Health Systems approach to the application of privacy protection for patients accessing health facilities in Ghana

Abstract

Abstract Aim The study aims at examining health systems approach to the application of privacy and confidentiality of patients’ medical information by senior and junior nurses and midwives in Ghana. Methodology. The study employed qualitative research design utilizing researcher observations and focus group discussions from a vignette with sixty nurses and midwives selected from six hospitals across three regions in the country. The vignette was created from real life situations and provides background stories that nurses and midwives used as a scenario. The views of participants were analysed using thematic data analysis method. Findings The findings show that inadequate and weak health systems impede privacy and confidentiality of patients’ medical information in health facilities. The results demonstrate unclear reporting lines, nepotism and favouritism leading to breaches, non-compliance to procedures and code of practices, misplace priorities, unsafe and inappropriate practices, staff shortages and limited capacity of staff to apply protocols on privacy and confidentiality, weak coordination of patient information flow, inadequate screens and space and poor electronic records system. The weaknesses in the health systems could be seen across four of the six building blocks: leadership and governance, health workforce, health information management and service delivery. Conclusion Health systems play an important role in privacy protection of patients’ medical information and being adaptive and complex in nature. Operating the systems in silos does not facilitate privacy protection in health facilities. Therefore, policy and practice implications on privacy and confidentiality in relation to systems strengthening need to recognize prospective changes and its application should be holistic to ensure protection of patients’ information.