2 2 South Australian Women s Health Policy To order copies of this publication, please contact: Department of Health PO Box 287 Rundle Mall Adelaide SA 5000 Telephone: (08) Facsimile: (08) Copies of the policy can also be obtained through the Health Reform website on: Government of South Australia Published March 2005 The text in this document may be reproduced free of charge in any format providing that it is reproduced accurately and not used in a misleading context. The material must be acknowledged as Government of South Australia copyright and the title of the document specified. ISBN: X
3 1 Why A Women s Health Policy? This is a policy like no other. It is about who we are and what we will do. It is about all of us the whole health system and the South Australian community. It is about how changing health for women, changes health for everyone but it starts with women. This policy commits all of us to improving the health of women and girls of all ages. The evidence for strengthening women s health and women s participation is clear. Around the world strong economies and inclusive societies rely on the growing participation of women. Health systems must respond to the particular and diverse needs of women. With women s health at the forefront, health services increase their responsiveness and their effectiveness in delivering HEALTH FOR ALL. This South Australian Women s Health Policy will bring women s health to the forefront of health reform. This Policy is here to make a difference in women s lives and the life of our State.
4 2 Policy Context The South Australian health system has started a generational reform process in health. The Government s agenda for South Australian Health Reform: First Steps Forward committed the health system to a range of reforms designed to: provide services closer to home, and increase prevention, early intervention and health promotion; strengthen primary health care services by creating greater opportunities for health professionals to work in local teams. This will include better opportunities for General Practitioners and allied health workers and nurses to work together, giving people easier access to health services; improve health services for the most vulnerable populations in the community, in particular Aboriginal people, children and young people, people with a mental illness, and the frail aged; develop a healthy workforce with the right skill balance and the required training, recruitment and retention strategies to support the new system; sustain the current system while reforms are developed and implemented; produce new governance structures, new models of funding services and new methods of sharing information which focus on the needs of the population, rather than on the health institution; and broaden the involvement of health practitioners and the community in health planning and policy decision-making. To achieve health reform, women s health issues must inform the way the health system plans, develops, drives and delivers these changes. South Australia s Strategic Plan Creating Opportunity identifies key priorities and targets to further improve our quality of life and the well being of individual citizens and the community. The focus is on people being healthier and fitter, with emphasis on preventative measures, including education programs. To achieve the priorities and targets of South Australia s Strategic Plan the health system must ensure strategies are developed which reflect and respond to the health needs and conditions of all women. Women make up approximately 51% of the South Australian population. Women are the majority of health consumers, the majority of health service providers and the majority of carers. Improving the health of all women will improve the health of the whole community.
5 3 Policy Context The South Australian Women s Health Policy provides the foundation on which we will build a new approach to women s health and a new approach to the delivery of health services. It guides reform of the health system, so that it becomes more accessible, safer, equitable, flexible and responsive to women s lives. This Policy is a driver for South Australian Health Reform. It sets out the key priorities for action to ensure the health of women throughout their lives is promoted, maintained and sustained. The Government is committed to HEALTH FOR ALL but that does not mean one size fits all. Progressively further policies and strategies are being developed and rolled out which aim to improve the health of all South Australians. We are starting with women s health. Our health system must reflect and respond to our community s diversity. The place to start is with women in all their diversity. A reform agenda that is silent on the issues and needs of women is a reform agenda that will not succeed. That is why this Policy has been developed early in the Government s 20 year generational health reform agenda. We want to make sure it makes a difference. This Policy is our chance to change what we do in health and it will when we all act together.
6 4 South Australian Women s Health Policy Strategic Goals The purpose of this Policy is to improve the health of all women. It is universal in its reach, but it starts with those women who have the least access and experience the worst health outcomes. This particularly means ensuring this Policy works for Aboriginal and Torres Strait Islander women. To implement this South Australian Women s Health Policy means: To protect, promote and advance the health of all women. To drive the development of a health system that is sensitive and responsive to women s health. To establish effective mechanisms for women to influence the health system. To improve health outcomes, access and participation of Aboriginal and Torres Strait Islander women. To ensure women from Culturally and Linguistically Diverse backgrounds get the services they need in ways that respect their culture and their rights. To reduce physical, social and environmental factors that contribute to the poor health of women. To ensure continuum of care for women spans all life stages. To build broad understanding that women s health status includes physical, emotional and mental health. To strengthen the responsiveness of Primary Health Care services to women s health issues.
