Publications

One of the core strategies of the organisation is to disseminate information through databases and relevant publications. The finding of the research conducted by CEHAT should reach out to people’s movement, policy makers and also for policy implementation. The publications are outcome of CEHAT's own research projects which have focused on relevant research and has endeavoured to inform campaigns around social issues. They are in the form of books, research reports, manuals, posters and resource materials. CEHAT is using APA standard referencing style for the publications. Read More....

Current Publications

2014

90. David, Siddarth; Contractor, Sana and Jain, Anita (2014). Hospital Preparedness and Response: 2008 Mumbai Terror Attacks. Mumbai: CEHAT. [ISBN: 978-81-89042-65-3].

The nature of the health system in India is such that the primary and often the only health responder during mass emergencies is the public health sector. This makes it critical to develop systems in this sector respond from the pre-hospitalization phase right up to discharge and compensation.

Documentation, research, and sharing of the experiences, lessons and challenges related to such events is critical in policy-making and planning of hospital preparedness. However, such work today exists mainly in the international sphere with little in India despite the fact that India has had a history of responding to mass-casualty events like terrorism and riots.

During the 2008 Mumbai Terror Attacks, which left 172 dead, the hospitals that responded were the state-run public hospitals. Using in-depth interviews of the healthcare providers on duty in these hospitals during the attack, this study seeks to identify strengths and gaps in the response capacities of public hospitals in Mumbai city and the procedures that were followed in the wake of the attack. The insights it provides would be of value to the government which has continuously been trying to review and rethink its health services, administrative procedures and systems in order to keep pace with the rising health care needs of the population especially during emergencies, moving from impulsive reaction to proactive response. Download full report

2013

88. Kurian, Oommen C., David Siddarth (2013). Free Medical Care to the Poor: The Case of State Aided Charitable Hospitals in Mumbai. Mumbai: CEHAT, 2013 [ISBN : 978-81-89042-64-6].

Charitable Trust Hospitals get various benefits from the government such as land, electricity at subsidised rates, concessions on import duty and income tax, in return for which they are expected to provide free treatment to a certain number of indigent patients. In 2005, a scheme was instituted by the high court formalising that 20 per cent beds set aside for free and concessional treatment at these hospitals. In Mumbai, these hospitals have a combined capacity of more than 1600 beds. However, it has been brought to light both by the government and the media that these hospitals routinely flout their legal obligations. Considering that charitable hospitals are key resources for provisioning of health services to an already strained public health system it is vital to ensure their accountability.This study by CEHAT intended to look at the literature on the history of state aided charitable hospitals in Mumbai, and appraise the nature of engagement between the private sector and the state aided hospitals. It critically reviewed the data submitted by the state aided charitable hospitals of Mumbai to the Charity Commissioner on free and subsidised patients, to estimate the degree of compliance to by the hospitals and also to monitor them. The study found that a substantial number of state aided charitable hospitals do not comply with the scheme, and the degree of non compliance is quite high. Most state aided charitable hospitals never allotted the mandatory 20% beds for treating the poor and instead complained that they were treating too many patients. Data reported to the Charity Commission by the state aided charitable hospitals is inadequate, inconsistent and unsystematic. Charitable hospitals predominantly treat indigent or weaker section patients at the outpatient level because outpatient (OP) admissions can be passed off as in patient (IP) admissions in the current scheme of things and frees an extra bed that can earn thousands of rupees per day. State aided charitable hospitals invariably underreported donations and bed numbers at the office of the Charity Commissioner. No matter how serious the allegations were, no kind of penalties were levied on the offending hospitals. There was not a single instance where disciplinary action was taken against an offending hospital in Mumbai.

We hope that the findings of the study would be useful in making key recommendations for effective implementation of the high court scheme, especially for guaranteeing access to the poor to the 20% beds that are set aside. Download full report

2012

87. Establishing a Comprehensive Health Sector Response to Sexual Assault. Mumbai: CEHAT, 77 p., 2012 [ISBN: 978-81-89042-63-9]

This report is based on the experience of establishing a comprehensive health care response to sexual assault at three public hospitals in Mumbai, in collaboration with the Municipal Corporation of Greater Mumbai. CEHAT is the first institution in India to have directly engaged with the public health sector to develop a model to respond to sexual assault. The model includes development and implementation of a gender sensitive examination proforma, operationalization of informed consent and provision of medical care along with crisis intervention services. The report presents ways in which such a model can be run within the existing resources of the hospital.

