ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By Mathew George

Hysterectomy as a ‘Magic Bullet’ for Gynaecological Morbidities

The increasing prevalence of hysterectomies among young women in various states of India over the past decade has raised significant concerns. The study on hysterectomy among rural women from weaker socio-economic backgrounds in a district in Maharashtra examines the factors that shape the choice of healthcare facilities. Existing studies and news reports indicate that among the various stakeholders, private practitioners unnecessarily prescribe hysterectomy for monetary interests.

Trust in Public Health Practice

Two instances of trust deficit during the COVID-19 pandemic reveal that trust-building is a process based on past experiences of people, built through engagement with institutions and service providers over a longer period. First, it is in the context of accessing treatment in the midst of inadequate access to healthcare, and second, about vaccine hesitancy. There is a need to acknowledge the role of public trust for effective public health practice, especially when the science behind the programme is intellectually arduous for the common public.

The Fragmentation and Weakening of Institutions of Primary Healthcare

Originally envisioned to offer preventive, promotive, curative and rehabilitative services as per the needs of people at affordable costs, the health services in India are currently grappling with varied forms of fragmentation, at the macro-level institutions as well as at the level of primary healthcare. To arrest this crisis, it is necessary to revive referral services needed for primary-level curative care, by focusing on strengthening community health centres and developing a strong public health workforce at the grassroots level. The only way forward is to strengthen institutions of primary healthcare by effectively balancing people’s public health with their curative care needs.

AYUSH and Health Services

Maharashtra’s policies for AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) professionals are discriminatory, allowing them to engage in “mixed practice” and recruiting them either as paramedics or as administrators in the general health services system, without ensuring equal status with their allopathic counterparts. It is in this context that the nature of engagement of AYUSH professionals with the state health system is examined.

How Not to Modernise Alternative Medicine Systems

The implications of the Maharashtra government's permission to homeopathic practitioners to prescribe allopathic drugs are manifold. This form of "modernisation" not only threatens the identity of the alternative systems but also hampers their most important characteristic, namely, healing, which has helped most of the medical systems to stand the test of time.

Healthcare through Community Participation

This study of the operation of the Accredited Social Health Activist programme of the National Rural Health Mission in one of the tribal blocks of Thane district in Maharashtra fi nds that incentives given to ASHAs generate a bias in their work activities and shift the attention of these community health workers from the community to the health services system. Moreover, the poor socio-economic background of ASHAs makes them depend on the incentives offered since this is their main source of income. Additionally, due to the excessive focus of ASHAs on curative care, the community considers them more an extended arm of the health service system, not as change agents as envisaged in the programme.