Violence against Women as a Health Care Issue

2018 ◽  
pp. 286-302
Author(s):  
Sangeeta Rege ◽  
Padma Bhate-Deosthali
Keyword(s):  
Health Care ◽  
Violence Against Women ◽  
Health Professionals ◽  
Health Facilities ◽  
International Treaties ◽  
Health Consequences ◽  
Care Issue ◽  
The Government ◽  
Forms Of Violence ◽  
Care Response

Women often approach health facilities to seek treatment for health consequences emerging out of violence. Health facilities are also mandated by several laws in India to play a therapeutic and forensic role in responding to women facing violence. Despite India being a signatory to international treaties, health professionals are unable to respond to violence owing to their own biases and misconceptions related to the issue. The chapter discusses the prevalence of violence against women, the resultant health consequences, and perceptions of health professionals towards this violence. While doing so the chapter raises concerns about the lack of institutionalised health care response and draws attention to the policy gaps that keeps the government from committing itself to ending all forms of violence against women.

scholarly journals Barriers to disclosure of violence against women in health services in Palestine:  qualitative interview-based study

2020 ◽  
Author(s):  
maggie evans ◽  
Amira Shaheen ◽  
gene feder ◽  
loraine bacchus ◽  
manuela colombini ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Violence Against Women ◽  
Health Professionals ◽  
Care Service ◽  
Health Care Service ◽  
Global Public Health ◽  
Public Health Response ◽  
Palestinian Women ◽  
Lack Of Knowledge

Abstract Background Violence against women (VAW) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the globe, barriers to disclosure of VAW have been recorded, including self-blame, fear of the consequences and lack of knowledge of services. This is the first qualitative study to address barriers to disclosure within health services for Palestinian women. Methods In-depth interviews were carried out with 20 women who had experienced violence from their husbands. They were recruited from a non-governmental organisation offering social and legal support. Interviews were recorded, transcribed and translated into English and the data were analysed thematically. Results Women encountered barriers at individual, health care service and societal levels. Lack of knowledge of available services, concern about the health care primary focus on physical issues, lack of privacy in health consultations, lack of trust in confidentiality, fear of being labelled ‘mentally ill’ and losing access to their children were all highlighted. Women wished for health professionals to take the initiative in enquiring about VAW. Wider issues concerned women’s social and economic dependency on their husbands which led to fears about transgressing social and cultural norms by speaking out. Women feared being blamed and ostracised by family members and others, or experiencing an escalation of violence. Conclusions Palestinian women’s agency to be proactive in help-seeking for VAW is clearly limited. Our findings can inform training of health professionals in Palestine to address these barriers, to increase awareness of the link between VAW and many common presentations such as depression, to ask sensitively about VAW in private, reassure women about confidentiality, and increase awareness among women of the role that health services can play in VAW.

scholarly journals SKILLINGEN, BRODEREN OG TABLETTEN: Penge og sundhed i det østlige Uganda

2004 ◽  
Author(s):  
Hanne O. Mogensen
Keyword(s):  
Health Care ◽  
Everyday Life ◽  
Health Care System ◽  
Health Care Providers ◽  
Social Relations ◽  
Health Facilities ◽  
Care Providers ◽  
The Public ◽  
Government Health ◽  
The Government

Complaints about fees at the government health facilities in Uganda are incessant, and so are the more general statements about lack of money and problems of poverty. These complaints, however, cannot be reduced to questions of cost and the availability of resources. We also need to look at the kinds of exchanges money is made part of. Health has long been part of the economic sphere in Uganda, and people compensate healers and practitioners of different kinds for their services. The article explores why, then, people experience it as far more problematic to pay for treatment in the public health care system than to pay other health care providers. To answer this question requires a discussion of money, not as destructive to social relations, but as creative potential for relationships in all spheres of everyday life. In Uganda, as elsewhere, money can be used both to pay somebody and to give somebody something. Money is being made part of different modalities of exchange. In order to understand what takes place in various kinds of clinical interaction we need to look at the complex intersection of social relations, modalities of exchange, and the objects exchanged.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

scholarly journals Handling medical negligence: necessity of a proper system

2017 ◽  
Vol 13 (4) ◽  
pp. 370-371
Author(s):  
Nuwadatta Subedi
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Consumer Protection ◽  
Health Professionals ◽  
Medical Service ◽  
Standard Of Care ◽  
Legal Issue ◽  
Medical Negligence ◽  
Care Providers ◽  
The Government

