Unpacking Zimbabwe’s Patients’ Charter

The government sacked the majority of 15,000 nurses who began a strike this week

THE healthcare sector in Zimbabwe has many notable shortcomings in all aspects but there are issues that are not clearly understood by the public that accesses health care from all public institutions.

By Setfree Mafukidze

Most recently there has been suspected cases of the dreadful Corona Virus (Covid-19) which is being closely monitored in Zimbabwe and the rest of the world.

Only a few days ago a patient under observation/investigation for the Corona Virus recently made his way out of an isolation facility at Wilkins Hospital in Harare.

Most people have turned to blame the government or health care providers for this “escape” but what most people are not aware of is the existence of what is known as the Patient’s Charter.This charter is in place for the purposes of protecting patients,these are the rights of patients without consideration of one’s medical condition.The patient in question might not necessarily have broken any laws that are existent in Zimbabwe today,though a great risk of exposure to others can be considered.

Most patients interviewed by this writer professed ignorance of the existence of The Patients Charter, 10 out of 10 patients interviewed did not know what The Patient’s Charter is all about despite the fact that it is meant to protect the patients themselves.In light of all that,below is The Patients Charter which will further explain the rights of all patients whether outpatient or inpatient,the Patients Charter also spells out what is expected of any patient who seeks medical services through the various health care providers.

The Patients Charter is a document that was put in place by the Ministry of Health and Child Care of Zimbabwe with the aim of improving the relationship between patients and health care providers by helping or allowing the Ministry to listen to and act on people’s views and needs, setting the best possible standards of health services and providing health services which meet these standards.

The Patients Charter explains the kind of service anyone should expect from the health delivery system,it explains the health rights of patients without ignoring the patient’s responsiblities and obligations as well as how one can give feedback on the quality of services you are provided with or have required.

1.PATIENTS RIGHTS

Patients have the right to health care and humane treatment.Every individual shall have access to competent health care and treatment regardless of age, sex, origin, religion, political affiliation,economic status or social class.

Health care services shall be available on the basis of clinical need regardless of the ability to pay. It shall be the responsibility of the government to ensure that every person has access to essential health services.

Every patient shall be treated with care, consideration,respect and dignity, without discrimination of any kind, including vulnerable groups such as children,women,people with physical challenges and rural dwellers, taking into consideration issues of accessibility to both physical structures and information.

All drugs and vaccines shall be of acceptable standards in terms of quality, efficacy and safety. In an emergency, every individual shall have the right to prompt treatment from the nearest medical /health facility. A child admitted to hospital shall whenever possible have the right to the company of a parent or guardian.

2.CONFIDENTIALITY

A patient shall have the right for the details if the patient’s care (including the use of new technology) prognosis and all communication and other records relating to the patients care to be treated as confidential unless the release of such information is authorized in writing by the patient. Information can also be released in situations in which it is undesirable on medical grounds to seek a patient’s consent, but it is in the patient’s own interest that confidentiality be broken or unless such information is required by due legal process.

3.PRIVACY

Patients shall be interviewed, examined and treated in surroundings designed to ensure reasonable privacy and shall have the right to be accompanied during any physical examination or treatment if they so wish.

4.RIGHT TO CHOICE OF CARE

A patient shall have the right to second opinion at any time while consulting the same medical or health care delivery system.

A patient or next of kin shall have the right to an explanation about their case history and medical records, and to have them explained. The patient or next of kin shall also have the right to authorize in writing for another for another health professional to obtain a copy of the medical records and to inform him or her of what they contain.

If a patient’s health professional refuses to allow another health professional to be called in, or breaches any other provisions of this charter, the patient shall have the right to seek alternative service /care or to take the issue up with the Health Professions Council.

5.RIGHT TO SAFETY

A patient, if not incapacitated, shall have the right to a clear, concise explanation -in layman terms-of the proposed procedure and of any available alternative procedure, before any treatment or investigation. The explanation shall incorporate information on risks, side effects, problems relating to recuperation, likelihood of success, risk of death and whether the proposed procedure to be administered is an investigation.

It is a legal requirement that clients/patients accept treatment or other intervention where the condition may affect the wider public.

6.RIGHT TO ADEQUATE INFORMATION AND CONSENT

A Patient shall have the right to know the identity and professional status of the individuals providing services to the patient and to know which health professional is primarily responsible for his or her care, including the right to adequate and coherent information on prescribed and purchased medicines. The patient also has the right to choose among competitive products based on unbiased information as well as the right to know his or her prognosis and everything about their medical problem.

