The Responses of Health Systems to Marital Sexual Violence – A Perspective from Southern India

Marital sexual violence is a serious problem in India. However, marital rape and most other forms of marital sexual violence are not criminalized in the country. This qualitative study with healthcare providers (physicians and nurses), lawyers, members of a non-profit organization that offers domestic violence support services out of a hospital, a journalist and two lawyers suggest that the majority of care providers recognize that marital sexual violence is a serious concern, and agree that health systems can play a vital role in addressing both the immediate biomedical concerns of survivors, and also overall well-being. The study reveals several systemic and internal factors that hinder responsiveness of Indian health institutions. These include, the absence of a protocol or uniform internal guidelines in most hospitals, a lack of screening programs to capture the presence of violence occurring when patients visit hospitals for other reasons, a large patient load, a lack of gender sensitivity in providers’ education, an absence of domestic violence shelters, and poor interlinkages between support services such as counseling and legal services. Notwithstanding these challenges, some exemplar physicians and nurses assist survivors of sexual violence, sometimes risking their own safety. The Indian health system can be made more responsive, provided these factors are addressed, and crucially budgets are allocated for interventions.