This paper covers a review of studies on health services conducted in India in the last decade through a gender lens. Here, we have tried to see the interplay of gender and social position in accessibility, acceptability, cost and effectiveness of health services for reproductive health concerns of women and men. It can be seen that since the mid-1980s health research has undergone a major shift as it went beyond the con ventional framework to understand linkages between the health care service system, and the socio-economic and cultural factors vis-à-vis access and utilisation, and in turn the health status of people. This was an important paradigm shift from under standing people's health status in terms of medical determinants alone to under standing it in terms of sociocultural determinants. The paper brings into light that in general health services research has not been sensitive to the specific health services need of women. It concludes with a series of unexplored issues in this regard, which could help undertake meaningful research that is informed by a gender and social perspective.
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References
1.
Bahl, S.K. and P.I. Trakroo (1996). An assessment of family welfare communication activities at the primary health centre level. The Journal of Family Welfare, 42(4), 39-44.
2.
Baru, R.V. (1993). Inter-regional variations in health services in Andhra Pradesh. Economic and Political Weekly, 28(20), 963-67.
3.
Baru, R. (1994): The rise of business in medical care. Health for the Millions, 2(1), 19-21.
4.
Benara, S.K. and S.K. Chaturvedi (1990). Impact of training on the performance of traditional birth attendants. The Journal of Family Welfare, 58, 32-35.
5.
Bennett, S. and V.R. Muraleedharan (2000). New public management and health care in third world. Economic and Political Weekly , 35(1&2), 59-67.
6.
Bose, R. and M. Prakasamma (1998). Midwifery in India: Past present and future. Indian Journal ofNursing and Midwifery, 1(3), 5-12.
7.
Celcy, M. (1998). The extent of information provided by health personnel to parturient mothers during their stay in the labour room. Indian Journal ofNursing and Midwifery, 1(3), 35-39.
8.
Chattopadhyay, M. (1996). Endangered professionals: Traditional birth attendants of south Bihar. Economic and Political Weekly, 31(1), 1831-32.
9.
Chhabra, S., K. Aher and U.N. Jajoo (1990). Paramedics in rural obstetric care. Journal of Obstetrics and Gynaecology of India, pp. 457-60.
10.
Chhabra, S. and S. Saraf (1997). Reproductive health care seekers' reasons for admission to tertiary level health care facility in rural central India. Health and Population: Perspective and Issues, 29(2), 80-88.
11.
Chirmulay, D. (1997). Factors affecting health seeking and utilization of curative health care. Draft Report, BAIF Development Research Foundation, Pune.
12.
deGraft-Johnson, J., A.O. Tsui, B. Buckner, K.K. Singh, I. Bou-Saada, C. Fowler, C. Viadro, J. Beamish and M. Khan (1997). Uttar Pradesh male reproductive health survey 1995-96. Report of the EVALUATION Project, USAID.
13.
Duggal, R. and S. Amin (1989). Cost of health care: A household survey in an Indian district. The Foundation for Research in Community Health, Mumbai.
14.
Duggal, R., S. Nandraj and A. Vadair (1995). Health expenditure across states: Part I & II. Economic and Political Weekly, 30(15&16), 834-44 and 901-8.
15.
Foo, G.H.C. (1995). A synthesis of research findings on quality of services in the Indian family welfare programme. Proceedings from the national workshop on Operations Research for Improving Quality of Services, sponsored by The Ford Foundation, USAID, The Population Council, Bangalore, Karnataka, 24-26 May.
16.
Gangopadhyay, B. and D.N. Das (1997). Quality of family planning services in India: The user's perspective. The Journal of Family Welfare, 43(3), 5-12.
17.
Ganatra, B.R., S.S. Hirve, S. Walawalkar, L. Garda and V.N. Rao (1998). Induced abortions in a rural community in western Maharashtra: Prevalence and patterns. Ford Foundation Working Paper.
18.
George, A. and S. Nandraj (1993). State of health care in Maharashtra: A comparative analysis. Economic and Political Weekly, 28(32&33), 1671-77 and 1680-83.
19.
George, A., I. Shah and S. Nandraj (1994). A study of household health expenditure in Madhya Pradesh. The Foundation for Research in Community Health , Mumbai.
20.
