"An Assessment of Adherence to Patient Privacy and Confidentiality Standard Operating Procedures in Comprehensive Care Clinics: A Case of Nakuru County Level 5 Hospital, Kenya."

Abstract

Background: Patient privacy and confidentiality are fundamental pillars of healthcare, particularly in the management of HIV/AIDS where social stigma remains a significant barrier to clinical adherence. Despite the constitutional protections afforded by the Kenya Constitution (2010) and the Data Protection Act (2019), significant gaps persist between legal mandates and clinical practice in high-volume referral facilities. This study assessed the level of adherence to privacy and confidentiality Standard Operating Procedures (SOPs) at the Comprehensive Care Clinic (CCC) of Nakuru County Level 5 Hospital, Kenya.
Methodology: The study adopted a descriptive case study design employing a triangulated approach for data collection. A sample size of 79 respondents (65 clients and 14 staff) was determined using Fischer’s formula for finite populations. Data were collected via structured questionnaires, an observation checklist, and an interview guide to evaluate policy adherence, infrastructural adequacy, and socio-psychological experiences. Statistical analysis was performed using SPSS version 25, with findings presented in thematic tables and narrative form.
Results: The study achieved an 82.28% response rate. Findings revealed high institutional awareness of privacy policies (91.7%), yet significant procedural gaps were identified, including non-secure data disposal methods (41.7% hand-tearing) and reliance on informal on-the-job training (58.3%). Infrastructural assessment showed that while the standalone clinic design and semi-permanent partitions provided adequate acoustic insulation, digital vulnerabilities existed due to staff failure to log off workstations. Socially, 70.8% of clients rated privacy as "excellent," correlating physical barriers (solid walls) with psychological safety. However, a profound knowledge deficit was noted, with 86.2% of clients unaware of their legal rights to privacy.
Conclusion: While Nakuru County Level 5 Hospital has established a foundational framework for privacy, adherence is undermined by infrastructural limitations and technical laxity. The high level of client satisfaction exists alongside low rights literacy, suggesting that patients may not recognize subtle breaches.
Recommendations: The study recommends mandatory annual formal training for staff on data protection laws, upgrading semi-permanent partitions to permanent soundproof masonry, and implementing automated system "timeouts" on clinical computers. Furthermore, a targeted patient-rights advocacy campaign is essential to bridge the existing gap in health-rights literacy.