Publications

Challenges and dilemmas in institutionalising a crisis centre for women facing domestic violence in the public health system

Authors : Sangeeta Rege; Rupali Gupta

Published Year: 2010

Paper presented in National Bioethics Conference, New Delhi, 2010

Domestic Violence (DV), well recognised as a public health concern worldwide, is still missing, as a concern, from the Indian public health system. In public hospitals, which are the only viable health care option for a majority of the socio-economically marginalised population, the issue of DV is still on the distant horizon of public health reforms. Hence, CEHAT felt the urgent need to bring it on to the radar of the public health system. Dilaasa, the first public-hospital based crisis counselling centre in India, was established in collaboration with the Municipal Corporation of Greater Mumbai in two public hospitals in Mumbai. Since 2001, Dilaasa has been engaged in providing counseling and psycho-social support services to women facing violence, and a training cell was set up to sensitise the hospital staff on DV. CEHAT was involved in demonstrating the crisis intervention model for DV response, merging the centre with the hospital’s medical services, and later in monitoring its services after handing over charge of both the centres to the hospital management in 2006. CEHAT implemented different mechanisms for monitoring of the centre, but ensuring the quality of services provided by the centre has always been a challenge. The hospital management provided infrastructure and resources for DV counselling and training, but issues such as transfers of deputed staff, a lack of reporting mechanisms or clear cut policies for referrals, and a lack of efforts to institutionalise the training cell, among others have been surfacing as on-going challenges. The Dilaasa experience highlights governance issues in institutionalising the issue of DV within a public health institution.