Gulani, K.K. (1998). Integration of primary health care concepts in GNM curriculum. Indian Journal ofNursing and Midwifery, 1(1), 23-26.
21.
Gupte, M., S. Bandewar and H. Pisal (1995). Women's perspectives on the quality of general and reproductive health care: Evidence from rural Maharashtra. In M.A. Koeing and M.E. Khan (eds.), Improving Quality of Care in India's Family Welfare Programme: The Challenge Ahead (pp. 117-39). New York: Population Council.
22.
Health Watch Trust (1999). The community needs-based reproductive and child health in India: Progress and constraints. Jaipur.
23.
Hitesh, J. (1996). Perceptions and constraints of pregnancy related referrals in rural Rajasthan. The Journal of Family Welfare , 42(1), 24-29.
24.
Indian Council of Medical Research (ICMR) ( 1991). Evaluation of quality of family welfare services at primary health centre level. ICMR task force study, New Delhi.
25.
Iyer, A., A. Jesani, A. Fernandes and S. Khanvilkar (1995): Women in health care: Auxiliary nurse midwives . The Foundation for Research in Community Health, Mumbai/Pune.
26.
Jejeebhoy, S. (1996). Adolescent sexual and reproductive behavior: A review of the evidence from India. ICRW Working Paper, No. 3, International Centre for Research on Women , Washington, DC.
27.
Jesani, A. and S. Anantharam (1993). Private sector and privatisation in the health care services, review paper for the ICSSR-ICMR Joint Panel on Health, Foundations for Research in Community Health, Mumbai , August 1990.
28.
Kambo, I.P., R.N. Gupta, A.S. Kundu, B.S. Dhillon, H.M. Saxena and B.N. Saxena (1994). Use of traditional medical practitioners to deliver family planning services in Uttar Pradesh. Studies in Family Planning, 25(1), 32-40.
29.
Kannan, K.P., K.R. Thankappan, V.R. Kutty and K.P. Aravindan (1991). Health and development in rural Kerala. Report, Kerala Sastra Sahitya Parishad, Thiruvananthapuram.
30.
Khale, M. and A. Dayalchand (1991). Alternative approaches for delivery of family planning, maternal and child health services. Indian Pediatrics , 28(December), 1465-67.
31.
Khan, A.G., N. Roy and S. Surender (1997). Utilization of reproductive health services in rural Maharashtra. The Journal of Family Welfare, 43(1), 37-44.
32.
Khandekar, J., S. Dwivedi, M. Bhattacharya, G. Singh, P.L. Joshi and B. Raj (1993). Childbirth practices among women in slum areas . The Journal of Family Welfare, 39(September), 13-17.
33.
Levine, R.E., H.E. Cross, S. Chhabra and H. Viswanathan (1992). Quality of health and family planning services in rural Uttar Pradesh: The client's view. Demography India , 21(2), 247-65.
34.
Madhiwalla, N., S. Nandraj and R. Sinha (2000). Health, households and women's lives: A study of illness and childbearing among women in Nasik district. Centre for Enquiry into Health and Allied Themes, Mumbai.
35.
Mishra, R. (1997). Female health workers: Problems and implications . Economic and Political Weekly, 32(4), 2791-93.
36.
Nanda, P. and R. Baru (1994). Private nursing homes and their utilisation: A case study of Delhi. Health for the Millions, 2(1), 6-9.
37.
Nandraj, S. and R. Duggal (1996). Physical standards in the private health sector . Radical Journal of Health (New Series), 2(2/3), 141-83.
38.
Nandraj, S., N. Madhiwalla, R. Sinha and A. Jesani (1998). Women and health care in Mumbai: A study of morbidity, utilisation and expenditure on health care in the households of the metropolis . Centre for Enquiry into Health and Allied Themes, Mumbai.
39.
Narayana, M.R. (1995). Programme inputs and performance of the family planning programme: Evidence from a comparative study of PHCs. The Journal of Family Welfare, 41(2), 14-24.
40.
National Council for Applied Economic Research (NCAER) (1992). Household survey of medical care. NCAER, New Delhi.
41.
National Sample Survey Organisation (NSSO) ( 1992) NSS 42nd Round (1986-87). Government of India, Department of Statistics, New Delhi.
42.
— (1998). NSS 52nd Round. Government of India, Department of Statistics, New Delhi.
