Abstract of Dissertation

Keyword : Privacy, confidentiality, knowledge, attitude

Objective : The objectives of the study are: • To review norms and/or guidelines related to privacy and confidentiality in healthcare setting. • To assess knowledge, attitude and practices of service providers, managers and users of facility-based public health services on privacy and confidentiality in public health facilities.

Background : Healthcare; Public Health Facilities; Practices of Service Providers; Review Norms and Guidelines; Privacy and Confidentiality in Healthcare Setting. Privacy and confidentiality are cornerstones of the doctor-patient relationship. Patients must feel comfortable disclosing all relevant information, most of which is highly sensitive in nature Maintaining the rights of patients, including privacy and confidentiality of medical information is the basis for a successful patient-physician relationship. It is in this regard that the following analysis studies the existing conceptions of privacy in the Healthcare sector. It aims to study the existing mechanisms of privacy protection and their application in everyday practices in a district hospital setting.

Methodology : The study is descriptive in nature. The study was conducted at district hospital, namely Pt. Deen Dayal Upadhyay District Hospital Varanasi, which also cater to the need for the adjoining districts during February-April 2017. The first part assesses domestic legislation for the provisions of privacy and confidentiality. For the second part of the study primary data was collected and analyzed regarding knowledge, attitude and practice of the health service providers and users of public health facilities. A total of 196 respondents were interviewed out of which 30 were doctors, 60 were nursing staff and 106 were the users of district hospital health services. Attitudes regarding privacy and confidentiality were measured using a five-point rating scale but middle point “neutral” was not used.

Findings : Review of the present legislature and regulations like Mental Health Act, PCPNDT Act, and MTP Act suggest that the Right to Privacy has been embodied in a multitude of domestic legislations pertaining to the healthcare. A strong foundational framework where the rights are addressed and find mention in a single document is still awaited. The embodied laws and regulation need to seep down to the level of healthcare service delivery at the facility level and need to be reflected in the knowledge and practice of healthcare providers which is lacking presently. Knowledge of the privacy and confidentiality was found low among patients. A majority of patients (95 percent) do not know about their right to privacy and confidentiality, which is the reason for their not being empowered enough to seek private and confidential health care. To ensure that patients’ rights are observed it is not sufficient merely to issue guidelines and instructions. It is essential also to provide education for care providers and medical students, as well as patients and their families, so that a joint approach may be adopted by all concerned. A comprehensive strategy is needed to engage with members of the public and the media through educational programs and information campaigns regarding all aspects of patients’ rights to privacy and confidentiality and a suitable legal framework for patients’ rights needs to be developed and implemented.