Evaluation of the Nutritional Quality and Food Safety of Meals Served in Hospital Canteens in Bujumbura, Burundi

Hospital catering is an important component of patient care. It must simultaneously meet the requirements of nutritional quality, food safety, and acceptability. However, data on the quality of meals served in Burundian healthcare facilities remain limited. This study aimed to assess the nutritional quality and food safety of meals served in the canteens of three national referral hospitals in Bujumbura and identify the main factors associated with their inadequacy. A descriptive cross-sectional study with an analytical component was conducted in the canteens of Prince Regent Charles Hospital (HPRC), Kamenge Military Hospital (HMK), and Prince Louis Rwagasore Clinic (CPLR) from October 1, 2025, to March 31, 2026. A total of 216 participants were recruited using stratified sampling, including 54 canteen staff members, 54 healthcare professionals involved in nutrition, and 108 patients or accompanying persons. Eighteen complete meals were assessed using a weighted checklist comprising 20 criteria grouped into five dimensions: nutritional value, food safety, dietary diversity, presentation, and taste. The acceptability threshold was set at 75%. Data were analyzed using Stata MP 17. None of the 18 meals assessed reached the acceptability threshold. The overall mean score was 0.57 ± 0.05, with a gradient of HPRC (0.62) > HMK (0.57) > CPLR (0.53). The mean scores were 0.58 ± 0.04 for nutritional value, 0.65 ± 0.06 for food safety, 0.50 ± 0.04 for dietary diversity, 0.55 ± 0.04 for presentation, and 0.58 ± 0.05 for taste. Food safety was strongly correlated with overall quality (r = 0.82; p = 0.001), as was nutritional value (r = 0.76; p = 0.003). Personnel hygiene was non-compliant in all three facilities (SS4 = 0%). Furthermore, 99.1% of observations indicated the absence of a dietetics service, 93.5% indicated the absence of adequate operational standards, and 83.2% indicated a lack of hygiene/HACCP training. External monitoring was virtually nonexistent. The nutritional quality and food safety of meals served in the three hospital canteens studied were inadequate, reflecting systemic shortcomings. Strengthening personnel hygiene, establishing or operationalizing dietetics services, providing continuous HACCP training, developing operational standards, and implementing a regular quality control system are priorities for sustainably improving hospital catering in Burundi.