43.
Pachauri, S. (1994). Relationship between AIDs and family planning programmes: A rationale for developing integrated reproductive health services . Health Transition Review, 4(supplement), 321-47.
44.
Prakasamma, M. (1998). Implementing the RCH programme: Challenges before nurses. Indian Journal ofNursing and Midwifery, 1(1), 27-30.
45.
Rajeshwari (1996). Gender bias in utilisation of health care facilities in rural Haryana. Economic and Political Weekly, 31(1), 489-94.
46.
Ram, K. ( 1994). Medical management and giving birth: Responses of coastal women in Tamil Nadu. Reproductive Health Matters , 4, 20-26.
47.
Ramachandran, V. and L. Visaria (1997). Emerging issues in reproductive health, Economic and Political Weekly, 32(3), 2244-47.
48.
Ramanathan, M., T.R. Dilip and S.S. Padmadas (1995). Quality of care in laparoscopic sterilisation camps: Observations from Kerala, India. Reproductive Health Matters, 3(6), 84-93.
49.
Ramanani, S. (1995). Household survey of health care and utilisation and expenditure. Working Paper No. 53, National Council for Applied Economic Research, New Delhi.
50.
Rao, K.S. (1998). Health care services in tribal areas of Andhra Pradesh: A public policy perspective. Economic and Political Weekly, 33(9), 481-86.
51.
Reddy, P.H. (undated). Quality of client-provider interaction and family welfare service in rural Karnataka. Draft report, Centre for Technology Development, Bangalore.
52.
Rohde, J. and H. Viswanathan (1994). The rural private practitioner. Health for the Millions, 2(1), 13-16.
53.
Roy Chowdhury, N.N. (1990). Mobilising traditional birth attendants for the safe motherhood. Journal of the Indian Medical Association , 88(8), 211-13. Sahachowdhury, S. (1998). Assessment of cost and quality of intranatal care provided by trained traditional birth attendants in the homes. Indian Journal of Nursing and Midwifery, 1(3), 41-47.
54.
Sharma, N., P. Bali, V.L. Bhargava and S. Garg (1990). An indepth study of the role of traditional birth attendants in providing intranatal care in an urban slum and villages of Delhi . Journal of Obstetrics and Gynaecology of India, 40(3), 617-22.
55.
Shatrugna, V. (1994). Women and health. Indian Journal of Social Science, 7(3), 307-17. Shrotri, A. and P.V. Bhatlavande (1994). Current status of trained dais. Journal of Obstetrics and Gynaecology of India, 44(3), 577-82.
56.
Singh, P. (1994). Women's health and population in India: An NGO perspective. Unpublished synthesis of reports of regional meetings of NGO's in the context of ICPD.
57.
Sokhi, S.S. (1998). Rural women take reproductive health matters into their own hands: Rural women's social education centre (RUWSEC). In Series on upscaling innovations in reproductive health in Asia, No. 1. Chengalpattu: International Council on Management of Population Programmes.
58.
Sridhar, S.S. (1998). Quality assurance in nursing. Indian Journal ofNursing and Midwifery, 1(2), 5-12.
59.
Subrahmanyam, V. (1997). Quality of care at community hospitals. Economic and Political Weekly, 32(3), 2320-21.
60.
Sukanya, S. (1996). Investment in medical equipment: Study of private hospitals in Madras city. Reproductive Journal of Health (New Series), 2(1), 9-25. Unnithan-Kumar, M. (1999). Households, kinship and access to reproductive health care among rural Muslim women in Jaipur. Economic and Political Weekly, 34(10&11), 621-29.
61.
Agarwal, K., J. Tandan, P. Srivastava and J.N.P. Gupta (1994). An assessment of delivery pattern of MCH services in urban varanasi. Indian Journal of Preventive and Social Medicine, 25(3&4), 146-51.
62.
Aggarwal, O.P., et al. (1997). Utilization of antenatal care services in periurban area of east Delhi. Indian Journal of Community Medicine, 22(1), 29-32.
63.
Anandalakshmy, P.N. and S. Mittal (1995). An innovative simplified MCH score for assessing the ideal babies in Well Baby Shows of postpartum outreach programme. Indian Journal of Maternal and Child Health, 6(2), 50-53.
