“We are nurses – what can we say?”: power asymmetries and Auxiliary Nurse Midwives in an Indian state

A narrative review of challenges related to healthcare worker rights, roles and responsibilities in the provision of sexual and reproductive services in health facilities

“…We identified several ways and SRH areas where the pressure to meet coverage, quality, and other goals engendered healthcare worker behaviour that was inconsistent with healthcare worker responsibilities to patients and, in some cases to their fellow providers, as these responsibilities are commonly defined in human rights and medical ethics. This included healthcare provider behaviours such as coercing women into giving birth in health facilities due to pressure to increase the percentage of births in health facilities, and falsifying hospital maternal death records or other data 50 51. One paper described single-minded governmental emphasis on institutional delivery in India as leading to safe, but violent deliveries, where patients in overwhelmed facilities experienced disrespect and abuse and health workers struggled to realise their responsibilities in facilities with unsupportive management and inadequate supplies 52.…”

“…Punitive supervision was one way that compliance with aggressive performance improvement goals was exacted. For example, an ethnographic study found that facility managers compelled auxiliary nurse midwives to meet unrealistic targets by threatening to withhold their salaries, public scolding or limiting their ability to exercise their full scope of practice 51…”

“…Several studies revealed how gender-based mistreatment and violence against female health workers affected the disproportionately female SRH workforce. Women health workers from varying cadres reported widespread verbal abuse, bullying, and sexual harassment in the workplace by colleagues and by people in the community 51 54–56. Midwives—who often occupy a lower status by virtue of their being women—experienced disrespect, lack of support and lack of recognition from their supervisors 56–59.…”

“…Midwives—who often occupy a lower status by virtue of their being women—experienced disrespect, lack of support and lack of recognition from their supervisors 56–59. This disrespect could manifest in blame, with midwives reporting that they were blamed irrespective of who—if anyone—was at fault for a complication 51 57 58 60…”

Orden De Género: Un Reto Histórico Y Actual Para La Enfermería

“…Históricamente la medicina ha sido la disciplina más influyente de las ciencias de la salud y desde sus inicios se caracterizó por mantener una filosofía patriarcal y cercanía con las fuentes de poder 8 , tanto políticas como eclesiásticas. Esto coincide con la asimétrica y perdurable relación médico-enfermera que todavía perdura en la sociedad moderna 9 . Sin embargo, en el siglo XIX (período en que se desarrollaba la tercera ola feminista), paradójicamente la medicina constituyó un campo con un importante movimiento de profesionalización femenina, y donde se apreció una proporción creciente de las primeras universitarias 3,10 .…”