Return to Main Page PROGRAMS & SERVICES:
ADVOCACY & POLICY ADVICE
Women and Health Reform Working Group Report


Main Page

What's New

Who We Are

Programs and Services

Health Education Catalogue

Our Newsletter

Volunteer Opportunities

Become A Member

 

 

Executive Summary


The Context

From a woman's perspective, the reshaping of the health system offers both potential opportunities and problems. Individual women and women's groups have long been concerned that issues related to women's health were down-played, overlooked or disrespected in the traditional health care system. For women, reshaping the face of health care is a two-edged sword. A "new" system offers the opportunity for a different philosophical approach that should be open to exploring the specific needs of women. On the other hand, there is the risk of women's special health needs once again getting lost in the shuffle.

A number of women's groups/organizations -- Manitoba Women's Institute (MWI); Manitoba Women's Advisory Council (MWAC); United Nations Platform for Action Committee (UNPAC); Provincial Council of Women (PCW); Women's Health Clinic -- have had a long history of advocating for woman-sensitive, community-based services and working on a variety of women's health issues such as midwifery, new reproductive technologies and smoking cessation.

To women who had been involved in women's health issues in Manitoba, it became increasingly obvious by 1996 that the provincial government was moving ahead quickly with its plans for radical changes to health services in the province. These women recognized it was imperative for women to have a voice in the change and any subsequent decision-making structure(s) which would evolve from the reform process. In order to have an effective voice, women needed to become informed about the implications, both positive and negative, of the intended health care reforms and, specifically, regionalization.

The Winnipeg Process

In January 1996, the Women's Health Clinic took a lead role in starting the information process by co-ordinating consultative meetings among representatives of MWI, UNPAC, MWAC and PCW. Following informal discussions, these women determined they had shared concerns about the health reform process as it would affect women. This group proceeded to contact other women and women's groups, holding several community information meetings in the process. Women from over 60 community and professional organizations, as well as interested individuals, were eventually involved in the networking. As a result of these informational sessions, the ad hoc Women and Health Reform Working Group (WHRWG) was formed.

At the same time as they were collecting information and meeting with those involved in the reform/regionalization process, the WHRWG members also recognized that there was a need for a method to disseminate information to the broader community of women and to establish a channel for their input into health reform. Consequently, the group dedicated five meetings to developing a strategic plan. As a result of the strategic plan, four new goals were set by and for the group:

  1. to outreach to groups and individuals not involved in the process to date;

  2. to provide women with opportunities for education and dialogue on the various aspects of health reform and restructuring;

  3. to articulate a shared perspective on Health Reform from the perspective of women and to communicate it amongst its members, contacts, and to decision-makers;

  4. to initiate a process that would result in the creation of new linkages across groups and individuals, particularly in the regions.

In response to the developments in rural health reform and the stated goals of the WHRWG, the group made application to Health Canada for funding to conduct an outreach pilot project to the rural and northern Manitoba regions.

Provincial Outreach

The goal of the provincial outreach pilot project was to provide, through a workshop process, women consumers and their grassroots organizations an opportunity:

  • to discuss women's health issues;

  • to gain some knowledge of the principles guiding health reform and the establishment of the regional health authorities (RHAs);

  • to formulate and share their vision for health reform; and

  • to discuss strategies to ensure the inclusion of women's voices in the health reform process.

Dauphin, in the Parkland RHA, was chosen as one location; Thompson, in the Burntwood RHA, was chosen as the second site. Each has a different ethnic mix while both confront problems of distance and isolation in health services delivery.

Although participants were invited to the workshops to discuss health reform, a number of the initial comments early in the day focussed on the details of health care -- what was missing or what needed improvement -- because it is the details with which most consumers feel comfortable. As the day progressed, though, a greater appreciation developed for the overall issue of health reform. In fact, the day could be likened to a metamorphosis of understanding. As the women threaded their life experiences into the fabric of the discussion, the details of health care evolved into broader issues related to health. Gaining a heightened awareness of the significance of health reform, the participants realized that it is essential that women's voices be included in the process. They recognized that if women do not have the ability to make input into decisions about health, then the details of health care which concern them will not be quickly changed.

Participating women brought a diversity of experience to both meetings, yet for all their diversity, they were unanimous in expressing confusion over what was happening and how to become involved with health reform.

Analysis and Findings

Enthusiasm generated at the outreach workshops in Dauphin and Thompson reinforced the importance of continuing towards the goals set during the WHRWG's strategic planning sessions. In fact, education was a major issue -- the importance of learning about the reform process, and about how to take an active role.

