Women's Health Policy

A national women’s health conference in 1985 saw the beginning of discussions on the need for a national policy concerning women’s health. In November of that year, following pressure from the women’s health movement, Prime Minister Bob Hawke announced the Government’s commitment to a national women’s health policy, "which would provide a framework and planned strategy to improve the health of women in Australia and to meet their health care needs to the year 2000" (1).

National Women’s Health Policy

In 1987, a special advisor in Women’s Health was appointed to coordinate the development of the policy with the Australian Health Ministers’ Advisory Council (AHMAC) Subcommittee on Women and Health (SCWH). Following informal consultations with service providers, women’s organisations, government representatives and individuals, the publication Women’s Health: A Framework for Change: A Discussion Paper for Community Comment and Responses was developed. Approximately 18 000 copies of this publication were distributed throughout Australia (2). A summary of meetings which took place as part of each State’s consultations were collected and collated (3). Overall, more than 1 000 000 Australian women were given the opportunity to contribute to the development of the policy.

In Queensland, a women’s health forum held in November 1987 was initiated as part of this consultative process. The Queensland Women’s Health Forum was attended by 400 women from all over the state and included presentations from several keynote speakers as well as 16 issue-related workshops (eg. Aboriginal women’s health, women as carers in the home and disabled women’s health). The aim of the workshops was to develop a list of policy recommendations relevant to the particular issue for consideration in the development of the National Women’s Health Policy (4).

In April 1989, the National Women’s Health Policy was launched. The goal of the policy was to "improve the health and well-being of all women in Australia, with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of women" (5). The policy endorsed the World Health Organisation’s definition of health as "a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity" (6). It also recognised that a range of environmental, socio-economic, cultural and biological factors impact on health.

Seven priority health issues for women

As a result of consultation, the policy identified seven priority health issues for women:

• Reproductive health and sexuality – a broad range of issues including menstruation, fertility control, sexuality, abortion, pregnancy and antenatal care, birthing, breast feeding, postnatal issues, teenage pregnancy, infertility, sexually transmitted infections, menopause and diseases of the reproductive organs were identified. Nutrition during pregnancy, lactation, menopause and the safety and effectiveness of contraception were highlighted as areas of special interest.

• Health of ageing women – specific issues impacting on the health of ageing women included lack of social supports, isolation, use of medications, mental illness and chronic illness. The need to break down existing stereotypes of older women, assist in maintaining independence and provide grief counselling, nutritional advice and programs to address immobility and incontinence was identified.

• Women’s emotional and mental health – recognition that women experience a higher incidence of mental health problems. Concern was expressed over the medicalisation of normal life stresses through the prescription of tranquillisers rather than providing women with appropriate support mechanisms. A need for the development and strengthening of social support networks and services as well as for further research into the impact of specific life events was identified.

• Violence against women – a need for preventative strategies was identified which addresses the conditions underlying women’s vulnerability to physical and sexual violence. Support services (including economic support) for survivors and their children and community education programs were highlighted as important requirements in this area.

• Occupational health and safety – need for governments, employers and unions to identify health care needs and specific hazards affecting both paid and unpaid women workers and to develop and implement preventative strategies.

• Health needs of women as carers – the majority of carers in the community are women who, as carers, experience physical, emotional and social demands. The need for additional support services and support mechanisms to protect the physical and emotional health of carers was recognised.

• Health effects of sex role stereotyping – some womens’ health is adversely affected by societal pressures to conform to particular images of women. The need to reduce these pressures and to help women develop more positive self-images was acknowledged. Improving physical fitness, raising community awareness of the damaging effect of sex role stereotyping and supporting women’s multiple roles were also highlighted (7).

Five key action areas

The policy also recognised that women’s health concerns were not limited to specific health problems, but extended to the delivery of health care and information as well as the processes which influence women’s interaction with the health system. Therefore, in addition to the seven priority health issues, the policy also identified five key action areas. These included:

• Improvements in health services for women – women require services that are affordable, acceptable, accessible and appropriate to their needs. There is a need for the provision of more specific women’s health services as well as complementary improvements to existing general health services.

• Provision of health information for women – women require access to relevant, timely and clear information to take responsibility for the maintenance and improvement of their health, to prevent specific health problems and to seek the most appropriate treatment when necessary. There is a need for special strategies for women who experience difficulty in accessing health information due to language barriers, culture, age, disability or isolation.