The report presents ways in which health professionals were equipped to provide emergency health care, recognize voluntary reporting by survivors to hospitals and document sexual assault related findings sensitively. The model also empowered health providers to formulate medical opinion and interpret negative medical findings. The report also presents profile of survivors and challenges faced by them in reporting sexual assault. Analysis of case records and medical records of survivors throws light on the dynamics of sexual violence, nature of health consequences and limitations of medical evidence - which have not been studied to a great extent in the Indian context. Specific recommendations for different agencies such as child welfare institutions , police machinery , community based organisations and so on are discussed in order to create a multipronged approach to respond to sexual assault. Download full report

86. रेमस, प्रशांत. महाराष्ट्र राज्य आरोग्य विभागाची अर्थसंकल्पीय प्रक्रिया : एक ओळख, एक मागोवा. मुंबई : सेहत, ४९ पा., २०१२ [ISBN: 978-81-89042-61-5] Download full report

85. Raymus, Prashant. Mapping Budget Processes in the Public Health Sector in Maharashtra. Mumbai: CEHAT, 163 p., 2012 [ISBN: 978-81-89042-62-2]

The Budget is an official policy document, which is indicative of the expenditure incurred and reflective of the policy priorities of the government. The budgetary processes in India are opaque and remain behind the extreme confidentiality of bureaucratic exercises. Even when accessed, the documents are not presented in a language and format that is user-friendly; the language used is too technical to understand making it difficult to comprehend. People, in general, consider the budget highly technical and very difficult, and only a miniscule proportion of the population understands the technicalities involved. Besides, the most crucial stage of the budget process, that of budget preparation does not allow any kind of participation by civil society organisations. In order to be conducive to public involvement, public understanding and involvement in the budget process is critical for ensuring that the Government is accountable to the public. This Public Expenditure Tracking Survey, conducted in two districts in Maharashtra, explores the budget process through its various stages. The findings of the study outline budgetary processes; the range of issues discussed will help the reader understand all four stages of the budget process (formulation, approval, implementation and auditing).This information on the key actors in the system will not only hold them accountable, but will also help civil society organizations identify opportunities for civic participation. Download full report

84. Ethical Guidelines for Counseling Women Facing Domestic Violence. Mumbai: CEHAT, 32 p., 2012 [ISBN: 978-81-89042-60-8]

This document lays down ethical principles and guidelines (translation of these principles) to inform counselling practice in the best interest of the client. Ethical principles include Autonomy, Beneficence, Non-maleficence, Veracity and Fidelity and Justice. The guidelines have been evolved through a process of consultation with an expert committee. The purpose of this document is to sensitize counsellors, protect and promote rights of the clients; to promote standards in counselling through observation of ethics and self regulation; to improve quality and credibility of counselling, and to make ethics an integral part of counselling practice. The universality of the core principles of ethics allows the present guidelines to be used by all counsellors and stakeholders engaged in domestic violence work in general, and domestic violence counselling, in particular. These include psychologists, social workers, protection officers, community development officers, and the like; as well those involved in private practice (including the individual counsellor). Organizations or institutions that provide counselling services, education, and/or training can endorse them and, make them applicable to their staff.Download full report

83. Manual for Medical Examination of Sexual Assault (Revised after Criminal Law Amendment Act, 2013). Mumbai: CEHAT, x,64 p., 2012 [ISBN: 978-81-89042-59-2]

This manual aims to equip health care workers with an appropriate understanding of sexual violence and the needs and rights of survivors of sexual violence, and to highlight the dual responsibilities-both medical and forensic-health care workers have toward survivors. Health administrators, educators, obstetricians, gynaecologists, paediatricians and forensic medical examiners to read this manual and adopt its approach in their practices. Reducing health risks faced by women and ensuring respect for the dignity and autonomy of each woman is central to the realization of the right to health. This manual provides critical support for these endeavors and is thus a welcome contribution to the promotion of women's health and the right to health in India....Download full report

2011

82. Kurian, Oommen C.; Wagle, Suchitra and Raymus, Prashant. Mapping the flow of user fees in a public hospital. Mumbai: CEHAT, 82 p., 2011 [ISBN : 978-81-89042-58-5]

