Impacts of participatory work improvement training in health care settings in the Republic of Burundi

Introduction
Participatory action-oriented training for work improvement in health care facilities in the Republic of Burundi was conducted with a focus on 5-S (five-es) housekeeping activities and reduction of safety and health risks in health care setting in Africa.

Methods
In a general hospital and 9 health centres, participatory training was organized in 2009 to improve workplace conditions in these health care facilities under the technical cooperation of JICA (Japan International Cooperation Agency). Initially serial meetings and short-term workshop were held for health care workers to review existing good practices and work related risks. Achievement seminars were held in 2010 and 2011 to discuss the actual improvements accomplished in the participating facilities.

Results
An emphasis of such improvements was placed on 5S activities and low-cost improvements feasible in the local Burundi context. Local good examples showing simple improvements in materials handling, workstations, physical environment, welfare facilities and work organization served as concrete guidance for proposing immediate improvements. The participants evaluated the workshop favorably agreeing with the applicability of participatory training for work improvement in local workplaces. In the serial achievement seminars held in 2010 and 2011, over sixty improvements were reported from participating health care facilities. Most these improvements could be accomplished at low cost with visible impacts on reducing safety and health risks at work.

Discussion
This experience evidenced the effectiveness of short-term training using locally adjusted training materials and emphasizing local good practices. As practical improvements were reported from a number of participating health care facilities, this locally adjusted nature of the training process was found workable in the context of Burundi culture. It is recommended to organize similar participatory training programmes with a focus on locally feasible improvements applying basic principles of occupational health and ergonomics.