Confidentiality breaches deter youth from clinics

However, concerns are growing that this trust is weakening. A rising number of youths say their personal medical information is being shared without consent, forcing many to avoid care even when they urgently need it.

One of them is Latifa Athuman (not her real name), who visited a neighbourhood clinic after suspecting she might be pregnant. She said she chose the facility because she believed her visit would remain confidential.

“I didn’t know anyone there. I went because I wasn’t feeling well and I wasn’t ready to tell my family,” she said.

“But after they tested me, my father called immediately asking what had happened. It made me feel exposed and betrayed.”

The experience left her discouraged and unsure of whether she could ever trust a health facility again.

A similar case was reported by Jumanne Abdul (not his real name), a university student in Zanzibar, who visited a local clinic for an HIV test.

He said he learned later that his relatives already knew his results before he had time to understand the diagnosis himself. “I felt like I had no rights,” he said.

“My friends encouraged me to stay strong and continue seeking help. Personal issues like these should only be shared when the person is ready.”

He said the situation at home became emotionally overwhelming, with family members fearing for his life.

Cases like these echo findings from a study by the Zanzibar Fighting Against Youth Challenges Organization (ZAFYCO), which identified lack of confidentiality as one of the main reasons youths avoid health facilities.

The study, conducted between 2017 and 2018, found that fear of exposure was pushing many young people toward self-medication and away from professional care.

ZAFYCO Executive Director, Abdalla Abeid said breaches of privacy are more common in extended family and close-community settings, where information spreads quickly. “The challenge becomes worse in extended family settings,” he explained.

“You can walk into a clinic and find a neighbour, a former classmate, or even a relative. Once someone knows your story, it moves quickly.”

He said the organization often receives youths seeking help to access treatment, despite ZAFYCO not offering clinical services.

“We are finalizing discussions with the Ministry of Health to introduce stronger training on confidentiality for both health workers and community volunteers,” he said.

According to Health Educator, Parent and Child Health Mobilizer, and supervisor of Youth-Friendly Services (YFS) in Zanzibar, Fatma Ussi Yahya, said confidentiality is part of every training session given to health workers and peer educators.

“We always teach our providers not to disclose a patient’s information. It is part of our ethics,” she said. However, she noted that some situations such as cases of teenage pregnancy, require involving a parent or guardian for safety and follow-up.

“But if information spreads in the community without any reason, that is unacceptable,” she said. “These cases are rare, but when they happen, they harm young people deeply.”

She urged youths to continue seeking health services, saying avoiding care can worsen their health.

“And to any health worker who leaks information, they must stop. When someone comes for treatment, they trust you completely.”

On his part, Dr Magnus Msango said confidentiality is a fundamental requirement for any health worker.

“Anyone who leaks patient information is not a health professional,” he said. “Medical workers are trained to uphold confidentiality, and patients should know that they have the right to report violations.”

Public health advocate Eric Mahatara said many neighbourhood clinics fail to meet proper standards, with some owners prioritizing profit over professional service.

“Some facilities operate without meeting qualification requirements,” he said.

He added that many of these clinics have only one or two rooms, making privacy nearly impossible.

“We need stronger regulation to ensure facilities meet national health standards,” he said, stressing the need for better training for health workers.

As more young people share similar experiences, concerns continue to rise that breaches of confidentiality are pushing them away from essential care.

Without trust, health experts warn, even the most accessible services lose their meaning.