Institutionnel and Opérationnel Déterminants of Meal Quality in National Hospitals in Bujumbura
Abstract
Hospital meals are an integral component of patient care. This study assessed meal quality and examined institutional and operational factors associated with deficiencies in three national hospitals in Bujumbura. A descriptive cross-sectional study was conducted from October 2025 to March 2026. Eighteen lunch meals were assessed : 7 at Prince Regent Charles Hospital , 6 at Kamenge Military Hospital , and 5 at Prince Louis Rwagasore Clinic . Data were collected from 216 respondents (54 canteen staff, 54 health personnel, and 108 patients/caregivers). Meal quality was assessed using a 20-criterion checklist covering five dimensions. A score ≥75%, with no critical non-compliance, defined acceptable quality. None of the 18 meals met the acceptability threshold (0%). The mean quality score was 0.57±0.05, with HPRC (0.62), HMK (0.57), and CPLR (0.53). Food safety had the strongest association with quality (r=0.82; p=0.001), followed by nutritional value (r=0.76; p=0.003), taste (r=0.69; p=0.008), dietary diversity (r=0.64; p=0.015), and presentation (r=0.58; p=0.026). Staff hygiene showed 0% compliance, while serving temperature compliance was 83.0% and absence of foreign bodies 100%. Among 162 consumers, 64.8% reported taste satisfaction ≥3/5. Moreover, 83.2% of 107 personnel had received no hygiene/HACCP training, and 93.5% of catering units lacked nutritional standards. Poor meal quality reflects systemic institutional and operational deficiencies. Establishing dietetic services, standardized nutrition and food-safety procedures, continuous staff training, quality control, and improved procurement should be prioritized to improve hospital meal quality and patient care.
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