Articles by Abhay Shukla

Novel public health experiments from Maharashtra in the pandemic times, involving co-production of healthcare, interventionist regulation of private hospital rates and popular initiatives to ensure social accountability of private hospitals, demonstrate significant potentials to advance people-centred health system changes.

Forced to migrate to sugar belt for work, women face multiple reproductive health problems, due to the back-breaking work and poor sanitation and hygiene conditions, including menstrual hygiene. This situation along with an absence of public health facilities, allows a fertile and lucrative ground to the private healthcare facilities to provide unnecessary and extreme treatments even for minor gynaecological ailments, including the removal of their wombs. More than 4,605 hysterectomies are said to have been performed in the Beed district alone in the last three years.

The application of the “pathological normalcy” perspective is used to examine the ongoing violence by cow vigilante groups and recent lynching incidents. These are not just isolated “aberrations” arising among scattered small groups, but could be viewed as morbid manifestations of much deeper disturbances in society as a whole. There is a need to recognise the underlying dynamic of these incidents—the cultivated shift towards a pathological culture of insecurity, hatred of the marginalised, and violence—without which effective prevention may be impossible.

Maharashtra, which recently witnessed several attacks on front line doctors, has comparatively very low levels of per capita public health spending, shortfalls in health facilities, and major shortages of specialist public doctors. Dialogue mechanisms should be developed based on community monitoring, while existing legal provisions for grievance redressal need implementation. Doctor–patient communication must improve, and the serious ailments afflicting public health services in Maharashtra must be addressed to move beyond superficial solutions.

The Anna Hazare situation invites two common reactions among progressives and those concerned with social change: some dismiss it as a middle class “urban picnic” and others acclaim it as just short of a revolutionary movement to establish “people’s power”.