The issue of medical negligence has been catching attention of many people nowadays. With advancement of technology in medical field, many incurable diseases of past time can now be managed well at the cost of burdening expenditure. This   has resulted in obvious expectations to the patient and their families that any ailment can be cured from the medical procedures and therapies. When these expectations are not met in terms of complications or death of the near ones, people get frustrated and tend to allege health care providers against medically negligent.Negligence are of two types; civil negligence where the doctors are alleged to have lost simple degree of care and attention to the patients thereby causing damage whereas in criminal negligence, the doctors grossly deviate from the standard of care and competence or perform activities which are understood prima facie as a crime, for eg: performing criminal abortion, organ transplantation against the law etc.Whatever the type of negligence, there are legal measures to file complaint against the doctors who are alleged to have caused negligence. Gone are the days when people regarded doctors near to gods. Medical service also falls under the consumer protection act where the patients are the consumers and medical personnel, the service providers. The patients have rights to get quality medical service under this act. If the patients or their relatives are dissatisfied with the medical service rendered to them by the health care providers, they have the right to lodge complaint to the compensation committee of the district in which chief district officer (CDO) is the chairman in each district. If there is an issue of criminal negligence, the complaint can also be filed in the concerned court.In some circumstances, when the patient develops complications or dies, the attendants accuse the doctors for the failure in treatment and protest in the hospital premises rather than opting the legal way of charging them against negligence. The health professionals are at times threatened and forced to apologize in public. Most of the times, they demand for compensation and many direct benefits to the relatives of the deceased. The hospitals and the health professionals feel insecure and often they have agreed to the demands put forth to peacefully settle the issue and to get prevented from defamation. The government is also unable to provide security. Similar cases have been reported time and again in Nepal, creating a sense of lawlessness in the country.When deciding whether a doctor is held liable for negligence, the “standard of care” should be analysed. It means the practice should be an accepted one and standard, such that doctor of the similar filed and competence would have also opted the same procedure in given circumstances. Even when a doctor has duly acted opting standard procedure, still there can be chances that a patient can develop complications. Every human body cannot react exactly same to a medical intervention though that may be a scientifically proven one as there can be chances of medical misadventure. The doctors should have possessed reasonable degree of care and skill when he is attending the patient. According to Bolam’s test, a person is said to have inappropriate standard, and becomes negligent, if it is proven that he had failed to do what a reasonable person would do in the circumstances.1 The degree of care and skill should be comparable to an average doctor in similar settings. In order to analyse these issues, expert opinion from reputable and unbiased experts of the similar field of medicine should be taken. In case of death due to alleged medical negligence, the dead body should be autopsied by qualified experts in Forensic Medicine. This can explain so many facts about the deceased which can be helpful to decide whether negligence has factually taken. It highlights the need of taking opinion from the experts of the concerned field by the councils framed to settle the cases of medical negligence, especially the consumer protection council, Nepal Medical Council, etc.It is a high time for the government to play role to address to this sensitive and quai-legal issue. If this trend is not ended, the trust of patients towards the doctors may nullify. The doctors also cannot work effectively when there is no safe working environment and may begin to have tendency to abandon handling critical cases with a fear of vulnerability to defamation if not physical assault in worst case. The situation is ultimately disastrous to the entire health care system. The very sensitive issue of health care delivery cannot be compared to any other commercial issues. The proper mechanism of addressing the issue of medical negligence should be practiced alongside encouragement from governmental urge to come up with better medicolegal systems in this regard. This is highly essential for balancing expectations of the patients and performance of medical professionals.