64.
Baburajan, P.K. and R.K. Verma (1991). Job satisfaction among health and family welfare personnel: A case study of two primary health centres in Kerala. The Journal of Family Welfare, 36-37, 14-23.
65.
Bang, R. and A. Bang (1989). A community study of gynaecological disease in Indian villages. S. Zeidenstein and K. Moore (eds.), Learning about sexuality: A practical beginning (pp. 223-37). New York: The Population Council.
66.
Bansal, R. (1995). Interns as health educators. World Health Forum, 16, 164-66.
67.
Behera, R.C. and K. Padte (1991). Unwanted adolescent pregnancy: It's present status . Journal of Obstetric and Gynaecology, 41, 25-29.
68.
Bhalerao, A.R., S.V. Desai, N.A. Dastur and S.N. Daftary (1990). Outcome of teenage pregnancy. Journal of Postgraduate Medicine, 36(3), 136-39.
69.
Bhardwaj, N., S.B. Hasan and M. Zaheer (1995). Maternal care receptivity and its relation to perinatal and neonatal mortality. Indian Pediatrics, 32(April), 416-23.
70.
Bhardwaj, N., M. Yunus, S.B. Hasan and M. Zaheer (1990). Role of traditional birth attendants in maternal care services: A rural study. Indian Journal of Maternal and Child Health, 1(1), 29-30.
71.
Bhatia, J.C. and J. Cleland (1995). Self-reported symptoms of gynaecological morbidity and their treatment in south India. Studies in Family Planning , 26(4), 203-16.
72.
Bhattacharya, R. and J. Tandon (1991). Managerial gaps in the delivery of ante-natal care services in a rural area of Varanasi. Indian Journal of Public Health, 35(4), 113-16.
73.
Bhide, A.G. (1991). Caesarean section: How safe is it? Journal of Obstetrics and Gynaecology, pp. 330-33.
74.
Chhabra, S. (1991). Perinatal outcome in teen age mothers. Journal of Obstetrics and Gynaecology, 41(1), 30-32.
75.
Devi, D.R., S.R. Rastogi and R.D. Rutherford (undated). Eight million women have unmet need for family planning in Uttar Pradesh.
76.
Dubey, V., S. Prakash and A. Gupta (1998). Voices from the silent zone: Women's experiences of incest and childhood sexual abuse. Recovering and Healing from Incest (RAHI), New Delhi.
77.
Duggal, R. (date not available). Health care utilisation in India. Health for the Millions, pp. 10-12.
78.
Duraisamy, P. (1997). Morbidity in Tamil Nadu: Levels, differentials and determinants. Report based on the project Morbidity, Utilisation of and Expenditure on Medical Services in Tamil Nadu, sponsored by UNDP/GOI/IDRC .
79.
Ganatra, B.R., K.J. Coyaji and V.N. Rao (1998). Too far, too little, too late: A community based case control study on maternal mortality in rural west Maharashtra, India . Bulletin of the World Health Organisation, 76(6), 591-98.
80.
Gupta, R.B., A. Pulikkal and S. Kurup (1995). Unmet health needs and paying capacity of the community in Sidhpur area: A focus group based case study. The Journal of Family Welfare, 41(3), 10-17.
81.
Institute of Health Management, Pachod (1998 ). District IEC planning for reproductive & child health: Report 1—Social assessment. World Bank, June. Aurangabad.
82.
International Institute of Population Sciences (IIPS) (1995). National Family Health Survey (MCH and FP). In India: Summary Report 1992-93. Mumbai: IIPS. Iyer, A., A. Jesani and S. Karmarkar (1996). Patient satisfaction in the context of socio-economic background and basic hospital facilities . Draft report of a pilot study of indoor patients, Centre for Enquiry into Health and Allied Themes, Mumbai.
83.
Jejeebhoy, S. (1997). Addressing women's reproductive health needs: Priorities for the family welfare programme. Economic and Political Weekly, 32(9), 475-84.
84.
Joseph, G.A., S. Bhattacharji, A. Joseph and P.S.S. Rao (1997). General and reproductive health of adolescent girls in rural south India. Indian Pediatrics, 34(3), 242-45.
85.
Kanitkar, S. (1997). Abortions for family planning: Attitude of housewives of low income group towards abortion for family planning. Unpublished paper, Family Planning Association of India, Pune.