Given the opportunity as well as support in over-coming barriers to participation, women in both workshops expressed interest in:

  1. extending outreach to communities and other groups

  2. improving and strengthening communications with RHA boards and CEOs

  3. participating in or doing a community health needs assessment

Concerns over gender and geographical imbalances at the decision-making levels must be addressed. Women at the meetings were concerned about the lack of women appointed to the regional health authority (RHA) boards.

In both regions, a keen interest was shown in establishing a women's health advisory committee in each RHA and at the provincial level. It was noted that the WHRWG had requested that this be included in the legislation and the regulations governing the regional health authorities.

In assessing the outcomes of the two workshops, it was apparent that once women focussed on the global issue of health reform they shared the perspective of the Winnipeg-based WHRWG as expressed by the group's four goals. The fact that both rural and urban women recognized the need for increased outreach, networking, education and dialogue on the subject of health reform indicates that women throughout the province share similar levels of awareness about the health reform process and its implications.

The difference between rural and urban women is in their ready access to organizations and support groups that can assist them in meeting their goals. Not only does distance/geographic isolation make it difficult (and often costly) for women in rural and northern Manitoba to access information, but established channels with a female-focus do not exist to the same extent as they do in the province's urban centres. Urban women have more ready access to "female friendly" groups, and they can often more easily access those familiar with the health system whether they be health professionals or government staff.

The workshop process itself underscored the importance of providing the community with information/education about health reform and regionalization. During both sessions, the initial focus of the participants was on what was lacking or what needed improvement with respect to health care. As the meeting progressed, though, the focus gradually changed to a more global perspective -- specifically what was required to ensure that the newly developing system would accommodate the needs of women. Without a basic awareness of the elements of the health reform process, it is difficult for people to contribute knowledgeably to reshaping of the system.

Recommendations

  1. It is recommended that community information outreach meetings specifically directed to women be continued. Funding will be required to conduct these meetings.

  2. It is recommended that gender analysis and gender-sensitive planning be incorporated into all policies and activities undertaken with respect to health reform at the regional and provincial level, including, in particular, the community needs assessment. In order to ensure that women do experience positive health benefits from health care restructuring in Manitoba, a formal commitment to gender-sensitive planning and the integration of women at all levels of decision-making and evaluation in health care is essential.

  3. It is recommended that the Women and Health Reform Working Group facilitate networking throughout the province starting with the participants who attended the workshops in Dauphin and Thompson, and by expanding the network to include women throughout the province who have expressed an interest in women's health issues and health reform.

  4. It is recommended that a women's health committee be established in each region to ensure that women's issues are addressed at the RHA board level. It is important these committees are representative of women within each region and that they have a direct link to the RHA boards by having a member of the RHA board as chair.

  5. It is recommended that gender sensitivity training and information about the impact of gender on health should be required for all regional health authority board members.

  6. It is recommended that every effort be made to remove barriers to women's participation in health reform, particularly in the community needs assessment process, by employing consultative methods that encourage the participation of women who may be uncomfortable in speaking at open meetings or who may have care giving responsibilities that preclude them from attending meetings.

  7. It is recommended that the following particular areas of concern for women's health services be included in health planning done by regional health authorities:

    • mandated health promotion services specifically directed toward women

    • services specifically directed towards high risk groups of women such as Aboriginals, seniors, young women and women experiencing violence in their homes.

    • choices in reproductive health services for all women including the promotion of safer sex, and support and resources for pregnant women including those who desire pregnancy termination and those who wish to remain within their communities for low-risk deliveries.

  8. It is recommended that each RHA establish a patient representative staff position and that this position be responsible for:

    • advocating for patients;

    • acting as a central information source about health programs and services, the RHA and the overall health system; and

    • assisting with outreach to the community and particularly those groups of people who may be at a disadvantage due to cultural or language differences, limited education, or restricted financial resources.

Conclusions

Health reform is of critical interest to women in the province. The outreach pilot project demonstrated that women are willing to participate in the reform process providing they have adequate information on how to become involved in the process, and what to expect from their involvement.

Education and communication are critical to the success of regionalization and health reform, particularly in the area of community needs assessment. Without an informed health consumer group, people have no knowledge base from which to assess alternatives to the existing system. It is also critical that the RHAs recognize that gender sensitivity is essential to developing a system that will equitably serve a group that represents more than half of the population.

Since the beginning of 1996, the Women and Health Reform Working Group has gained a breadth of knowledge about women and health reform. It has established an extensive network of contacts both within the health professional group and women consumers. It has gained expertise in facilitating community-based women's health interest groups.

The Women & Health Reform Working Group offers to those in decision-making positions within the health system a useful resource for developing contacts with those interested in women's health issues and a ready sounding-board for ideas to facilitate women's involvement in the health reform process.

(C)1997,1998 by The Women's Health Clinic Of Manitoba

top of page

Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic

This page updated