Lily Obenewaa Asare ^{1, 2} , James Antwi ^{1, 3} , ¹ Ghana Adventist Health Services, Ghana, ² University of Hull, Hull, United Kingdom, ³ Centre for Health and Social Policy Research, Ghana

This qualitative study examines how health system structures in Ghana impact nursing and midwifery adherence to patient data privacy and confidentiality protocols. The research involved observations and focus group discussions with 60 healthcare professionals across six hospitals selected from three geographical zones, using a clinical vignette for thematic analysis of practical situations. Findings demonstrate weaknesses across key health system building blocks that negatively impact patient information privacy and confidentiality. The findings indicate critical shortcomings within the leadership and governance, health workforce, health information management, and service delivery domains, emphasizing the need for comprehensive, holistic system strengthening to ensure robust privacy protection. As adaptive and complex entities, health systems are fundamental to safeguarding patients’ medical information. However, operating these systems in silos undermines the efficacy of privacy protections within clinical environments. Policy and practice frameworks need to adopt a holistic approach to systems strengthening to ensure robust protection of patient data.

Privacy, confidentiality, health systems, patients’ information