86.
Kartha, G.P., P. Kumar and C.K. Purohit (1993). A longitudinal study on some aspects of maternal and child health in an urban community of Ahmedabad. Indian Journal of Preventive and Social Medicine, 24(1), 15-19.
87.
Kavitha, N. and N. Audinarayana (1997). Utilisation and determinants of selected MCH care services in rural areas of Tamil Nadu. Health and Population: Perspective and Issues, 20(3), 112-25.
88.
Khan, M.E., S. Rajagopal, S. Barge and N. Kumar (1998). Situation analysis of medical termination of pregnancy (MTP) services in Gujarat, Maharashtra, Tamil Nadu and Uttar Pradesh. Working paper, Centre for Operations Research and Training, Baroda.
89.
Khanna, R. (1997). Dilemmas and conflicts in clinical research on women's reproductive health. Reproductive Health Matters, 5(9), 168-73.
90.
Korah, L. (1998). Truth, virtue and beauty of midwifery. Indian Journal ofNursing and Midwifery, 1(3), 15-19.
91.
Kulkarni, S. and S. Parasuraman (1997). Status of maternal and child health in Maharashtra . Paper presented at a Workshop on Child Health and Family Planning Policy Issues in Maharashtra, organised by Directorate of Health Services, Government of Maharashtra, Centre for Health Policy and Promotion, Pune, and Institute of Health Management, Pachod, in Pune, 13-15 May.
92.
Kumar, R. (1993). Streamlined records benefit maternal and child health care. World Health Forum, 14, 305-7.
93.
Kumar, V.K. and J. Singh (1991). Assessment of community attitude regarding the services of primary health centre: A medical geographic study. Indian Journal of Preventive and Social Medicine, 35(3&4), 118-26.
94.
Lal, S., P. Khanna, B.M. Singh Vashisht and S. Satpathy (1994). Situational analysis of preparedness of mahila swasthya sangh for health and family welfare activities. Indian Journal of Preventive and Social Medicine, 25(3&4), 101-9.
95.
Meerah, R. (1998). The effectiveness of a planned teaching programme based on the learning needs of traditional birth attendants regarding prevention and control of AIDS. Indian Journal ofNursing and Midwifery , 1(1), 51-56.
96.
Mondal, A.M.D. (1998). Induced abortions in rural society and need for people's awareness. Journal of Obstetrics and Gynaecology , 41, 450-51.
97.
Mondal, A. (1992). Non-use unsatisfactory use and satisfactory use of contraceptives (a rural study). Journal of Obstetrics and Gynaecology, pp. 678-82.
98.
Mukherjee, S. (1991). Family welfare programme in India with special reference to NGO's collaboration. Health and Population: Perspectives and Issues, 14(3&4), 109-17.
99.
Mukherji, R. (undated). MTP programme in Uttar Pradesh. Unpublished paper, Directorate of Family Welfare, Uttar Pradesh.
100.
Muthurayappa, R. (1998). Indigenous health care system in Karnataka: An exploratory study. Radical Journal of Health (New Series), 3(3), 187-201.
101.
Noronha, J. (1998). Teaching primigravid women about warning signs in pregnancy using a specially designed information booklet. Indian Journal ofNursing and Midwifery, 1(3), 27-34.
102.
Oumachigui, A., A. Bhupathy, P. Rajaram and G. Ramalingam (1989). Competency based curriculum in the primary prevention of obstructed labour. Journal of Obstetrics and Gynaecology of India, 40, 191-95.
103.
Parikh, I., V. Taskar, N. Dharap and V. Mulgaonkar (undated). Gynaecological morbidity among women in a Bombay slum. Draft report, Streehitakarini, Mumbai.
104.
Patel, D., A. Patel and A. Mehta (undated). The effects of quality of service upon IUD continuation among women in rural Gujarat. Draft report, Action Research in Community Health (ARCH), Gujarat.
105.
Pavithran, S. (1998). The effectiveness of incentive spirometry and deep breathing exercises in improving pulmonary function. Indian Journal ofNursing and Midwifery, 1(1), 57-60.
106.
Purohit, B.C. and T.A. Siddiqui (1993). Post-partum programme in India: Some financial issues in Rajasthan (sub-district level). The Journal of Family Welfare, 39(4), 9-15.
