Medical Litigation in Hospitals in Kampala, Uganda

Abstract

Seeking legal redress for harm sustained while receiving medical care is common in some developed countries but less common in most developing countries. However, unconfirmed reports suggest that litigation is on the increase even in developing countries like Uganda. Litigation influences the behaviour of both health care workers and hospital managers, with significant consequences for patients and the entire health system. Given the dearth of publications on the extent of medical litigation in developing countries, this exploratory study sought to determine the prevalence, trends, determinants and effects of medical litigation on medical practice in hospitals in Kampala. Using a mixed methods approach, ten Kampala hospitals belonging to the government, private not-for-profit (PNFP) and for-profit (PFP) organisations that had been in operation for at least 5 years were purposively studied. Participants included medical directors, officials from courts of judicature, health professional bodies, and officials from health care consumer organisations. The study revealed that medical litigation in Kampala was still minimal but increasing steadily. Surgeons and Obstetricians / Gynecologists were the specialties most at risk of medical litigation. Significant factors responsible for the increase in medical litigation trends were: heavy workload; increased exposure to medical information; and increased awareness on patient rights. Medical litigation has led to improvement in quality of health care, huge financial burden to the health care providers, and suspension or outright withdrawal of health workers from medical practice. Efforts to reduce litigation include continuous professional development, better staff recruitment practices and strict enforcement of standard operating procedures. There is need for dialogue between the patient safety stakeholders, staff training on patient-centred care and training of managers on the implications and processes of medical litigation.