A patient’s written consent shall be required for the inclusion of a patient in any research or teaching programme. The patient shall be adequately informed of the aims, methods, anticipated benefits and potential hazards of the study and any discomfort it may entail. The patient shall be informed that he or she is free not to participate in the study and that he or she is free to withdraw his or her consent to participate at any time.

To ensure that informed consent is not obtained under duress or from a patient in dependant relationship to a health professional, the informed consent shall be obtained by a health professional who is not engaged in the investigation and who is completely independent of the official relationship between the patient and the health professional responsible for the research.In the case of a child, informed consent shall be obtained from the parent or guardian.

7.RIGHT TO REDRESS OF GRIEVANCES

A patient shall have access to appropriate grievance handling procedures,bearing in mind that health cared delivery professionals are not superhuman.

A patient shall have the right to claim damages for injury or illness incurred or aggravated as a result of the failure of the health professional to exercise the duty and standard of care required of him or her,whike treating the patient.

A patient shall have the right to legal advice regarding any malpractice by a health care professional.

8.RIGHT TO PARTICIPATION AND REPRESENTATION

A patient shall have the right to participate in decision making affecting his or her own health with the health professionals and other support staff involved in direct health care or through consumer representation, in planning and evaluating the system of health services, the types and qualities of service and the conditions of service under which health services are or were delivered or to give an assessment of the quality of services offered to him or her.

9.RIGHT TO HEALTH EDUCATION

Every individual shall have the right to seek and obtain comprehensive information advice regarding preventive and curative medicine, after care and good health.

10.THE RIGHT TO A HEALTHY ENVIRONMENT

Every individual shall have the right to an environment that is conducive to good health. This includes and extends to the health professionals office, health centre, hospital room and other facilities.

11.PATIENTS’ AND FAMILIES’ RESPONSIBILITIES/OBLIGATIONS

Whilst you have the right to be heard, you also have an obligation to listen to medical instruction concerning your treatment.

The patient and family shall provide accurate and complete information to assist the health professional to plan for your stay and treatment adequately.

The patient and family shall produce proof of inability to pay for health care services, except in emergency cases as determined by the health care professionals.

To avoid inconvenience to yourself and others, follow the referral chain and ensure you have the necessary documents to effect your access into hospital.

Keep your hospital notes safe and clean, you will need them during your next visit or contact with the health services.

The patient and family shall ensure that the patient understands the purpose and cost of any proposed investigations or treatment before deciding to accept it.

The patient shall insist upon explanations until he or she is adequately informed and shall consult with all relevant persons before reaching a decision.

The patient and family shall accept the consequences of the patient’s own informed decisions.

The patient and family shall establish a good relationship with the health care provider and follow treatment, determined by the health professional primarily responsible for the patient’s care.

The patient and family shall inform the health professional if the patient is currently consulting with or under the care of another health professional including traditional medical practitioners in connection with the same complaint or any other complaint.

The patient and family shall keep appointments and shall inform the health professional if unable to keep an appointment.

Every individual has a responsibility to maintain his or her own health and that of society by refraining from indulging in:

*Consumption of unhealthy food

*Substance abuse, such as alcohol and drugs.

*Life styles that have an adverse impact on health, such as sexual promiscuity, reckless activities and physical inactivity.

Every individual has a responsibility to accept all preventive measures sanctioned by law.

The patient and family must be aware of the limits of health care providers.

Patients should not expect a prescription at every visit. Many illnesses are short term and not require medication. You do not need a pill for every sickness.

Take your medicines exactly as instructed and complete any course of treatment.

Take interest in your own condition and read more information to get the best our of health promotions.

Do not share prescribed medicines.

The patient shall conduct himself or herself so as not to interfere with the well being or rights of others patients or providers of health care.

It is my hope this very long article will help patients as well as my fellow health care professionals.

Please note that the better part of this article is based on extracts from THE PATIENTS CHARTER which is property of the Ministry of Health and Child Care.

•Setfree N Mafukidze (RGN) writes in his own capacity,he is a Registered General Nurse, Certified HIV and AIDS Counsellor and Tester, Health Promoter and Health Blogger. This was first published by the Review Mail.