107.
Qadeer, I. (1998). Reproductive health: A public health perspective . Economic and Political Weekly, 33(41), 2675-84.
108.
Rajaratnam, T. and R.V. Deshpande (1994). Factors inhibiting the use of reversible contraceptive methods in rural south India. Studies in Family Planning, 25(2), 111-21.
109.
Rao, M. ( 1997). Myths of reproductive profligacy of poor: Evidence from Mandya district, Economic and Political Weekly, 32(2), 1447-49.
110.
Razia, R. (1998). Report of an assessment on how staff nurses evaluated the clinical nursing inservice training imparted to them at four training centres in the state of Andhra Pradesh under World Bank project. Indian Journal ofNursing and Midwifery, 1(3), 61-65.
111.
Salunke, S.R., S. Mohamed, S.K. Hira and M.R. Jagtap (1998). HIV/AIDS in India: Country responds to a challenge . AIDS Supplementary, 12(Supplement B), S27-32.
112.
Salvi, V., K.R. Damania, S.N. Daftary and D.N. Patel (1991). MTPs in Indian adolescents. Journal of Obstetrics and Gynaecology, pp. 33-36.
113.
Sarbajana, S. (date not available). Intra-uterine device as a means of contraception in our population. Journal of Obstetrics and Gynaecology, pp. 510-13.
114.
Shariff, A. (1995). Health transition in India: Part I-Differentials and determinants of morbidity in India: Disaggregated analysis; Part II—Health scenario and public policy in India. Working paper no. 57, National Council of Applied Economic Research, New Delhi.
115.
Shatrugna, V., N. Soundarajan, P. Sundaraiah and L. Raman (1990). Backpain: The feminine affliction. Economic and Political Weekly, 25, WS 2-6.
116.
Singh, A. and A. Kaur (1993). Perceptions of traditional birth attendants regarding contraceptive methods. The Journal of Family Welfare, 39(1), 36-39.
117.
Sinha, R.K. and T. Kanitkar (1994). Acceptance of family planning and linkages with development variables: Evidence from an 80-village study in Orissa. The Journal of Family Welfare, 40(2), 18-26.
118.
Sood, A.K. and B.K. Nagla (1994). The extent and pattern of utilisation of health services by rural women: A study in district Rohtak, Haryana. Indian Journal of Preventive and Social Medicine, 25(3&4), 110-17.
119.
Srivastava, R.K. and R.K. Bansal (1996). Please use the health services: More and more . Would Health Forum, 17, 165-68.
120.
Stevens, J.R. and C.M. Stevens (1992). Introductory small cash incentives to promote chid spacing in India. Studies in Family Planning, 23(3), 171-86.
121.
Subramanian, T., N. Charles, R. Balasubramanian, V. Sundaram, S. Ganapathy and D. Dharmaraj (1996). Role and acceptability of traditional birth attendants (dais) in a rural community in south India. Indian Journal of Preventive and Social Medicine, 27(3&4), 109-16.
122.
Swaminathan, P. (1997). Work and reproductive health: A Hobson's choice for Indian women. Economic and Political Weekly, 32(4), WS 53-61.
123.
Talwar, P.P., A.O. Tsui and G. Narayana (1995). Monitoring the quality of family planning care through the PERFORM system of indicators. Paper prepared for the Quality of Care Workshop, organised by The Population Council , India, and the Ford Foundation, India, Bangalore, May.
124.
Townsend, J.W. and M.E. Khan (1993). Target setting in family planning programmes: Problems and potential alternatives. Demography India, 22(1), 113-25.
125.
Ved, R. ( 1997). Private voluntary organizations in health II: An overview . Indian Journal of Community Health, 1, 1-11.
126.
Visaria, L. (1997). Unmet need for family planning in Gujarat: A qualitative exploration. Economic and Political Weekly, 32(2), 29-36.
127.
Voluntary Health Services (undated). Research summary of STD prevalence study in Tamil Nadu.
128.
Zodgekar, A.V. (1996). Family welfare programmes and population stabilization strategies in India. Asia-PacificPopulation Journal, 11(1), 3-24.
129.
Health for the Millions (1997). Health services in rural and urban areas. 23(5&6), 17-19.
