Is ignorance of patients’ rights the latest challenge to healthcare service delivery?

Josephine Kantarama had been waiting for over an hour when The New Times spoke to her at Kibagabaga Hospital. The previous day, she had come to the same hospital but left without being attended to due to the long queues and waiting hours. In her early 50s, Kantarama says she suffers from a severe stomachache and has decided to wait as long as it takes to see the doctor. Asked if she tried to ask why it takes too long to see a doctor, she replied that she never asked and none of the patients waiting in the long queue tried to. On one of the walls in the room where she was seated, there was a huge white poster. On it there are words inscribed that; “The patient is informed that they have the right to complain regarding services and are entitled to information regarding the hospital’s mechanism for the initiation, review and resolution of such complaints.” The message, which is contained in the Patient’s Rights Charter, literally gives Kantarama the right to complain and seek an explanation on why she has to wait for hours later on days without treatment. “I haven’t read the poster and didn’t know my rights and responsibilities as a patient,” she said. Despite the Patient’s Rights Charter being 12-years-old, many patients don’t do it while some healthcare workers continue to violate it. According to the Ministry of Health, at least 25 complaints about poor healthcare services are received every day at the Rwanda Health Communication Center. The bulk of the complaints received are about long waiting hours at hospitals and long unnecessary procedures patients have to go through before receiving the services they seek. On a wider scale, patients are faced with many challenges beyond having to wait longer. Christopher Sengoga works at Health Development Initiative, a local NGO that seeks to improve health quality in Rwanda, as Human Rights and Litigation Officer. He says lack of awareness is not limited to patients who are denied quality healthcare services but also healthcare providers. He says that violation of patients’ privacy by healthcare workers are among the complaints made by patients. “It has happened before when the concerned staff were not aware that they should keep the information secret and even avoid disclosing the names and particulars of the clients they received,” he explained. Are the solutions in place working? Edward Kamuhangire, Director of Health Services Quality Assurance at the Ministry of Health explained that since 2013, different initiatives aimed at creating patient-based solutions about healthcare services were put in place. Among them is the Patients’ Rights Charter, which contains all the rights and responsibilities of patients and healthcare providers. The charter is placed at a noticeable spot in every public hospital. It adds on an initiative dubbed ‘Ijwi ry’Umurwayi’ (or Patient’s voice) that seeks to get feedback from citizens and recommended solutions. Although there has been a decrease in complaints received about poor healthcare services, Kamuhangire admits that there are still a lot of problems when it comes to healthcare services in public hospitals. “Patients’ rights charter posters and Patient’s Voice initiative are implemented in all the hospitals across the country. We also conduct surveys on a quarterly basis about patient’s satisfaction. But we are aware that we still have a long journey ahead especially with awareness among both the beneficiaries and healthcare providers,” he explained. However, the shortage of healthcare workers, the rise in the number of patients seeking healthcare services and mutuelle de sante-related challenges continue to hinder patients’ better experiences in hospitals. Marcel Uwizeye, the Director General of Masaka Hospital, echoed Kamuhangire’s point that although the hospitals continue to train patients and staff about patients’ rights and quality services, there are still a significant number of complaints. “No doubt that any inconvenience in healthcare services yields a number of impacts on our clients. There are efforts in place to address the issue but we still see patients complaining,” he said. They both say that there’s need to raise public awareness on the rights and obligations of hospital staff and patients.

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Is ignorance of patients’ rights the latest challenge to healthcare service delivery?