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LETTER TO THE EDITOR
Year : 2018  |  Volume : 11  |  Issue : 3  |  Page : 280-281  

Addressing the issue of discrimination in health-care settings


1 Department of Community Medicine, Member of the Medical Education Unit & Medical Research Unit, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication29-Jun-2018

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram – 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJDRDYPU.MJDRDYPU_132_17

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Addressing the issue of discrimination in health-care settings. Med J DY Patil Vidyapeeth 2018;11:280-1

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Addressing the issue of discrimination in health-care settings. Med J DY Patil Vidyapeeth [serial online] 2018 [cited 2019 Aug 25];11:280-1. Available from: http://www.mjdrdypv.org/text.asp?2018/11/3/280/235551



Sir,

In the global arena, different types of discrimination have been reported in the health settings and that too in huge numbers. It is vital to understand that such discrimination not only affects the clients of health-care services but also even health workers are not spared.[1] This discrimination raises serious objections on the ability of a person to exercise their basic rights, and often vulnerable and stigmatized group of people are the frequent victims.[1] Moreover, such acts of discrimination have been acknowledged as one of the major impediments toward the accomplishment of the sustainable development goals, which in itself is developed on the principles that no one should be left unattended.[1],[2],[3]

Regardless of the sociodemographic attributes (namely age, gender, race, ethnicity, health condition, migration status, etc.), people from all walks of life have been subjected to compound forms of discrimination in health-care settings.[2] Discrimination in health settings can present in many ways, ranging from denying access to health care to some people, whereas it is available to others or not providing services which are exclusive for certain categories of people or breach of confidentiality or not obtaining free and informed consent, etc.[1],[2]

Further, even gender-based discrimination is quite prevalent, as witnessed by reports of physical/verbal/sexual abuse, salary disparity, and even lack of contribution toward leadership and decision-making activities.[1] In fact, most of the women health workers themselves are at the receiving end of discrimination.[1],[2] This results in a wide range of consequences such as reluctance to avail health care, impact on the quality of delivered services, encouragement of the exclusion of either individual or group of people from society.[2]

Acknowledging the scope of the problem, the United Nations has called for a multi-sectoral and synchronized efforts to ensure that discrimination in health-care settings are eliminated.[1] This will not only improve health-care delivery but also aid in the accomplishment of many of the relevant sustainable development goals.[1],[3] Further, it is the need of the hour that nations should be supported to ensure no discrimination, and this can very well happen provided the national laws or policies that encourage discrimination in health care settings are modified or abolished.[1],[2] In fact, the laws should respect the principles of autonomy in health-care decision-making, and the laws or policies should be strictly adhered.[1]

Moreover, steps such as pre- and in-service orientation should be performed to empower health professionals and users of health services to understand their rights, roles and duties.[1] In addition, effective mechanisms should be developed to timely address the complaints of both the health users and the health workforce, and customized remedies should be suggested.[1],[2] This essentially requires a strengthened framework to report, monitor, and evaluate any report of discrimination, which in turn requires strong support from community people.[1]

To conclude, incidents of discrimination in health-care settings are a very common, yet unreported phenomenon. As it significantly affects various domains of health care, it is high time that measures should be taken to eliminate such detrimental practices universally.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Joint WHO/UN statement. Joint United Nations Statement on Ending Discrimination in Health Care Settings; 2017. Available from: http://www.who.int/mediacentre/news/statements/2017/discrimination-in-health-care/en/. [Last accessed on 2017 Jul 03].  Back to cited text no. 1
    
2.
Bastos JL, Celeste RK, Silva DA, Priest N, Paradies YC. Assessing mediators between discrimination, health behaviours and physical health outcomes: A representative cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2015;50:1731-42.  Back to cited text no. 2
    
3.
Shrivastava SR, Shrivastava PS, Ramasamy J. Accelerating progress to achieve the Sustainable development goal target 3.3 worldwide. Ann Trop Med Public Health 2017;10:299-300.  Back to cited text no. 3
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