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Report on the 9th KR Memorial Lecture

Report on the session conducted by Dr. Sunil Pandya and discussant Dr. S.P. Kalantri on  Contemporary Issues in Health and Social Sciences.


Dilaasa crisis centres prove a haven for women facing domestic violence.


Report on National Course on Comprehensive Healthcare Response to Survivors of Violence Against Women and Children, 30th August to 1st September 2018, Mumbai

CEHAT conducted a three-day intensive training for the health care providers on comprehensive response to violence against women and children, their roles and problem solving methods. There were 37 participants who were deputed from government hospitals from various states of India namely Haryana, Jammu and Kashmir, Uttar Pradesh, Chhattisgarh, Maharashtra, Punjab, Delhi. The participants were doctors and nurses from departments such as Gynecology, Pediatrics, Forensic, Surgery, and Casualty that are likely to come in contact with survivors of violence. The objective of the course was to build the perspective to identify the survivors of violence based on health complaints and enhance skills to provide first line support.

The methodology was experiential and interactive, informing participants of theoretical concepts with scope for hands-on learning through discussion of case studies and role plays, followed by Q&A. This provided opportunity for discussion and debate. The participants were inquisitive and enthusiastic and shared various examples of instances that they had intervened in.

U.Vindhya, Professor and former Chairperson, School of Gender Studies at Tata Institute of Social Sciences, Hyderabad campus, oriented the participants about the difference between sex and gender and root causes of gender based violence. Participants found the concept of intersectionality interesting as it brought forth the underlying complexities and helped place the survivor in the social context. This was followed by a session on understanding the link between violence and health and recognizing types and forms of violence.

The second day was facilitated by the CEHAT team. The day began with a session on legal responsibilities of healthcare providers, providing clarity on their role vis. a vis. various laws related to VAW. This was followed by day long practice sessions on strengthening communication with survivors. Participants were introduced to the LIVES model (WHO) to provide first line psychological support. The model was demonstrated by Dr. Sneha Khedekar, the nodal person of Dilaasa at M.T. Agrawal Hospital, Mulund and Matron Sneha Chandan, core group member of Dilaasa at  Rajawadi Hospital.

Following the demonstration, participants tried their hand at practicing the model in small groups of threes where they got a chance to play the role of survivor, doctor, observer with the help of case studies.

The third day focused on the response to survivors of sexual violence. The session was facilitated by senior forensic expert, Dr. Jagadeesh Reddy. Participants were familiarized with the nuances of the protocol and guidelines laid down by the Ministry of Health. They got hands-on experience of drafting opinions through sample proformas assigned to them in groups.

The major learning of the health care providers was the understanding of violence, patriarchy being the root cause, strengthening skills on how to ask survivors about violence and communicate first line support and understanding of medico legal care – both theoretical and application.

Participants gave feedback that the well structured training encouraged them to critically analyze and apply the concepts to their work with enhanced understandig

Some health care providers also showed keen interest in setting up hospital-based centers back at their hospitals. They shared that there is a shift in perspective which helped them understand their therapeutic role as well as how to reach out to survivors in a more sensitive and empowering manner.

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Orientation to Gender Integrated Modules Workshop, 27 - 28 February 2018

Gender in Medical Education (GME) is a pioneer initiative in India to include gender in medical education. The need to include gender in a predominantly biomedical curriculum which reinforces patriarchal notions was recognised by CEHAT. The GME project is a joint initiative of CEHAT, DMER and MUHS. As part of the initiative, a two-day workshop was held on February 27 and 28 at St. George Hospital, Fort, in Mumbai. It was attended by around 40 mid to senior level medical educators hailing from public hospitals of Mumbai Pune, Kolhapur, Solapur and Miraj.


