The document discusses uniformity in health systems and protocols for responding to survivors of sexual assault. It summarizes discussions between organizations and individuals on gaps in practices across hospitals in Mumbai and the central ministry's uniform protocol. It outlines key aspects of Maharashtra's uniform gender-sensitive protocol based on the central guidelines, including who can conduct medical examinations, what information should and should not be included in medical reports, and areas still needing discussion like informed consent versus mandatory reporting and sensitivity training. The uniform protocol aims to standardize practices and create an unbiased, scientific approach focusing only on relevant forensic evidence when examining survivors.

1. UNIFORMITY IN
HEALTH SYSTEMS
Health Group

2. Introduction
 Group Members:
Organisations: CEHAT
SNEHA
ENFOLD, Bangalore
PRERANA
Individuals: Ms. Manisha Tulpule,
Ms. Sneha Khandekar

3. Points of Discussion
 Individual practices followed by each hospital (Sion,
Rajawadi, Bhabha & Bangalore’s Baptist Hospital)
 A thorough discussion and identification of gaps in
the Central Ministry’s Uniform Protocol
 Lack of uniformity in practices in hospitals within
the city of Mumbai
 Challenges during medical examination in POCSO
cases
 Per vaginal examination

4. Paving the way towards a uniform
protocol
 Government Resolution with effect from 7th August
2015
 The Guidelines and Protocol to respond to
survivors/victims of Sexual Assault by the Ministry
of Health and Family Welfare to be followed in
Maharashtra
 This protocol is already being followed in several
other states

5. Who can conduct the medical
examination?
 Registered Medical Practitioner (RMP)
Currently, as per the Indian Penal Code, only a
registered M.B.B.S. qualifies as a Registered Medical
Practitioner.

6. Salient features of the uniform
gender-sensitive protocol
i) The proforma categorically does not include any of the
following:
 Size of the Vaginal Introitus/Hymenal Opening/Number of
fingers admitted by the opening
 Comments on old tears of the hymen
 Comments on habituation to sexual intercourse
 Irrelevant Obstetric History (such as history of past
abortions)
These allude to past sexual history, which are irrelevant, biased
and unscientific.
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7. ii) Comments on ‘built’ or ‘nutrition’ of the survivor are not
recorded as they are irrelevant to sexual assault.
iii) Emphasis on seeking a detailed history so that only
relevant forensic evidence is collected.
iv) Information such as lapse of time, type of assault, inability
to resist due to use of threats, restraint or intoxication is
documented.
v) The proforma includes a component of medical treatment
and psychological support to be provided to all survivors
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8. Areas of Contention
 Who takes the history?
 Who should be present during the history-taking
process?
 ‘Information to be revealed to the police’ : Is it
redundant in the light of Mandatory Reporting
 Per Vaginal Examination

9. Issues flagged for future discussion
 Informed consent versus mandatory
reporting
 Insistence on medical examination in cases
where there is history of sexual harassment
 Training of medical practitioners to respond
sensitively to survivors of sexual assault

10. THANK YOU