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Effect of Healthcare Facility Privacy on Patient Satisfaction in Nigerian Primary Healthcare Centres

Abstract

Privacy is an important component of patient-centred healthcare because patients need a safe and confidential environment in which they can discuss personal health information, undergo physical examinations, receive treatment, and interact with healthcare professionals without unnecessary exposure or interruption. Healthcare facility privacy refers to the physical, visual, auditory, informational, and interpersonal measures used by healthcare facilities to protect patients' personal information, dignity, confidentiality, and personal space during the delivery of healthcare services. Patient satisfaction refers to the extent to which patients' expectations and perceptions concerning healthcare services and their overall experience at a healthcare facility are met. In Nigerian primary healthcare centres, inadequate consultation spaces, overcrowded waiting areas, insufficient partitions, poor sound insulation, shared examination rooms, inappropriate patient positioning, and weak confidentiality practices may compromise patients' privacy. Such conditions may make patients uncomfortable discussing sensitive health concerns, reduce trust in healthcare providers, and negatively affect their perceptions of service quality. Conversely, appropriate privacy arrangements may promote dignity, trust, comfort, effective communication, and confidence in healthcare services. Against this background, this study investigates the effect of healthcare facility privacy on patient satisfaction in Nigerian primary healthcare centres. The study is anchored on Donabedian's Structure-Process-Outcome Model, the Servicescape Theory, and Expectancy-Disconfirmation Theory. Donabedian's Model identifies the physical infrastructure and organizational arrangements supporting patient privacy as important structural components that can influence healthcare processes and patient outcomes. Servicescape Theory emphasizes the influence of the physical healthcare environment on users' perceptions, emotions, and evaluations of service quality. Expectancy-Disconfirmation Theory explains patient satisfaction as the outcome of comparing patients' expectations regarding privacy and healthcare services with their actual experiences. Collectively, these theoretical perspectives provide a suitable framework for explaining how healthcare facility privacy may influence patient satisfaction in Nigerian primary healthcare centres. The study will adopt a quantitative cross-sectional research design. Primary data will be collected from selected Nigerian primary healthcare centres using structured patient questionnaires, healthcare worker questionnaires, privacy assessment checklists, facility observation tools, and relevant healthcare records. A multistage sampling technique will be employed to select states, local government areas, communities, primary healthcare centres, healthcare workers, and eligible patients. Healthcare facility privacy will be assessed using indicators such as availability of private consultation rooms, physical partitions, curtains or screens, adequate examination spaces, sound privacy, visual privacy, privacy during physical examinations and treatment, confidentiality of patient records, controlled access to patient information, appropriate separation of patients, and availability of private spaces for sensitive consultations. Where feasible, direct facility observation will be used to objectively assess physical privacy arrangements rather than relying solely on patient perceptions. Patient satisfaction will be assessed using indicators such as satisfaction with privacy, dignity, confidentiality, comfort, provider communication, perceived service quality, trust in the facility, willingness to return, willingness to recommend the facility, and overall satisfaction. Additional information will be collected on patients' age, sex, educational level, type of healthcare service received, frequency of facility visits, and department or service area attended. Descriptive statistics will be used to summarize privacy conditions, patient characteristics, and satisfaction levels. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of healthcare facility privacy on patient satisfaction. Diagnostic tests will also be conducted to assess the reliability of research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that better healthcare facility privacy has a significant positive effect on patient satisfaction in Nigerian primary healthcare centres. Patients attending facilities with adequate consultation rooms, appropriate partitions, sufficient examination spaces, effective sound privacy, and secure patient information systems are expected to report higher levels of satisfaction than patients attending facilities with inadequate privacy arrangements. Physical privacy is expected to improve patients' comfort and dignity during examinations and treatment, while auditory and informational privacy are expected to strengthen patients' confidence when communicating sensitive health information to healthcare providers. Effective privacy arrangements may also promote trust and encourage patients to disclose relevant health information, thereby supporting patient-centred care. Conversely, overcrowded consultation spaces, shared examination rooms, inadequate partitions, audible conversations, and unauthorized access to patient information may create discomfort, embarrassment, and dissatisfaction. However, privacy alone may not fully determine patient satisfaction because satisfaction is also influenced by waiting time, provider communication, availability of medicines and equipment, healthcare costs, facility cleanliness, accessibility, and perceived quality of clinical care. Therefore, improving privacy should form part of a broader strategy for strengthening patient-centred primary healthcare services. The study is expected to contribute to the literature on healthcare facility privacy, patient satisfaction, patient-centred care, primary healthcare, healthcare quality, patient dignity, confidentiality, healthcare environment, and public health in Nigeria by providing empirical evidence on the relationship between privacy conditions and patients' perceptions of healthcare services. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, state primary healthcare development agencies, local government health authorities, primary healthcare managers, healthcare professionals, facility planners, healthcare quality-improvement teams, development partners, and policymakers regarding strategies for improving patient privacy. The study will also provide evidence-based recommendations for improving consultation-room design, installing appropriate partitions and curtains, strengthening sound privacy, improving patient-flow arrangements, protecting medical records, restricting unauthorized access to patient information, and incorporating privacy standards into the planning, renovation, monitoring, and quality assessment of Nigerian primary healthcare centres.

Keywords: Healthcare facility privacy, patient satisfaction, Nigerian primary healthcare centres, patient privacy, confidentiality, patient dignity, patient-centred care, healthcare quality, primary healthcare, privacy standards, healthcare environment, public health.