Poor hygiene in the food service industry is a critical public health concern in the Maldives, and is caused by several issues, such as limited inspections and monitoring, inadequate training and knowledge, and a lack of a regulatory framework. Thus, this study aims to identify the levels of knowledge, attitude, and practice (KAP) of food handlers in the Maldives as well as the potential association between the variables (knowledge, attitude, and practice). A total of 290 food handlers from restaurants were surveyed for four months through a quantitative questionnaire; most of them are male, Bangladeshi, and aged 26–35 years old. The result demonstrates that the food handlers have an acceptable level of knowledge (55.5% ± 1.51), an acceptable attitude (3.62 ± 0.51), and a good level of practice (4.18 ± 0.54) in food safety. The food handlers in Malé have poor practices in time and temperature control, especially in thawing and storage, resulting from a lack of training in the temperature danger zone. Work experience influences the level of knowledge, education impacts attitude and training, and work experience and education impact practice. A positive moderate association was observed between knowledge and practices (r_s = 0.536, p < 0.05), knowledge and attitudes (r_s = 0.407, p < 0.05), and practices and attitudes (r_s = 0.317, p < 0.05). Despite the good scores obtained in practices from the self-report questionnaire, the results of the observational assessment made on 102 restaurants exhibit overall poor practices, including deficient time and temperature control, and other categories of food safety need further attention in the design of training processes. This study can help policymakers to review and improve law enforcement to address the current food safety situation in the Maldives and can help businesses to selectively plan food safety training based on the KAPs of Maldivian food handlers.

Poor hygiene in the food services industry is a critical public health concern in the Maldives, with an average of 35 public complaints per month regarding the poor hygienic conditions of the restaurants in Male’, the capital of Maldives. Thus, this study aimed to identify the level of knowledge, attitude, and the gap of self-reported with the observed practice (KAP) of food handlers as well as the potential association between KAP. 290 food handlers from restaurants were surveyed, demonstrating moderate knowledge (55.5%), moderate attitude (3.62±0.51) and good practice (4.18±0.54). However, it is critical the result shows the food handlers in Male’ have poor practice on the time and temperature control where especially on thawing and storage resulting from a lack of training in the temperature danger zone. The work experience impacting the level of knowledge, education impacts the level of attitude and age, and education and work experience impacting practice. Male’ restaurants mostly employed the foreigners mostly from Bangladesh and the food handlers were identified to have low level of education. Association analysis identified significant relationships between knowledge, attitude, and practice, while the principle component analysis shows categories that are related to each of KAP. This study is fundamental for policymakers to review and improve law enforcement to address the current food safety situation in the Maldives.