ADVOCACY & POLICY ADVICE
Women and Health Reform Working Group Report
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PROGRAMS & SERVICES: ADVOCACY & POLICY ADVICE Women and Health Reform Working Group Report |
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Recommendations The following recommendations are compiled from the experiences of the Women and Health Reform Working Group; the ideas generated in the Dauphin and Thompson outreach workshops; and the review of literature prepared by Liz Loewen for the WHRWG. 1. Expand the information outreach process It became abundantly clear as a result of the outreach workshops that women do have a keen interest in health reform, and that they are concerned that both their needs and those of their family be reflected in changes to the health system. However, it was also obvious that for women, or any consumers for that matter, to make contributions to the reform process they must feel comfortable about participating in the process. It is essential that information be provided to them in an easily understandable format, prior to their becoming involved in the process. As the two workshops demonstrated, small-group, community-based, facilitated meetings can provide women with a base of knowledge from which they can go forward and more confidently participate. To assist with the information outreach process, the Women and Health Reform Working Group has prepared a "Tool Kit" that will provide interested women details on how to run a community meeting as well as resource material related to health reform. It is recommended that community information outreach meetings specifically directed to women be continued. Funding will be required to conduct these meetings. 2. Encourage gender analysis and gender-sensitive policies Gender neutral policy, or policy that does not appear to discriminate against men or women, might seem to provide equal opportunities for all people. However, men and women, because of their differing circumstances, may not be able to take advantage of similar opportunities equally or may be affected by different aspects of a policy in different ways.[3] Without gender sensitive analysis, presumed outcomes may be considerably different from reality. For example, in the 1996 Report on the Health of Canadians, women's health was identified as better than that of men's as women had longer lifespans. In the same document it was also reported that: women had lower self-reported health ratings and spent more years living with chronic illness; the gap in life expectancy between women and men was decreasing; and there had been no improvement in the incidence of low birth weight deliveries. When all these health measures are included in overall health status, it seems women's health is not necessarily better than men's, and it is not improving at the same rate as the health of men[4] Specific needs and preferences that are gender-based must be kept in mind if health-related policies are to achieve their intended ends. Women have often turned to alternative methods for managing illness. Support groups have proven to be effective in helping women with specific health concerns. Access to female health providers may be of particular concern to some women seeking services for specific health needs. A gender-based analysis of health care reform in Manitoba will identify possible strengths and weaknesses and increase the chances of improved health for women and men resulting from the reforms.[5] 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. Develop networks of women interested in women's health issues In order to ensure that there are women available to provide advice and to participate in all levels of decision-making in the health system (eg. regional health authority boards, provider advisory councils and district health advisory councils), it will be imperative to continue to network among women across the province and within regions. This can be achieved through the maintenance of a list of interested women, the exchange of information (perhaps via a newsletter and web page), and the convening of meetings as issues arise. 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. Enable women's participation in governing boards, advisory councils and community needs assessment For a number of reasons, including economic and social, women are often reticent or unable to participate actively in decision-making and policy setting relating to issues of vital importance to them. Those reasons may include[6]:
There is an added dimension to health reform that further inhibits women's participation in the process. In an effort to ensure a fresh community voice without ties to the existing health care system, health care providers were excluded, by legislation, from appointment to regional health authority boards. However, this inadvertently discriminates against women as many women in rural areas, with the expertise and interest needed for board positions, are employed in health care.[7] 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. It is further recommended that gender sensitivity training and information about the impact of gender on health should be required for all regional health authority board members. And 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 caregiving responsibilities that preclude them from attending meetings.[8] 5. Incorporate crucial health services for women within the Core Services Agreement in Manitoba document The Core Health Services in Manitoba document outlines the services to which people in each region must have access. The document generally does not specify programs or specific focus groups for each service in order to allow the RHAs to structure the system to meet the needs of each unique region and community. While flexibility is important for region-specific planning, access to crucial health services for women in each region must be ensured.[9] 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:
6. Establish a "patient representative" staff position within each RHA It can be difficult and confusing for consumers of health services to know how to access needed services, or where to seek redress if they do not feel they have been treated appropriately either by care providers or the system itself. This can be a particular problem for cultural or linguistic minorities; those who are educationally or financially disadvantaged; or those who, by societal tradition, do not easily question authority. For women, who can fall into all three categories and are responsible, in the majority of cases, for the family's health care, dealing with the health system can be daunting. Given that the system is undergoing change, there is an opportunity to make the system more "user friendly" by creating a staff position of patient representative in each region. While the patient representative would advocate within the system for patients, this person would also be a central source of information for consumers about the system and available services while assisting the RHA with community outreach. Additionally, the patient representative would be available to help those consumers who, for reasons of culture or language, require assistance in finding providers or services that can meet their needs. Implementing a patient representative position would also assist the RHA with quality assurance considerations. A front-line staff person designated as "patient friendly" would provide the RHA credible feedback regarding services and programs that are or are not serving the needs of the region's health consumers. It is recommended that each RHA establish a patient representative staff position and that this position be responsible for:
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Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic * Women's Health Clinic
