PRESS RELEASE: New Report Highlights Gaps in Quality of Female Sterilization Services in Bihar, India

WASHINGTON, D.C.– Given the increased demand for reproductive health services in India, more attention is needed to assess the quality of care for these services. To assess the current state of care and patient satisfaction, The International Center for Research on Women (ICRW) and the Government of Bihar conducted research in Bihar, auditing 79 facilities (including district hospitals, sub-divisional hospitals, primary health centers, and private hospitals), and conducting interviews with around 800 providers, female sterilization and IUD clients from 2013 to early to mid-2014.

Today, ICRW released a new report with findings from that assessment, which sheds light on the quality of these services, as well as patient satisfaction, finding that while there have been some improvementsto infrastructure, there is much more to be done in the provisioning of female sterilization services to ensure that clients are satisfied with the sanitary conditions, as well as privacy and dignity that they expect while receiving these services.

ICRW’s research found that the overall quality of care received by many women was substantially low, with a lack of a focus on women’s needs and their right to high-quality health services that fit their needs and lifestyle.

In only one in ten primary health centers were all women provided a bed post-surgery, leaving the vast majority of women who recently underwent sterilization procedures to recover on mattresses or thin cotton mats on the floor, a breeding ground for infection. In nearly one out of three facilities, hospital waste, including used syringes, cotton and bandages were found scattered around, further compounding the risk of infection for female patients.

“Safe, sanitary conditions are absolutely non-negotiable and can be achieved with very little or no heavy additional costs but will surely yield long-term dividends to establishing the credibility of these programs,” said Pranita Achyut, lead researcher on the report.

The findings highlight that very few private and public hospitals had all the drugs identified by the Government of India as necessary to have on hand while performing sterilization procedures; many women after the procedure were discharged without ensuring that they received check-ups or counselling and advice; the infrastructural facilities at the sub-divisional hospitals and primary health centres were very poor, including within the operation theatres themselves; and fewer than half of all the facilities surveyed had separate functional toilets for women.

“The evidence generated by our research reinforces the oft-repeated reality of poor quality health services for women who seek sterilization procedures,” said Dr. Ravi Verma, head of ICRW’s Asia Regional Office. “The plight of poor women denied of the dignity and respect they deserve, coupled with the high risk of exposure to infections and post-surgery complications, are clearly highlighted by our research. It is hard to overemphasize the clear, demonstrated need for women-oriented and sensitive family planning services.”

RECOMMENDATIONS: Based on our findings, ICRW puts forth a host of recommendations to improve the safety and sanitary state of health facilities so no woman’s life is at risk. These recommendations include designating safe, clean waiting and recovery areas for women; equipping facilities with necessary, sanitary equipment, drugs, and supplies to effectively perform sterilization and IUD procedures; ensuring health facilities have qualified health providers who ensure they respect the rights of women undergoing procedures; and educating women on their right to safe health care procedures.

Overall, our research indicates that while the government is taking many steps to improve provider and clinical quality, without addressing clients’ understanding and demand for quality, we will not be able to fully address the issue.

Pranita Achyut, lead researcher and Dr. Ravi Verma, head of ICRW’s Asia Regional Office are available for interviews and commentary.

Press Contacts:

Washington DC – Erin Kelly, [email protected], 011. 571.265.1110

New Delhi– Ruchika Kumar, [email protected], 91.11.46643333

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Mission Statement:

About ICRW: For nearly 40 years, ICRW has been the premier applied research institute focused on women and girls. Headquartered in Washington, D.C., with regional offices in South Asia and Africa, ICRW provides evidence-based research to inform programs and policies that help alleviate poverty, promote gender equality and protect the rights of women and girls. Learn more at