Identifying disrespect and abuse in organisational culture
A study of two hospitals in Mumbai, India
Bibliographic Data
| ID | 3972680 |
|---|---|
| Authors | Neha Madhiwalla (0000-0002-0922-7186, Anusandhan Trust, corresponding author), Rakhi Ghoshal (0000-0001-9854-4425, Anusandhan Trust), Padmaja Mavani (0000-0003-2869-2988, Associate Professor, Department of Obstetrics and Gynaecology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, India), Nobhojit Roy (0000-0003-2022-7416, Head, WHO Collaborating Centre for Research on Surgical Care Delivery in LMICS, Surgical Unit, BARC Hospital, Mumbai, India) |
| Year | 2018 |
| Volume | 26 |
| Issue | 53 |
| Pages | 36-47 |
| Publication date | 2018-08-27 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Reproductive Health Matters (JOURNAL) |
| Journal identifiers | ISSN: 0968-8080 • E-ISSN: 1460-9576 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09688080.2018.1502021 |
| PMID | 30102132 |
| OpenAlex | W2886042740 |
| Language | EN |
| Citations received | 13 |
| References cited | 19 |
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
Bureaucracy · Focus group · Institution · Political science · Public relations · Sociology · Global Maternal and Child Health · Grief, Bereavement, and Mental Health · Law · Maternal and Perinatal Health Interventions · Medicine · Nursing
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| Unique citing works | 13 |
|---|---|
| Citations per year | 2,17 |
| Citation span | 2020 - 2025 (6) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 11 |