National Women's Health Research Articles

August 2002 National Women's Health Report: Adolescent Girls' Health

August 2002 National Women's Health Report: Adolescent Girls' Health

The National Women's Health Information Center

The National Women's Health Information Center

Job-based health insurance in 2000: premiums rise sharply while coverage grows.

Job-based health insurance in 2000: premiums rise sharply while coverage grows.

The Balanced Scorecard: a strategic management system for multi-sector collaboration and strategy implementation.

This article illustrates the application of the Balanced Scorecard, a method more commonly associated with the business world, to a nonprofit multisector National Women's Health Quality Initiative (NWHQI). The article delineates the following multiple uses of the Balanced Scorecard for the NWHQI effort: Set NWHQI strategy and structure. Provide the framework and principles to implement NWHQI's strategy. Develop a measurement system to assess the progress and success of NWHQI's strategy. Serve as a collaboration mechanism for multisector stakeholders. Advance women's health knowledge base. This article concludes by sharing key insights regarding the utility of the Balanced Scorecard to promote the success of this nationwide women's health quality initiative.

How Australia came to have a National Women's Health Policy.

A National Women's Health Policy was launched in Australia in 1989, and Australia became the only country to have a comprehensive policy on women's health. The policy is intended to provide a framework for decision-making in both mainstream and separate women's health services. The author examines the forces and factors that led to the formulation and adoption of the policy, then addresses the question of why Australia is alone in choosing a national policy as a focus for women's health action. A number of key influences, either absent or weaker in comparable countries, worked together to facilitate policy development. The activities of women working in a number of arenas coincided with the election of relatively supportive governments, creation of women's policy machinery in bureaucracies, employment of feminists in key positions, and opportunities for policy expansion afforded by federalism. These influences, within the Australian ideological context of strong support for social liberalism, account for the country's distinctive policy position.

Indirect Services Funded by the National Women's Health Program in Victoria

Victoria's Women's Health Services and Centres Against Sexual Assault have implemented a range of indirect activities utilising various strategies and methods with a particular focus on information and resource provision, education and training, community development and promotional activity. They have increased women's access to existing services by working to make those services more appropriate and relevant. To achieve this they have involved women in the community in program management, design and implementation. Collaboration with other agencies in health and related services has also been a key strategy in achieving changes to mainstream services and fulfilling the aims of the dual strategy.

Keynote Addresses: What Makes Women Sick? Promoting Women's Health: The Changing Agenda for Health Promotion

The creation of a National Women's Health Policy in 1989 put Australia at the forefront of developments in women's health. By contrast, in the United Kingdom there is still no clear strategy for improving gender equity in the health service, and many of the principles taken for granted in Australia are not even on the National Health Service agenda. The current reforms of our health service do reflect a backing away from the 'quasi markets' of the Conservative era. However, little attention has been paid during this process to the specific needs of women. So Australia is still ahead, with Victoria in particular playing a key role in disseminating examples of good practice, both at home and internationally. The Australian Women's Health Policy and Program provides a fertile environment for innovation in good practice, but this does not mean that there is nothing left to achieve. Indeed, it may well require considerable effort just to maintain what has already been put in place. To move forward will mean continuing to confront those challenges in trying to improve women's health around the world. These are addressed by looking at three key themes: reconfiguring medicine; dealing with diversity; and gendering the social model of health. In each case these themes are placed in a global context.

The National Council on Patient Information and Education

To the Editor. —In the Medical News & Perspectives article by Mr Marwick,1Ray Bullman, executive director of the National Council on Patient Information and Education (NCPIE), was reported to have said that a coalition has been organized to implement theAction Plan for the Provision of Useful Prescription Medicine Information(MedGuide) and that all 34 original steering committee organizations responsible for drafting the plan have joined. If these statements have been correctly attributed to Mr Bullman, they are untrue. As public interest groups and members of the original steering committee responsible for drafting the MedGuide, the AIDS Treatment Data Network, Center for Medical Consumers, Citizen Advocacy Center, National Women's Health Network, and Public Citizen have not joined NCPIE in the coalition alluded to by Mr Bullman. We have refused to associate with the NCPIE implementation program for 2 reasons. First, we view NCPIE's economic and philosophical juxtaposition to

Women's Health Australia: Establishment of The Australian Longitudinal Study on Women's Health

The Australian Longitudinal Study on Women's Health was begun in June 1995 in response to initiatives arising from the National Women's Health Policy. Now renamed Women's Health Australia, the study involves six cohorts of women, selected on the basis of age or ethnicity to represent young, middle-aged, and older women (main cohorts), as well as Aboriginal and Torres Strait Islander women and women migrants to Australia (special cohorts). The main themes of the study are time use; health, weight, and exercise; violence against women; life stages and key events; and use of and satisfaction with health care services. Results of pilot studies indicate that it is feasible to use the Health Insurance Commission (Medicare) database as a sampling frame for the three main cohorts and that middle-aged women are more likely than older or younger women to consent to participate. The baseline survey for the main cohorts began in April 1996, with data collection for the special cohorts progressing over 1996–1997 as appropriate consultation with the communities concerned is established. Data from this Australian study should make a valuable contribution to current international efforts to identify the factors that promote and reduce health in women.

