Background: The respect of confidentiality is a fundamental and key aspect in ethics when conducting public health programs. In implementing the HIV program (Atteindre 95) with the Ministry of Health, EGPAF has access and uses patients' identifiable information (PII) routinely generated. We share the results of the evaluation of data confidentiality, the knowledge of staff on patients' confidentiality principles and we present the actions taken to address gaps.
Method: As part of its program optimization on quality of services, EGPAF carried out in November 2019, a mixed cross-sectional survey. A structured anonymous 'awareness questionnaire' was self- administered to both facility and office-based staff, having access to HIV patients' identifiable information and an 'observation grid' used to access data flow and ethical practices. Poor practices identified and improvement strategies implemented.
Results: Of 289 staffs reached, 202 (67%) were field staff in contact with PII. 182 (63%) had valid ethics certificate, 229 (79%) could identify 'client's name' and phone numbers as PII. 166 (57%) wrongly identified WhatsApp and messages as a secure means of sharing data. 224 (84%) agreed data containing PII should be stored in a locked cabinet and 251 (87%) agreed that sharing PII with family members was a breach in confidentiality. Unethical practices observed were counseling and testing usually done in open and shared offices, support group attendance list and viral load results shared with finance team for payments usually contains PII. This led to breach in patients' confidentiality. As improvement strategies, the use of partition stands when performing counselling, SOP on handling PII on personal phones was developed and refresher training on human subject protection performed amongst others.
Conclusion: This assessment highlighted ethical issues when dealing with HIV data. Ensuring confidentiality and securing PII are critical. Staff continuous training on ethics are essential to maintain ethics standards.