Privacy concerns regarding personal health information in Myanmar: A cross-sectional survey in a least developed country

Protecting personal health information has long been a key ethical concern in healthcare. With the rise of digital health systems, privacy concerns have intensified. In least developed countries like Myanmar, where digital literacy is low, public and governmental awareness of privacy issues is limited, and data protection laws are lacking, the health information privacy area remains largely unaddressed and understudied. This study, therefore, aimed to assess the extent of privacy concerns related to personal health information in Myanmar and identify the factors associated with these concerns. A cross-sectional survey was conducted from March to May 2024 among 424 participants recruited online and through two private clinics. A validated 21-item scale measuring six domains: Collection, Errors, Unauthorized Secondary Use, Improper Access, Control, and Awareness, was used. Confirmatory factor analysis was performed to validate the scale, and logistic regression was used to identify factors associated with the concerns. Among the 424 participants, 77.83% reported high concerns. The highest concern was observed in the Awareness domain (mean 5.02, SD 1.65), while the Collection domain showed the lowest (mean 3.41, SD 1.44). Participants aged 45 years or older had significantly lower odds of high concerns compared to those aged 18-24 years, with an adjusted odds ratio (aOR) of 0.29 (95% CI 0.09-0.88). In contrast, those reporting good health (aOR 3.72, 95% CI 1.69-8.23) and high health concerns (aOR 5.26, 95% CI 3.02-9.45) had increased odds of high privacy concerns. These findings highlight the need for robust privacy safeguards, legal frameworks, and trust-building measures to support Myanmars transition to digital health systems. They also provide insights relevant for other least developed countries facing similar challenges in balancing digital innovation with the protection of personal health information. Author SummaryWe examined the extent of personal health information privacy concerns of people in Myanmar at a time when digital health tools are growing but legal protections and public awareness remain limited. From March to May 2024, we surveyed 424 adults online and in two private clinics. We asked about six kinds of concerns, related to the amount of personal health information collected, errors in the information, who can access the information, whether they are reused without permission, how much control people have over their own information, and how clearly rules are explained. More than three in four participants reported high overall concern. People were more worried about not knowing how their information would be used, and least worried about the act of collection itself. Older adults tended to be less concerned than younger adults, while those who felt in good health and those who were more worried about their health showed greater concern. Patterns also varied by sex, place of residence, type of occupation, and familiarity with electronic medical records. Our findings point to practical steps for Myanmars digital health transition: communicate clearly about data practices, give people meaningful control, prevent misuse and improper access, and strengthen organizational and legal safeguards. These actions can build trust and support safe, more equitable health information systems in Myanmar and in similar settings.