Publications

Poster Presented

2010

Understanding Violence faced by Women Health Workers: A Need to Develop Hospital Based Response

Rege, Sangeeta; Padma Deosthali
Published Year: 2010

Poster Presented in Second International Conference on Violence in the Health Sector: From awareness to sustainable action, 27 – 29 October 2010, Amsterdam, the Netherlands.


Mapping of Urban Health Facilities in the Evolving City of Aurangabad, Maharashtra, India

Dantas, Anandi
Published Year: 2010

Poster Presentation in First Global Symposium on Health Systems Research, 16-19 November 2010 - Montreux Switzerland.

Abstract: Maharashtra is the second most urbanized state in India. It had an urban population comprising 42.4 percent of the total state population in 2001. Between 1991-2001 population growth rate of cities at the second tier level was faster than for the top level cities of Mumbai and Pune. The objective of the research was to examine if the growth in health facilities within the city has kept pace with growth of population. The methodology used was geographic information, using secondary data. The changes in growth are shown through a series of maps. Aurangabad is the sixth largest city in Maharashtra outside the Mumbai-Pune urban agglomerations. Population of Aurangabad grew by 52.34% between1991-2001. An analysis of geographical locations and growth of public and registered private hospitals from 1991 to 2010 found that the ratio of health facility to population have improved through the years. Ratios for hospitals to population in Aurangabad was 1: 4646 in 2001, public facilities being 1: 2,18,328 and registered private hospitals 1: 4746. Three areas of concentration of registered private hospitals were found at the intra-city level. The concentrations were market induced and their locations were also affected by geographical accessibility criterion. There has been a clustering of public and private health facilities near the city centre the last twenty years. Less geographical access to both public and private health facilities were found for the population of the peripheral areas of the city. The urban rich were found to have been served better than the urban poor in Aurangabad as most of private hospitals were found to be concentrated in or close to higher income residences. The study has highlighted the need for an urban norm for location of Urban Health Post which primarily serve the urban poor and a gaping need for a geographic norm for location of private hospitals for the country.


Engaging the Private Health Sector for Universal Access : Issues of Concern.

Padma Deosthali; Ritu Khatri
Published Year: 2010

Poster Presentation in First Global Symposium on Health Systems Research, 16-19 November 2010 - Montreux Switzerland.

Abstract: The objective was to understand the quality of care in private health sector in India. The is based on interviews with owners of private hospitals on human resources, standards of care and their perceptions of the existing law. The sample was drawn from 11 districts of the state based on level of development with 261 hospitals selected. The findings indicate phenomenal growth of private hospitals in the state, predominance of allopathic doctors, multiple practices of doctors, lack of qualified resident medical doctors. The ratio of qualified nurses was 1:1.6 in these hospitals which is miserable and raises several doubts about the quality of care available. The standards of care in terms of provision of emergency care, maintenance of records, respecting patient’s rights, compliance to universal guidelines on HIV/ AIDS was found to be poor. While most were registered under the law, it was mere paper work as they did not comply to even minimum requirements under the law that seeks to regulate these hospitals. However the compliance to other laws was found to be high. The study concludes that there is a need to evolve standards of care for private hospitals that are less than 30 bedded and ensure better monitoring of the these hospitals. Need for bringing various laws governing private sector to be brought under one umbrella for greater efficiency and compliance, review of situation of shortage of nursing staff in the state so that corrective measures can be made. This is essential in the context of the National health Bill that seeks to establish health as a right. This would require that the private sector be brought under a common system that ensures universal access to health care but this can be done only if it is regulated and conforms to minimum standards.


Implementing a Comprehensive Health Sector Response to Sexual Assault.

Rege, Sangeeta; Sana Contractor
Published Year: 2010

Poster Presentation in First Global Symposium on Health Systems Research, 16-19 November 2010 - Montreux Switzerland.

Abstract: Sexual Violence is an important Public Health issue for various reasons. Not only does such violence impact the health of those affected by it, but there is also a very crucial role that the health system has in providing treatment to survivors. Health professionals are in a unique position to provide treatment to survivors of violence as well as document and collect forensic evidence that can help a survivor prove her case in a court of law. Despite its importance, this role of Health Systems in such cases is a neglected one. In an effort to address the lack of systematic protocols for examination and evidence collection, we implemented a Sexual Assault Forensic Evidence kit (SAFE kit) in two public hospitals in the city of Mumbai, India. The pilot implementation of this kit highlighted several problems with the response of the health system to cases of sexual assault, in addition to improper forensic examination and evidence collection. Based on the findings of this pilot implementation, we designed a comprehensive health sector response to sexual assault which goes beyond the medico-legal role of health professionals and addresses several other issues which hinder provision of care to survivors. This paper will discuss the components of this model response and the manner of its implementation. These include laying down standard operating procedures in the hospital for management of cases of sexual assault, implementing protocols for seeking consent, documenting history, injuries and collecting evidence, maintaining a fool-proof chain of custody, building capacity of health care providers in understanding the issue of sexual violence and their role, and providing guidelines for medical treatment and provision of psychological support to cases of sexual assault including referrals to relevant departments and external agencies. We conclude that any effort by health systems to address sexual assault must take into account all of these components in order to fulfill its role.


Marathi and Hindi Publications