Competition, Organizational Change, and Conflict: The Changing Role of Case Managers in Ontario’s Homecare System

2007 ◽  
Vol 8 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Glen E. Randall
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Case Manager ◽  
Case Managers ◽  
Managed Competition ◽  
Competitive System ◽  
Care Access ◽  
The Government

As health care costs climb, governments continue to seek ways of controlling expenditures and improving accountability. One approach recently used by the government of Ontario to reform the delivery of homecare services focused on the introduction of competitive market forces in conjunction with the establishment of greater managerial controls over the activities of frontline health professionals. The purpose of this article is to assess how this “managed competition” model impacted the role of homecare case managers and their relationships with frontline health professionals. Data for this case study were obtained primarily through 36 in-depth key informant interviews with representatives from homecare provider agencies and the community care access centers (CCACs), which contract with the provider agencies for client services. The managed competition reform dramatically altered the role of homecare case managers by requiring them to take on greater responsibility for monitoring budgets and rationing services. This shift from a collaborative to a competitive system promoted conflict between case managers and other health care professionals. In the presence of an increasingly bureaucratized case manager role, interprofessional conflict and a focus on cost containment seems to have left clients without any clear advocate of their interests.

Violence Against Women in South Africa

2012 ◽  
Vol 18 (5) ◽  
pp. 580-594 ◽  
Author(s):  
Ramadimetja S. Mogale ◽  
Kathy Kovacs Burns ◽  
Solina Richter
Keyword(s):  
South Africa ◽  
Domestic Violence ◽  
Human Rights ◽  
Violence Against Women ◽  
Criminal Law ◽  
Sexual Offense ◽  
The Government ◽  
Forms Of Violence

Violence against women (VAW) in South Africa remains rampant, irrespective of human rights– focused laws passed by the government. This article reflects on the position of two acts: the Domestic Violence Act No 116 of 1998 and Criminal Law (Sexual Offense and Related Matters) Act No 32 of 2007. Both are framed to protect women against all forms of violence. The article discusses the prisms of the two laws, an account of the position taken or interpreted by the reviewed literature regarding the acts, and the findings and recommendations regarding the infrastructure and supports needed to appropriately implement the two acts.

scholarly journals Return Service Agreement in the Context of the Universal Health Care Act: Using International and Local Experiences to Guide Application of the RSA

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Theo Prudencio Juhani Z. Capeding ◽  
Ma-Ann M. Zarsuelo ◽  
Michael Antonio F. Mendoza ◽  
Leonardo R. Estacio Jr. ◽  
Ma. Esmeralda C. Silva
Keyword(s):  
Health Care ◽  
Health Workforce ◽  
Health Professionals ◽  
System Level ◽  
Universal Health Care ◽  
Policy Reforms ◽  
Local Literature ◽  
The Government ◽  
Service Agreement ◽  
Universal Health

Background. Philippines is in a constant struggle to address shortage and maldistribution of health professionals, affecting equity in service delivery. The government endeavors to generate adequate supply of health workforce through scholarship and training programs which have been further expanded with the enactment of the Universal Health Care (UHC) Act. This article aimed to give a background for discussion on the application of return service agreement (RSA) provisions in the light of attaining universal health care. Methods. A modified systematic review of literature was conducted guided by the key issues determined by the Department of Health with focus on the extent of scholarship grants and on number of recipients. Results. The Philippine government enacted policy reforms through implementing RSA in response to the progressive decline of the net flow of health professionals. However, the criticisms lie in that RSA is not a long-term solution. With the RSA provisions in the UHC Law, metrics on determining the under-produced and maldistributed professional cadre must be created. These should be responsive in addressing facility-level and health system-level gaps. Conclusion and Recommendation. Paucity of current local literature impedes attaining a conclusive body of evidence, therefore, further research is needed. Operationalization of RSA should not be viewed as a singular means to solve the health workforce gaps, but as part of holistic assessment, taking into consideration epidemiological, geographical, political, and social determinants. Stakeholders must ingress in collaborative intersectoral policy actions to warrant bottom-up support. Activities related to mapping, monitoring, and incentivizing medical and health-related professionals must be established to support a system conducive for workforce retention.

scholarly journals Perceived militating factors to the practice of preventive measures for COVID-19 pandemic among health professionals in public health facilities of southern Ethiopia: a phenomenological study

