

Food safety is a major global public health concern and a key contributor to the burden of foodborne diseases. This scoping review examined the knowledge, attitudes, and practices (KAP) related to food safety among urban consumers in low- and lower-middle-income countries (LLMICs). A systematic search was conducted across seven electronic databases: Medline (PubMed), Web of Science (Social Science Citation Index), Embase (Ovid), Global Health (Ovid), PsycINFO (Ovid), Econlit (EBSCOhost), and Scopus to identify studies published in English between 2000 and 2025. Data extraction and quality appraisal were conducted independently by two reviewers, and findings were synthesized in a narrative analysis. Twenty-six studies from 14 LLMICs met the inclusion criteria. Of the 25 studies assessing knowledge and awareness, the majority reported that consumers had some understanding of food safety, although 10 (40%) highlighted limited awareness. Fifteen studies examined practices, with several noting appropriate behaviours; however, nine (56.2%) reported poor practices. Seven studies assessed attitudes, with most reflecting positive perceptions, while one (16.7%) identified negative views. Only four studies examined the full KAP triad. Across studies, factors such as age, education, gender, marital status, training, employment status, income, field of study, and residential status were found to influence food safety KAP. Overall, the evidence suggests that while consumers in urban LLMIC settings generally demonstrate some knowledge and positive attitudes towards food safety, there remain significant gaps in practices that could compromise public health. Future research should prioritise underrepresented regions, employ more rigorous study designs, and incorporate longitudinal and qualitative approaches to gain deeper insights and inform targeted interventions.