JMIR Publications

ABSTRACT

Background:

Protecting personal health information (PHI) has long been a key ethical concern in healthcare, but with the rise of eHealth systems, privacy concerns have intensified. In least developed countries (LDCs) like Myanmar, where digital literacy is low, public and governmental awareness of privacy issues is limited, and data protection laws are lacking, PHI privacy challenges remain largely unaddressed and understudied.

Objective:

This study aimed to assess the extent of privacy concerns related to PHI (PHIPC) in Myanmar and identify the factors influencing these concerns.

Methods:

A cross-sectional study design was employed, using a questionnaire to measure PHIPC across six domains: Collection, Errors, Unauthorized Secondary Use, Improper Access, Control, and Awareness. The survey was distributed via social media and shared with patients, attendants, and healthcare staff at two clinics in Myanmar. Confirmatory factor analysis validated the questionnaire, and logistic regression identified factors associated with PHIPC.

Results:

A total of 424 valid responses were collected. PHIPC was rated at moderate level across all domains, except for Collection, which was rated at a lower level. Respondents were more concerned about data management—such as errors, misuse, and access control than about data collection itself. The most significant factors influencing PHIPC were individuals' perceived health status and health concerns. Those with higher health concerns and those who viewed themselves as healthier tended to report higher PHIPC. Sociodemographic factors such as age, gender, education level, and urban versus rural residence did not significantly influence overall PHIPC. However, they played a role in certain domains. Furthermore, individuals who had heard of Electronic Medical Records (EMRs) but lacked a clear understanding of them were less likely to express high concerns about data errors compared to those who were unaware of EMRs.

Conclusions:

The study underscores the need for strong privacy protections and trust-building in Myanmar’s eHealth platforms. The findings serve as a crucial foundation for shaping future eHealth technologies in Myanmar once the country achieves stability. To ensure the effective development, adoption, and implementation of these systems, it is imperative to address privacy concerns through well-defined policies, open communication, and strong data management practices. These insights extend beyond Myanmar, providing valuable lessons for other nations navigating similar challenges in the digital health sector.