By women for women: Australia's national women's health policy

Australia is now in the sixth year of its National Women's Health Policy and Programme. It started when the women's movement broke the silence on women's experience and fuelled women's determination to do things for themselves as society was not providing what was needed. The knowledge base on women's health and the demands for change developed by women's health activists, taken up by a government with a strong social justice policy, led to a national consultation with Australian women in 1988 which lasted nearly two years. Groups and individuals representing more than a million women defined what they considered to be priority women's health issues: violence against women, reproductive health, mental health, occupational health, the health effects of sex role stereotyping, the health of carers, and the health of older women. A wide variety of services for women are now funded, including centres against sexual assault, health information, education and training programmes, and research and clinical services.

A policy is not enough: Women's health policy in Colombia

In 1992, thanks to the involvement of women's groups and a favourable political context the Ministry of Public Health in Colombia put forward a national women's health policy that calls for interventions in five areas: self-care, abuse and violence, mental health, occupational health, and reproductive health and sexuality. Three years and several international conferences later, there have been few sustained efforts to implement the policy and it is difficult to assess the impact of those that have taken place. Serious and well planned efforts among women, and on the part of governmental and non-governmental sectors, will be needed to put it into practice.

National women's health network and the US FDA: Two decades of activism

The National Women's Health Network (NWHN) in the United States works for more power for women at all levels of health care decision-making. This paper describes some of the campaigns carried outby the Network since the 1970s to influence US Food and Drug Administration (FDA) guidelines and policy. These include: requirements for patient package inserts for oral contraceptives, oestrogen during menopause, and drugs for pregnant women. The Network has also consistently taken up the safety and efficacy of drugs and devices used by women. It has opposed approval of Depo Provera, supported approval of the Prentif cervical cap and the female condom, opposed a large trial of tamoxifen for prevention of breast cancer in healthy women because of its risks, and supported studies on the safety ofbreast implants.

Estrogen therapy for geriatric osteoporosis: just one ball in a complex juggling act.

The use of estrogens is the single therapy that has been found consistently to prevent bone loss and fractures in postmenopausal women. Traditional osteoporotic risk factors should be used to select women for bone densitometry. The numeric result provided by densitometry, combined with age-based comparisons, is extremely useful in convincing reluctant women to be treated. The few studies that have been done in geriatric women show that estrogen therapy continues to be effective in reducing bone loss, but the absolute benefit is less than in perimenopausal women. The effects of estrogen therapy extend beyond osteoporosis. A consensus of epidemiologic reports has shown that women who comply with postmenopausal estrogen therapy have a 30% to 50% reduction in the risk of coronary artery disease. Given the frequency of these two conditions, widespread use of estrogen as a national health care policy would be appropriate if it were not for the evidence that estrogens may increase the risk of breast cancer and endometrial cancer. Given these lingering cancer fears, recent calls for a randomized national women's health study of postmenopausal estrogen therapy should be heeded.

Micropolitics of Medicine: Theoretical Issues

the 1980s, conflict analysis of mental illness treatment continues. Sociological scholarship is represented, for example, in the International Journalfor Health Services, and by an associated group of scholars who began meeting to discuss Marxist critiques of health and mental health care in the 1970s under the name of the HMO-The Health Marxist Organization. Health-PAC, the Health Policy Advisory Center, another child of the middle years of the movement, continues its critique of health and mental health treatment, as does the National Women's Health Network. Issues of orthodox dialectical-historical materialism and mental health

The Cervical Cap

In the past several years, a new trend has emerged where women in in- creasingly growing numbers are becoming hesitant to accept the risks associated with hormonal and invasive methods of birth control. It is as part of this trend that a revival of sorts is occurring with the cervical cap, a form of birth control with roots which precede recorded history and which, in its modern form, was widely advocated in late 19th and early 20th century Europe. Based on the prin- ciple of occlusion, the cervical cap appears effective and risk-free, both vital concerns to women of all centuries. Women's health activists and organizations have been in the forefront of this revival. Two of the first organizations t o take an active interest in making the cap available were the New Hampshire Feminist Health Center inconcord, New Hampshire, and theEmmaGoldman Women's Health Clinic in Iowa City, Iowa. The National Women's Health Network, a national organization based in Washington, D.C., has also been an active advo- cate on the cervical cap's behalf.