• Research and data collection on women’s health – need for research studies to better understand how social and environmental factors affect women’s health and to develop effective ways of preventing and managing women’s ill health.

• Women’s participation in decision making – need to strengthen women’s participation in decision making about their health and health services, both at government and community levels. Other factors include equality of opportunity in health industry employment and the need to increase women’s involvement in health research.

• Training of health care providers – both undergraduate and postgraduate health professionals should be trained in women’s health needs and the issues which affect women’s health and the health care needs of particular groups of women. The training should involve both clinical and interpersonal skills (8).

The recommendations of the National Women’s Health Policy were implemented through the establishment of the National Women’s Health Program.

National Women’s Health Program

The first phase of the National Women’s Health Program was launched in 1989 with approximately $34 million in funding, contributed by both States/Territories and the Commonwealth on a dollar for dollar basis for a period of four years, to end on 30 June 1993 (9). The implementation of the program was overseen by the Australian Health Ministers’ Advisory Council (AHMAC) Subcommittee on Women and Health.

Like the goal of the policy, the goal of the National Women’s Health Program was to improve the health and well-being of women in Australia, focusing on those most at risk, and to encourage the health system to be more responsive to the needs of women. The objective of the program was to provide funding for the promotion of primary health care for women. The program would focus on all of the seven priority areas, but only fund three of the key action areas identified in the policy.

Of the total program funding :

• 94.5% was allocated to improving health services for women
• 3.0% to health information and education strategies for women
• 2.5% to the training of health care providers (10).

The key action areas of research and data collection on women’s health and women’s participation in decision making on health were not funded.

In the area of improvements in health services, a diverse range of new or extended health services in major population centres and rural and remote areas were funded. Funding was available for the establishment of new women’s health centres, the extension of existing centres and the development of other new services. Illness prevention, counselling and support services, screening services and treatment, were emphasised rather than clinical and curative medical treatment (11).

Funding for the provision of health information and education was directed towards the development of information in varied formats and community languages and the dissemination of information using innovative methods (12). Funding for the training of health care providers focused on expanding continuing education courses on women’s health for general practitioners, nurse practitioners and for teachers of young women (13).

Implementation in Queensland

The implementation of the National Women’s Health Program differed greatly between States and Territories, depending on what services were established prior to the program. For instance, in New South Wales and Victoria there were a number of existing women’s health services, such as women’s health centres and sexual assault services. Program funding allowed these States to expand existing services to regional areas and to address specific groups of women (women of non-English speaking background, Aboriginal women, rural women, older women, young women). However, in Queensland there were limited services dedicated to women’s health prior to the program, except family planning and obstetric and gynaecological services (14). Therefore, the focus of funding allocation in Queensland was for the provision of primary health care and health information.

Funding was used to establish:

• Women’s health centres – centres providing counselling, education, information and referral services to both individual women and to groups. Some centres also provided clinical services and participated in community education and development.

• The Mobile Women’s Health Program – employment of women’s health nurses in seven regional centres, to provide health promotion activities, counselling, screening, information and education to women within a 300 kilometre radius of their base.

• Women’s health workers – employed in existing organisations to provide health information and education services, counselling and referral.

• Other projects within existing organisations which focused on particular health needs – for instance, the employment of a part time health worker by the Cathay Club to provide health information and education, referral and counselling to Chinese women (15).
  

Evaluation of the program

In June 1992, a steering committee was appointed to evaluate the National Women’s Health Program. Part of the evaluation was to examine the functioning and effectiveness of funded activities within the three components of the program, provide recommendations on further funding and to identify appropriate future strategies.

The National Women’s Health Program: Evaluation and Future Directions report was released in 1993. The report stated that the:

• The program demonstrated the capacity to reach target population groups.
• The program had yet to focus systematically on the needs of particular groups (young unemployed women, women with low incomes, women who are carers, ageing women).
• Priority needed to be given to the development of a data collection strategy for the program.
• The program produced skilled and experienced women’s health workers and members of the community.
• Lack of funding for two key action areas (research and data collection and women’s participation in decision making) resulted in significant gaps in these areas.
• There was conclusive evidence of some well-defined frameworks for the participation of women in areas of planning and service provision in the mainstream health system (16).
  

Continued funding

The evaluation report recommended that the National Women’s Health Program be funded for another two four year periods, until the year 2001 (17). Instead, funding for the program was continued for one period of four years to 1996/97. Total funding for this second phase was approximately $60 million, again contributed by both the Commonwealth and States/Territories (18).

