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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.

The most challenging aspect of this project was to organize, co-ordinate and report within a six-week period. Beginning in mid-February, a Winnipeg-based co-ordinator was hired and began to work with local contacts to get the one-day workshops set up. A list of prospective participants was developed from names of local women known to have had a previous interest in health issues.

The Dauphin meeting, on March 15, was attended by 17 women from Dauphin, Swan River, Flin Flon, Garland, Ste. Rose du Lac and The Pas. Some listed themselves simply as consumers while others were affiliated with the following groups/organizations:

• Manitoba Women's Institute
  
  
• Action Committee on the Status of Women
  
  
• Prairie Women's Health Centre of Excellence
  
  
• Child & Family Services
  
  
• Swan River Hospital Auxiliary
  
  
• Medical Services Branch, Health Canada

The Thompson meeting on March 22, was attended by 28 women from Thompson, Cross Lake, The Pas, Norway House and Wabowden. This group had stronger ties with organizations/groups including:

• Opasquiak Women's Resource Service
  
  
• Cross Lake Community Council
  
  
• Norway House Community Council
  
  
• Regional Women's Native Group
  
  
• Action Committee on the Status of Women
  
  
• Keewatin Community College
  
  
• INCO
  
  
• Indigenous Women's Collective
  
  
• Thompson Hospital
  
  
• Thompson Senior's Community Resource Council,
  
  
• Department of Northern Affairs
  
  
• Wabowden Native Women's Group
  
  
• Society of Manitobans with Disabilities
  
  
• Immigrant Women's Association
  
  
• Office of Oscar Lathlin (MLA)
  
  
• Business and Professional Women's Club
  
  
• Thompson Immigrant Women's Association
  
  
• Thompson Native Women's Group
  
  
• Keewatin Community Council
  
  
• Faculty of Social Work (UofM) in Thompson
  
  
• Manitoba Health, Home Care (Thompson Region)

Each meeting was attended by a Health Program and Operations Liaison Officer (Manitoba Health) who was able to share information about the progress of health reform. The liaison officers offered some insight into the process for community involvement in health reform and regionalization.

The agenda for both meetings was identical: introductions with an overview of WHRWG's activities as a way of setting the context, followed by the participants separating into smaller discussion groups. Four questions served as the basis for discussion.

1. What ideas do you have to make the health system more responsive to women?
   
   
2. What are the issues regarding women's health in your region, as you see them?
   
   
3. How do you see health reform taking shape in your region? What opportunities do you perceive?
   
   
4. What ideas do you have to make women more involved in health reform?

The discussions were not limited to the narrow definition of women's health issues. At each meeting, it was clear that the women understood that women continue to bear most of the responsibility for looking after their families regardless of whether they work for remuneration outside the home, as unpaid volunteers in the community, or as full-time homemakers. As such, concern was expressed that there is a lack of support services for women placed in a care-giving role in the case of illness within the family.

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 input into decisions about health, then the details of health care which concern them will not be quickly changed.

In both meetings, there were common concerns expressed over the increasing lack of health care services in rural and northern regions including:

• home care and personal care home facilities;
  
  
• shortage of physicians (particularly female doctors);
  
  
• lack of specialists;
  
  
• reproductive services and information, midwifery, social services for pregnant teens and single mothers;
  
  
• cutbacks to health care education and delivery in schools; and
  
  
• mammography and other services for women, particularly relating to menopause and post-menopause.

As well as the foregoing, the conviction was expressed at both meetings that there is a lack of sensitivity to health care problems that are exacerbated by distance and isolation.

In addition to similarities in health care concerns, there were also striking differences. For example, in the Parkland region, a policy that has led to the restriction of reproductive services is a matter of concern. In Burntwood, concern was raised over the need for more culturally sensitive health services. Also raised as a major irritant is the apparent unequal access to health care due to geographic isolation and differences in available services on the basis of treaty or non-treaty status for Aboriginals. For example, the cost of transportation, both within the region and for patient evacuation to Winnipeg, was cited as very expensive for non-treaty Northerners.

Areas of strategic discussion with respect to health reform focussed on the common concerns regarding:

• the scarcity of female appointments to RHA boards;
  
  
• barriers to women's participation;
  
  
• a lack of recognition that women's health is an issue; and
  
  
• the absence of information about the reform process itself.

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.

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