Women's Health Policy Research Articles

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.

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.

Standing Together: A Cross-Cultural Approach to Working with Victim/Survivors of Sexual Assault

The Western Region Centre Against Sexual Assault (WestCASA) is located in a culturally rich and diverse Melbourne community. As a small agency, with limited resources, we wondered how we could respond to the often silent and unmet needs of victim/survivors of sexual assault from non-English speaking backgrounds (NESB) communities. The Cultural Equity Program (CEP), based on principles of respect and empowerment, strongly advocates a collaborative approach and also recognises the importance of identifying structural, organisational and individual barriers preventing NESB victim/survivors from accessing support and/or counselling. Vietnamese and Filipino workers were invited to be cultural consultants to WestCASA and met regularly during 1996/1997. These meetings enabled the exchange of cultural knowledge/expertise and an opportunity to discuss sensitive cultural issues. Together we also developed a culturally and linguistically respectful community education and training strategy. WestCASA also introduced initiatives for developing a more culturally sensitive practice. The paper presents the CEP as a model of best practice. The ideas and concepts are outlined which have guided us in the design of the developmental framework. We also reflect on our learning which has been rich and inspiring, and comment on the implications for Women's Health Policy.

Expanding the visibility of women's work: Policy implications

S ocie ta l concep tua l i za t ions and images of women and work have an impact on the way health and social policies are formulated and how these policies in turn affect the lives, health, and wellbeing of women. Nurses, the majority of whom are women, have an inherent interest in issues of women's work and women's health. Our purpose in writing this article is to examine the policy implications for women's health that stem from the dominant societal images of women's work. In our discussion, we attempt to uncover the inherent contrasts and inconsistencies between media images, the changing Social and economic realities of women's work, and health and social policies. We advocate the active involvement of nurses in expanding the visibility of women's work and in promoting gender-sensitive policies related to women's work and health poli-

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.

Developing women's health policy in South Africa from the grassroots

The Women's Health Conference in South Africa in December 1994 aimed to identify women's health needs and translate them into policy proposals. The process was inclusive and bottom up and cut across barriers of race, class and ideology. Prior to the conference, policy groups developed draftproposals on major areas of women's health, while provincial networking got input from the grassroots. The conference gave women space to talk about their experiences and finalise the proposals. Work on implementation has now begun; some proposals are being used by a number of provinces and by the Ministries of Health and Welfare and the Reconstruction and Development Programme's Gender Commission. In light of the proposal on abortion, the current abortion law is being reviewed by a Parliamentary Select Committee.

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.

Women's health policy: Where lie the interests of physicians?

Women's health policy: Where lie the interests of physicians?

Developing a National Mental Health Policy for Women in the UK

Developing a National Mental Health Policy for Women in the UK

Unwanted pregnancy: challenges for health policy

In Latin America, governments fail to recognize that information and services for sexuality, reproduction and contraception are essential to women's health. Governments should adopt comprehensive women's health policies and programs to help women avoid unwanted pregnancies that lead to dangerous illegal abortions. This includes sex education, especially for adolescents; contraceptive choices; accessible services; decriminalization of abortion and removal of obstacles to legal abortion services; and support for women who wish to carry their pregnancies to term.

Australia.

A nurse has been appointed to an important job, steering national health policies for women in Australia.