NATIONAL COURSE ON COUNSELLING SURVIVORS OF VIOLENCE 7-9 MAY 2018


CEHAT – TISS conference on Health Insurance and Universal Health Care (UHC) in India - Core findings and recommendations 13th and 14th of October, 2017, held at TISS, Mumbai


Vacancy in CEHAT for the post of Senior to middle level researcher


Workshop on building perspective and skill-development on response to VAW and children for POs and DSWs

CEHAT carried out a workshop on building perspective and skill-development on the response to violence against women and children through a survivor-centric approach on January 8-10, 2018 at Bharathiyar University, Coimbatore, Tamil Nadu. The participants consisted of 25 protection officers with upto 10 years of experience from various districts, one counsellor appointed at the OSC (Kanchipuram District) and 7 District Social Welfare Officers. The Social Welfare Department of Tamil Nadu showed its commitment to the issue of VAW and children by deputing senior officers who participated in the 3 day workshop.  The purpose of holding the first round of training with this group was to ensure that the state response is sensitive, since they are major stakeholders.


Training session on comprehensive healthcare response to violence against women and children, 14-15 Dec 2017


CEHAT Calendar 2018 Universal Health Coverage

The 2018 calendar uses simple case studies to demonstrate these principles in practice. The cases are adapted from real incidents from CEHAT's research and experience. 


Evidence-based Clinical Practices: A joint initiative of DMER, KEM, UNFPA and CEHAT on Nov 24-25 2017, Mumbai

The Centre for Enquiry into Health and Allied Themes (CEHAT) is conducting a 1.5 day workshop on ‘Evidence-based Clinical Practices’. This event, organised by CEHAT in collaboration with DMER, KEM and the UNFPA is aimed for senior medical college faculty members of government medical colleges across Maharashtra, such as heads of the department and associate professors of disciplines such as gynaecology, forensic science, internal medicine, community medicine, psychiatry, paediatrics and surgery departments. CEHAT initiated project “Integration of Gender in Medical Education Project (GME)” in select medical colleges of Maharashtra with the aim to sensitise medical students and healthcare professionals to gender inequality and its interaction with health.

Until now, social determinants of health were rarely included in pure medical studies. The need for awareness and sensitivity regarding patients’ gender and social backgrounds among medical practitioners has been acknowledged by the World Health Organization (WHO). Right from the patient’s approach to the doctor’s evaluation and treatment, gender disparity is evident and clearly visible in the medical field, as proved by CEHAT’s ongoing work in this field.

This workshop, sanctioned by Maharashtra University of Health Sciences (MUHS), is a pioneer attempt to include gender as a component in medical education in India, and would dwell on the need for gender in medical education, current efforts, informed consent and communication strategies, privacy and confidentiality, respectful maternal care, care for survivors of violence and clinical checklists for implementing gender-sensitive health care. CEHAT will also release gender integrated medical education modules on Forensics and Toxicology, Medicine, Obstetrics and Gynaecology, Preventive and Social Medicine, and Psychiatry.

The timings for the workshop are as follows:

Friday, November 24: 9:30 am to 5:00 pm

Saturday, November 25: 9:30 am to 2:00 pm


It will be held at the YMCA, Mumbai Central.


NATIONAL COURSE ON COMPREHENSIVE HEALTHCARE RESPONSE TO VIOLENCE AGAINST WOMEN AND CHILDREN ON 17TH -19TH NOVEMBER 2017, MUMBAI


NATIONAL COURSE ON COUNSELLING SURVIVORS OF VIOLENCE, 25TH – 27TH AUGUST 2017, MUMBAI

BACKGROUND

The One Stop Scheme by the Ministry of Women and Child Development has presented the opportunity to influence the current crisis intervention services. Through this scheme, crisis intervention centres called One Stop Centres have been established or are underway in various states across the country with the objective to provide integrated support and assistance to women affected by violence, both in private and public spaces and to facilitate immediate, emergency and non-emergency access to a range of services including medical, legal, psychological and counseling support under one roof to fight against any forms of violence against women. For effective implementation of these OSC, counselors must work in coordination with the hospital within which or near which they are located. Violence against women has been recognized as a health issue under the National Health Policy, 2017. The link between violence and health has been acknowledged along with the recognition to create services to respond to survivors. In 2005, The Protection of Women from Domestic Violence Act, was developed to offer civil remedies and reliefs to women facing violence. In 2012, the Protection of Children from Sexual Offences Act was introduced. Both these laws have brought in the role of support persons and Protection Officers, generating a growing reliance on counselling services. It is imperative that counselors be trained to respond to different forms of VAW and children and be equipped with the perspective and skills in responding to VAW.