The election of a new Federal and Queensland State Government in 1996 resulted in uncertainty about the continuation of funding for the National Women’s Health program. However, following an awareness raising campaign highlighting the importance of women’s health issues, provision was made in the 1997/98 budget for the continuation of the National Women’s Health Program for a further two years. An evaluation of the second phase of the National Women’s Health Program was published in 1997.

In December 1997, the Public Health Funding Outcomes Agreement (PHFOA) was signed between the Commonwealth and States/Territories. The Agreement pools funds from eight Commonwealth program areas that were formerly the subject of individual arrangements between the Commonwealth and State/Territory Governments, including the National Women’s Health Program. A third agreement between the Commonwealth and States is now in place, covering five years from 2004/5- 2008/9 (19).

Queensland Women’s Health Policy

The Queensland Women’s Health Policy was developed to complement the National Women’s Health Policy, but to take into consideration the state’s decentralised population, geographical isolation and related difficulties of health access (20).

In 1992, a discussion paper Towards a Queensland Women’s Health Policy was developed and circulated statewide for public comment. Public meetings were held in Brisbane, Mackay, Rockhampton, Gladstone, Emerald, Bundaberg and Gayndah to gather feedback and to allow for consumer participation in the development of the policy. Consultations also took place with women from the Torres Strait Islands and remote Aboriginal communities. A total of 138 written responses to the discussion paper were received, representing 51 individuals and 87 organisations (21).

The feedback from the meetings and written responses were included in the Towards a Queensland Women’s Health Policy: Green Paper which was approved for publication by Cabinet in April 1993. Copies of the Green Paper were provided for comment to all participants involved in the initial consultation and relevant community based organisations, professional associations and government departments. There were 210 written responses to the Green Paper (22).

The Queensland Women’s Health Policy was released in late 1993. It was closely linked to the National Women’s Health Policy and incorporated the same seven priority health issues and five key action areas. The aim of the policy was: "To maintain and improve the health and well-being of Queensland women, paying particular attention to those most at risk and to reorient the health system to be more responsive to the needs of all women" (23).

The policy identified six goals and corresponding objectives to meet these goals:

Goal 1 - The Queensland Government is committed to the reduction of inequities experienced by women in the health system:

• To promote and implement the Queensland Women’s Health Policy and its guiding principles.
• To facilitate the establishment of women specific services in the 13 Queensland Health regions.
• To facilitate improved access by women to appropriate and adequate health services.
• To reorient the public health system to better meet the diverse needs of Queensland women.
• To maintain a high level of quality and effectiveness in women’s health services and programs.

Goal 2 - The Queensland Government is committed to the improvement of women’s access to health services, programs and information:

• To develop and deliver programs and services in ways accessible to women with regard to their age, geographical location, financial circumstances, social role or cultural background.
• To develop information and resource material enabling women to better understand health issues and to make informed health decisions.
• To extend the knowledge and skills of professionals in the area of women’s health to subsequently improve the quality of services offered to women.

Goal 3 - The Queensland Government is committed to improvements in the quality, relevance and usage of data on women’s health and well-being:

• To initiate and promote research consistent with women’s health priorities.

Goal 4 - The Queensland Government is committed to women’s participation in health and decision making:

• To increase the participation of women in health decision making as consumers, service providers and policy makers.

Goal 5 - The Queensland Government is committed to the promotion and protection of women’s right to health care which meets their needs:

• To address reproductive health issues for women through policy innovation, implementation and program development.
• To improve service design and delivery to women who experience violence.

Goal 6 - The Queensland Government is committed to addressing the health effects of sex role stereotyping on women:

• To promote positive attitudes to, and non-biased images of women (24).
  

National Women's Health Policy today

Over the last few years there have been discussions in the women's health sector about putting women's health back onto the national health policy agenda. The Australian Women's Health Network developed a discussion paper, Women's Health: The New National Agenda and held a summit in Canberra in September 2007 (25).

References

For further information sources on this topic see our Internet resources for assignments page.

This student factsheet is one of a series produced by Women's Health Queensland Wide. They have been developed in response to students' most frequently asked question and reflect a range of topics examined by high school and tertiary students. It has been reviewed by our Editorial Committee. This factsheet is designed for student assignment purposes and, therefore, may not be an appropriate source of information for personal use.

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Last Modified: October 30, 2007