2020 ◽  
Author(s):  
Abera Mersha ◽  
Shitaye Shibiru ◽  
Meseret Girma ◽  
Gistane Ayele ◽  
Agegnehu Bante ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Phenomenological Study ◽  
Preventive Measures ◽  
Health Facilities ◽  
Southern Ethiopia ◽  
Key Informants ◽  
Care System

Abstract Background: Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored militating factors that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting.Methods: A semi-structured interview guide used to conduct this phenomenological study among 16 key informants. Key informants recruited by the purposive sampling method. The data analyzed inductively by using a thematic content analysis approach in NVivo 12 Pro software. Results: In this study, six main themes identified with the sub-themes. Overview of COVID-19 pandemic, consequences (with the two sub-theme), perceived practice (with four sub-theme), perceived militating factors (with four sub-theme), newfangled activities (with three sub-theme), and suggestion for improvement (with seven sub-theme) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. Conclusions: Conclusions: This study showed that there were gaps in the practice of preventive measures for the COVID-19 among health professionals in the health care system. Community influences, health care provider related factors, institutional factors, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care professionals must recognize, and credit should consider.

Domestic Violence again Women in Sri Lanka: The Role of Primary Health Care in Complementing Human Rights and Legal Responses

2007 ◽  
Vol 13 (1) ◽  
pp. 52 ◽  
Author(s):  
Loshan N Moonesinghe ◽  
Simon Barraclough
Keyword(s):  
Health Care ◽  
Domestic Violence ◽  
Human Rights ◽  
Primary Health Care ◽  
Sri Lanka ◽  
Violence Against Women ◽  
Service Providers ◽  
Legal Rights ◽  
Primary Health ◽  
The Government

Using an analysis of primary documents and secondary sources, the problem of domestic violence against women in Sri Lanka is surveyed from the perspectives of public health, as well as human and legal rights. The limited Sri Lankan literature on the measurements, context and prevalence of such violence, as well as legislation for its prevention, is reviewed. Responses to the problem by the government and non-government organisations are described. These include using international organisations, forums and conventions to further the human rights dimensions of the problem, the establishment of support services and domestic legal reforms to accord greater protection to women. While The Prevention of Domestic Violence Act 2005 gave legislative recognition to the problem and put into place some welcome reforms, it lacked a comprehensive response to the problem. It is argued that health service providers need to be trained to be aware of domestic violence as the potential cause of physical injuries and mental conditions and that the medical record should document the circumstances and nature of domestic violence. Hospital outpatient departments should offer counselling, referrals to crisis centres and shelters, and should collect sex disaggregated data on domestic assaults. Finally, primary health care workers can both support women in dealing with domestic violence as well as performing a sentinel role in prevention. Specific and comprehensive public policy on violence against women must be developed to allow the health sector to play its role within a context of inter-sectoral collaboration.

scholarly journals The impact of international treaties on the shape of national criminal law on the basis of Article 48 1 of the Istanbul Convention

2019 ◽  
Vol 52 ◽  
pp. 37-54
Author(s):  
Dominika Bek ◽  
Olga Sitarz
Keyword(s):  
Domestic Violence ◽  
Violence Against Women ◽  
Criminal Law ◽  
Alternative Dispute Resolution ◽  
International Treaties ◽  
Council Of Europe ◽  
Resolution Processes ◽  
Forms Of Violence ◽  
The Impact ◽  
Istanbul Convention

The Council of Europe Convention on preventing and combating violence against women and domestic violence has been ratified by 29 countries, including Poland. Among other things, pursuant to art. 48, Parties shall take the necessary legislative or other measures to prohibit mandatory alternative dispute resolution processes, including mediation and conciliation, in relation to all forms of violence covered by the scope of this Convention. It is regulation that will provide a clear illustration of the reasons which render the implementation difficult or even impossible. Considerations set out in this paper will focus on three basic aspects — the ambiguity of the wording of art. 48 1, discrepancy between the legal text and its official substantiation, as well as the commanding and peremptory tone of its language.

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