CEHAT has been instrumental in developing an evidence-based model to respond to VAW and children. In 2014, the MOHFW laid down the guidelines and protocols for medico-legal care for survivors of sexual assault including psychosocial support. CEHAT had the opportunity to present its evidence based work of having established Dilaasa, a hospital based crisis centre in collaboration with the Municipal Corporation of Greater Mumbai. This evidence-based model has also featured in the leading international medical journal Lancet.

CEHAT is pleased to announce its National Course on counselling survivors of violence. The course is aimed at building a critical feminist perspective on the issue of violence against women and children and enhancing skills of the participants in responding to survivors of violence.

Feminist counselling has been accepted as one of the most effective counselling method for women living in abusive relationships as it questions power and inequality within the relationship. It encourages women to understand what they are experiencing in context of inequalities that arise out of larger oppressive structures. This form of counselling is gender-sensitive and has been used effectively while engaging with various vulnerable groups including transgenders and boys.

AIM

  • To understand violence against women and children as a public health issue
  • To identify the social and cultural determinants of VAW
  • To be equipped with skills to provide psychosocial support to different age groups of women and children
  • To be equipped to respond to special groups (children, intersex, sex workers, persons with disability)
  •  Learn the principles and values of feminist counselling and their application while engaging with survivors
  • To ensure self care and prevention of burnout


Conference on Health Insurance and Universal Health Care (UHC) in India, 13th and 14th of October, 2017, Mumbai

Prelude:

A key objective of the National Health Policy 2017 is to align the private sector towards public health goals. Its main strategy is to ensure free comprehensive primary care provision by the public sector, supplemented by strategic purchase of secondary care hospitalization and tertiary care services from both public and non-government sector to fill critical gaps. The key mechanism of strategic purchasing is insurance schemes. Thus in the larger context of ensuring Universal Health Coverage, government funded health insurance schemes seek to play a very large role. Services would be strategically purchased from public as well as private sector to improve health outcomes, reduce out of pocket payments and minimize moral hazards for the purpose of scaling up the schemes and made more effective. The policy provides for preferential treatment to collaborating private hospitals/institutes for CGHS empanelment and in proposed strategic purchase by Government. However, we need to ask critical questions such as: What have been the various bottlenecks, successes and failures of the existing national and state level insurance schemes? What are the lessons learnt so far for these to be scaled up? What have been the experiences of the users? What has been the experience of for-profit private health sector? What are the pros and cons for adopting the insurance approach to realise the goal of Universal Health Care? What are the crucial gaps that need to be addressed for health systems strengthening for UHC and how?

Themes for the conference:

1. Critically evaluate the role of government funded health insurance schemes. What has been the experience of the public and private sectors vis-a-vis the insurance schemes?

2. Evidence based learning from the various National level and State level insurance schemes and their role in improving health outcomes, health equity, reducing out of pocket payments and moral hazards to improve scalability and efficiency.

3. Role of State in Health Systems Strengthening for UHC: Infrastructure, human resource, regulations, standardization, quality assurance, etc.



Campaign Week Activities towards Elimination of Violence Against Women

Culminating in the celebration of Human Rights Day, the fortnight from 25th November-10th December 2016 is observed worldwide as a campaign to end VAW.  


Press Note “Government funded health insurance scheme in Maharashtra: Study of Rajiv Gandhi Jeevandayi Aarogya Yojana”


Cehat Calendar 2017

This year's calendar is aimed at creating awareness about gender in medical education.