Gendering Healthcare: Situational Analysis of Clinical Practices in Five Medical Colleges of Maharashtra, India

Since 2015, the Centre for Enquiry into Health and Allied Themes (CEHAT) has been committed to integrating gender concepts into medical education by training educators to recognize gender’s impact on health. This includes addressing gender sensitivity in clinical rotations, a crucial aspect of medical education, and healthcare delivery, particularly in teaching hospitals, the tertiary level of public health services in India. To facilitate these changes, a comprehensive assessment of medical practices is essential from an intersectional feminist perspective. To address this, a qualitative study was conducted in collaboration with CEHAT’s Gender in Medical Education project across five government medical colleges in Maharashtra. Interviews with 25 faculty members from various departments were conducted, including Obstetrics and Gynecology, Community Medicine, General Medicine, Psychiatry, and Forensic Medicine and Toxicology. Thematic analysis was performed to document existing clinical practices. The study aimed to apply a gender perspective to assess public teaching hospitals in Maharashtra, focusing on three key aspects: Comprehension of sex and gender: Providers had limited understanding of sex and gender beyond binary concepts, with minimal interaction with sexual and gender diverse individuals, revealing their invisibility within the public health system. Female bodily autonomy and gender stereotyping: Provider attitudes regarding bodily autonomy and gender stereotypes were noticeable in sexual and reproductive health (SRH) services, influencing their administration. Gender-based violence: Providers exhibited inaction in identifying signs of violence, both within facilities and the community, with no established protocols for effective psychosocial support to survivors. The findings highlighted that healthcare practices often prioritize healthcare providers’ convenience over patient needs, resulting in privacy violations and disregarding consent and choice in medical procedures. These practices are perpetuated from teachers to interns and residents, persisting within health systems. To drive gender-transformative changes, a stronger emphasis on gender perspectives is crucial in healthcare practices, not only in medical education institutions but also across the broader public health delivery system.