Maharashtra: the first state to include gender in medical education

Research has found that in case of heart attacks, women were likelier to wait 20 minutes longer than men, before they called for medical help. Antenatal care is known to be oftentimes delayed because of the violence she is facing and the restriction on her mobility. These are just some examples of the gaps that exist in medical knowledge, research and practice.

Healthcare, which is seen as purely scientific and neutral, has had a gender bias since conception. While teaching doctors to deal with rape victims, some MBBS textbooks showed an attitude of doubting the veracity of the woman’s claim, while constantly implying that the reader should be weary of false cases. Some of the texts included only figures of male bodies, without featuring the female anatomy anywhere.

On the face of it, diseases like blindness, malaria or tuberculosis are not specific to any gender. Women were found to be further affected than men. This was largely due to socio-economic and cultural reasons. Families spend considerably less on women’s health than on men’s. Maternal Mortality Ratio of India is 174 per 100,000 live births. This means that 45,000 women die every year due to causes related to childbirth which accounts for 17% of total MMR worldwide. Most of these deaths are preventable by inculcating a gender perspective in treatment and care. Women in traditional family setups tend to eat leftovers after the men have eaten. In some cases, women working outside are also expected to take the burden of all household duties, and therefore cannot rest as much as required. With this knowledge, a doctor attending to such a woman could attend to her specific needs and provide better care to her.

Normalisation of gender discrimination is costing us healthcare rights of almost half the population.There is an urgent need to address this, and the best place to start, are our young medical students.

Women should get quality health care as a right; without stigma, humiliation or discrimination. Gender discrimination and poverty are major factors that put women at risk. Due to patriarchal norms and financial restrictions, a woman reaching a health facility may be the only opportunity she has to take care of herself and her needs.  Under these circumstances, an HCP should address her health needs comprehensively. However, doctors come from the same patriarchal upbringings that the rest of us do. Medical textbooks tend to concentrate on biomedical knowledge, without taking into consideration the background of every individual patient. At times, these textbooks are found to be reinforcing patriarchal attitudes among MBBS students

 

In order to bridge these gaps and integrate gender concerns in medical education , pioneering efforts were made by CEHAT, in collaboration with DMER and MUHS, have developed up gender-integrated modules which take into account the realities of vulnerable groups such as women, children and sexual minorities. They aim to address healthcare needs in a holistic manner taking into account gender and the socio cultural realities of people. They take into account violence and abuse, and teach doctors how to deal with survivors, based on the Ministry of Health and Family Welfare guidelines.

Maharashtra has always been considered one of the more progressive states in India when it came to gender equality. It is the homeland of Anandibai Joshi, India's first female doctor. This year, Maharashtra will become the first Indian state to include gender-integrated modules in the MBBS curriculum. In August, educators across seven medical colleges in Maharashtra will be teaching gender to their students in the subjects of gynaecology, medicine, forensic medicine and toxicology, community medicine and psychiatry. With the help of these modules, we will be ensuring a holistic integrated approach, and moving in the direction of universal healthcare. 

From all of us at CEHAT, a very Happy Women’s Day to you!