Identifying disrespect and abuse in organisational culture: a study of two hospitals in Mumbai, India
| Autor: | Nobhojit Roy, Rakhi Ghoshal, Padmaja Mavani, Neha Madhiwalla |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
obstetric practice in LMICs
Attitude of Health Personnel media_common.quotation_subject Organizational culture India Context (language use) provider behaviour Interpersonal communication Gender-Based Violence lcsh:RC870-923 Respect hospital culture 03 medical and health sciences 0302 clinical medicine Pregnancy Institution Humans Maternal Health Services 030212 general & internal medicine Sociology Qualitative Research Research Articles childbirth in LMICs media_common Labor Pain Government 030219 obstetrics & reproductive medicine Cultural Characteristics lcsh:HQ1-2044 business.industry Hospitals Public disrespect and abuse Obstetrics and Gynecology Professional-Patient Relations Public relations Delivery Obstetric lcsh:Diseases of the genitourinary system. Urology Organizational Culture Contraception Reproductive Medicine lcsh:The family. Marriage. Woman Women's Health Female Bureaucracy Pregnant Women business Systemic problem Qualitative research |
| Zdroj: | Reproductive Health Matters, Vol 26, Iss 53, Pp 36-47 (2018) Reproductive Health Matters |
| ISSN: | 1460-9576 0968-8080 |
| Popis: | This paper draws on findings from a qualitative study of two government hospitals in Mumbai, India, which aimed to provide a better understanding of the institutional drivers of disrespect and abuse (D&A) in childbirth. The paper describes the structural context, in which government hospital providers can exercise considerable power over patients, yet may be themselves vulnerable to violence and external influence. Decisions that affect care are made by a bureaucracy, which does not perceive problems with the same intensity as providers who are directly attending to patients. Within this context, while contrasting organisational cultures had evolved at the two hospitals, both were characterised by social/professional inequality and hierarchical functioning, and marginalising women. This context generates invisible pressures on subordinate staff, and creates interpersonal conflicts and ambiguity in the division of roles and responsibilities that manifest in individual actions of D&A. Services are organised around the internal logic of the institution, rather than being centred on women. This results in conditions that violate women's privacy, and disregards their choice and consent. The structural environment of resource constraints, poor management and bureaucratic decision-making leads to precarious situations, endangering women’s safety. With the institution's functioning based on hierarchies and authority, rather than adherence to universal standards or established protocols, irrational, harmful practices endorsed by senior staff are institutionalised and reproduced. A deeper focus on organisational culture, embedded in the discourse of D&A, would help to evolve effective strategies to address D&A as systemic problems. |
| Databáze: | OpenAIRE |
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