Ward Boys in Gujarat, India: Doing Much More than Meets the Eye

Emily Sagalyn, MD, MPH, FAWM1, Chris Stratford, RN, MS1, Chris A. Rees, MS IV2, Peter P. Taillac, MD2, DeVon C. Hale, MD3

University of Utah Division of Emergency Medicine1, University of Utah School of Medicine2, University of Utah Division of Infectious Disease3

Background: Ward Boys are support staff found in every sector of health care in India. In addition to custodial tasks, they have duties that ward clerks, CNAs, EMTs, and nurses perform, but receive no formal training. Though there is little literature regarding Ward Boys, they have been shown to have poor knowledge of blood-borne pathogens and high rates of infectious diseases.

Objectives: To identify duties of Ward Boys and establish a pilot training curriculum using a train-the-trainer model for Ward Boys at the Sir Sayajirao General Hospital affiliated with the Baroda Medical College in Vadodara, India and the Shakti Krupa Hospital in Mota Fofalia, India. 

Methods: Key informant interviews were conducted with physicians, nurse supervisors, administrators and immediate supervisors to ascertain expectations of Ward Boys’ duties. Focus group discussions, key informant interviews, and non-participant observation were conducted to elucidate Ward Boys’ duties. Training curriculum is being developed with faculty at the Baroda Medical College.

Results: Many tasks that Ward Boys perform are done by necessity and may not be included in their job description. Their tasks include janitorial work, checking patient conditions, providing emotional support, taking vital signs, wound care, discharge instructions, and even performing vaginal deliveries and assisting in surgery in Mota Fofalia. Ward Boys are not well respected in these hospitals.

Discussion: Ward Boys perform a large amount of patient care and patient support services without uniform training. Ward Boys often have more time to interact with patients than physicians. Discrepancy exists between expectations and actual duties of Ward Boys. There is great support from hospital administration and Ward Boy leaders for a formalized training curriculum.

Future Directions: Formalized Ward Boy training is being developed, which will include training on infection control, stress management, lifting and transporting patients, and recognizing acute changes in a patients’ medical condition.

Author contact: chrisrees2@gmail.com