As the Asia Regional Focal Point of the IFHHRO, CEHAT has been actively participating in all its activities. IFHHRO, OSI and other NGOs have launched a campaign in 2010 to address certain key issues of human rights violations in health care settings. One of the issues being addressed through the campaign is that of forced and coerced sterilization. In the context of India, it was felt that there is a need to deliberate upon the existing guidelines for sterilizations, particularly to address issues of quality of care and consent. A working group for evaluation of existing guidelines on sterilization was constituted, comprising of gynaecologists, representatives of professional associations (FOGSI), and policy groups working on the issue of family planning in India. Dr. Nikhil Datar(R.N.Cooper Hospital and FOGSI), Dr.Abhijit Das (Center for Health and Social Justice), Dr. Surekha Mehta (Ex-Quality Assurance Committee Convener, MCGM), Dr. SuchitraDalvie (CommonHealth), Dr.P.K.Shah(President, FOGSI), Dr.M.C.Patel (Medico-legal Cell, FOGSI), Dr. Subha Sri (RUWSEC) were invited to be members of the working group in addition to three CEHAT representatives.
The working group met in August 2011 and discussed the existing policies and problems with the guidelines for sterilization. Prior to the meeting, CEHAT analyzed the various circulars on sterilization received from the State government, against national as well as international guidelines such as the FIGO ones. Under the national population program, there is a clear emphasis on female sterilization as a method of contraception, as against other reversible methods or even male sterilization. This raises several issues regarding women’s contraceptive choices and the potential for coercion. Analysis of circulars also found that there are discrepancies between the circulars issued by the State, the National guidelines on sterilization, and those of FIGO. Based on this analysis, several issues related to informed consent, case selection, sterilization concurrent with abortion, standards of care, functioning of quality assurance committees and the need for review of guidelines for sterilization were discussed at length in the first meeting. As a first step it was discussed that the FIGO guidelines which addressed some of these issues in a progressive manner should be modified to bring in the Indian context and presented to the FOGSI for endorsement as a policy statement. The FIGO guidelines were reviewed and amendments made, contextual to the Indian scenario. The statement was sent to FOGSI for endorsement. It was reviewed by the FOGSI managing committee and revisions suggested.
Team: Sana Contractor, Anita Jain
Supported by: IFHHRO