The Maharashtra state government introduced user fees in hospitals in the nineteen eighties, and the scope and scale has been steadily increasing. In 2001, there was a substantial increase in the average user fee paid per patient at government facilities in Maharashtra). Recently, there have been proposals to increase substantially the fees charged for medical services at civic hospitals in Mumbai and also a decision to hike user fees across the state. This study was aimed at mapping the flow of user fees in a public hospital located in Mumbai. It also aimed to understand the provider's role in the process of giving waivers from user fees to the patients, and also, reimbursement of fees from Poor Box Funds to the 'needy'... Download full report

81. Contractor, Sana... [et al]. Responding to sexual assault: A study of practices of health professionals in a public hospital. Mumbai: CEHAT and New Delhi: SAMA, 58 p., 2011 [ISBN: 978-81-89042-57-8]

The study showed that there are several gaps in both the medico-legal as well as therapeutic response of the hospital to sexual assault survivors. As far as the medico-legal role of health providers is concerned, we find that there are no uniform protocols for seeking consent, history, conducting examinations or for evidence collection and hence there is a lot of variation between the practice of various doctors. There is no protocol for how, from whom and for what consent needs to be sought and coercion was evident in certain types of cases. Doctors also articulate the lack of skills vis-ŕ-vis seeking history from children and building rapport with survivors which serves as a barrier to eliciting thorough history. The study also suggests that health care providers, in cases of sexual assault, perceive their role to be largely medico-legal rather than therapeutic... Download full report

80. Pradhan, Anagha and Shaikh, Tayyaba. Living on the Margins: Prawn Harvesters from Little Rann of Kutch (An Exploratory Study of Health Status). Gujarat: Anandi and Mumbai: CEHAT, 114 p., 2011 [ISBN: 978-81-89042-56-1].

Marathi and Hindi Publications

बुरटे, अरुणा (२०१४). लैंगिक हिंसा प्रतिबंधासाठी दिलासा. मिळून सार्याजणी मासिक, मे २०१४, पान. २२ - २५.

लैंगिक हिंसेच्या शिकार झालेल्या स्त्रियांना दिलासा देणारा एक अहवाल 'सेहत' या संस्थेने प्रकाशित केला आहे. इस्पितळे, न्यायपालिका, पोलिस, इतर सरकारी यंत्रणा लैंगिक हिंसेच्या केसेस हाताळताना कुठे कमी पडतात याचा सविस्तर अभ्यास करून या अहवालात सेहत ने अनेक उपाय सुचवले आहेत. पाच वर्षे अभ्यास करून सेहत ने तयार केलेली कार्यप्रणाली सरकारी यंत्रणा, स्त्रीप्रश्नावर काम करणाऱ्या संस्था, कार्यकर्ते यांना मार्गदर्शक ठरेल अशी आहे.

रेमस, प्रशांत. महाराष्ट्र राज्य आरोग्य विभागाची अर्थसंकल्पीय प्रक्रिया : एक ओळख, एक मागोवा. मुंबई : सेहत, ४९ पा., २०१२ [ISBN: 978-81-89042-61-5]

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पटेल, दिव्या; चौधरी, लेनी (संक) : स्त्रियांच्या माहितीकरिता पत्रक : गर्भापताविषयी सर्वकाही, मुंबई : सेहत, ४ पा., २००९

हे माहिती पत्रक स्त्रियांच्या मनात असलेल्या गर्भापाता विषयीच्या अनेक प्रश्नांना चालना देते. या पत्रकात गर्भपात म्हणजे काय, संबंधित कायदा, परवानगीची गरज, गोपनीयता, सेवा केंद्र, माहिती केंद्र, उपलब्ध पर्याय, सुरक्षितता, अश्या अनेक प्रश्नांची उत्तर आणि योग्य माहिती या पत्रिकेद्वारे मिळते.

पटेल, दिव्या; चौधरी, लेनी आणि म्हात्रे, उज्ज्वला (संक) : वैद्यकीय गर्भपात कायदा : महाराष्ट्रातील सेवा पुरवठादारांकरीता मार्गदर्शिका, मुंबई : सेहत, १९ पा., २००९

ही मार्गदर्शिका महाराष्ट्रातील सेवा पुरवठादारांकरीता तयार करण्यात आलेली आहे. या मार्गदर्शिकेत सर्व वैद्यकीय व आरोग्य सेवा पुरवठादारांना गर्भपात कायद्याची व भारतामध्ये स्त्रियांना सुरक्षित व कायदेशीर गर्भपाताची सेवा मिळण्याकरिता आवश्यक परिस्थितीची माहिती दिलेली आहे.