7 5 Priorities For Women s Health Health Services will reach out to women and work with women on issues that are important to them. Women s health is the responsibility of all Health Services, not just women-specific facilities. All Health Services will develop a focus that demonstrates an understanding of women s needs and delivers the kinds of services and strategies that women want. Women s Health Integrated Strategies All Australian governments have agreed on seven National Health Priority Areas. They are: Cancer; Asthma; Arthritis and musculoskeletal conditions; Diabetes; Heart, stroke and cardiovascular health; Mental health; and Injury. Each state, each region and each community must develop health strategies which address these priorities from within their own local context. However, it is critical to ensure strategies developed around these priorities also reflect and respond to the particular needs of women and their social and environmental conditions. Health Services will be required to demonstrate that services and strategies designed to impact on their community s main health issues include specific responses to women. In addition to these nationally identified priorities there are a range of health issues which are consistently raised by women as important for securing their health. These include obesity, mobility and physical activity, body image and eating issues and smoking and drug and alcohol issues. The best way to deal with these, and the full range of women s health issues, is through the adoption of integrated strategies that promote the physical, mental, social and emotional health of women and through strategies which give women a voice in their own health.
8 6 Priorities For Women s Health Women s Health Access to Health Services Health Services will work to ensure that all women, irrespective of where they live, their race, culture, sexuality or personal circumstances, have universal access to basic health care that is timely, of high quality, safe and responsive. These services must cater for the full range of physical, mental, social and emotional well being issues that confront women. Access also means that these services will be effectively coordinated, so that women consumers receive holistic, integrated care. The aim is that every woman will experience a health system which understands them and is responsive to their lives, backgrounds and circumstances. There will be an emphasis on addressing women s health issues early and preventing health problems. Increasing women s access to primary health care services will be a major focus. Access is critical for health promotion, prevention, early intervention and the effective management of health problems. Working closely with and supporting General Practitioners and other primary health care providers is a fundamental cornerstone of this approach. Health Services will be responsible for providing and coordinating a continuum of services from health promotion and illness prevention through to more specialised women s health services. There will be an integrated approach that puts the needs of women consumers at the forefront. In addition to the development of primary health care services that are accessible to women, Health Services will also reorient specialist secondary and tertiary care services in order to take account of the needs of women. This will include the need to review the way these services are developed and delivered to ensure they are responsive to women s needs, flexible in their delivery and respectful of women s rights. Women s Health Aboriginal Health This Policy recognises the imperative to improve the health of Aboriginal and Torres Strait Islander women who have had unacceptable levels of poor health in our community for too long. There will be a specific emphasis on increasing the full participation and leadership of Aboriginal and Torres Strait Islander women in the health system and in Aboriginal communities.
9 7 Priorities For Women s Health Improving the health of Aboriginal and Torres Strait Islander women is not just about the provision of health services. It is about their participation in those services. Health Services will work in partnership with Aboriginal and Torres Strait Islander women and communities to: increase community participation and leadership in health; increase Aboriginal and Torres Strait Islander specific primary health care services for women at both statewide and local levels; increase employment and training opportunities for Aboriginal and Torres Strait Islander women in the health system; provide services that respect culture and rights; and identify and eliminate discriminatory practices. Health Services and partnerships will take into account the demographics of Aboriginal communities. While recognising the importance of an ageing population, Health Services will respond to the higher proportion of children and young people in Aboriginal communities. By working with Aboriginal and Torres Strait Islander women, we can improve the health of all Aboriginal and Torres Strait Islander people. Women s Health Women s Safety Women experience violence, including sexual violence, in their families and in our community. Women face violence in ways that entraps them, damages them and can kill them. We must have zero tolerance to violence. No level of violence is acceptable. There are no reasons no excuses. Health Services must develop strategies which: promote women s safety in the home and in the community; help women to safely disclose their experience of violence; provide immediate responses when needed; link women to the range of community supports they need; and above all else, make sure that Health Services persist until women are safe.
10 8 Priorities For Women s Health Women s Health Reproductive Rights and Sexual Health It is a given that women must have access to: a full range of contraceptive advice and services; woman-centred, safe and flexible birthing services; well-coordinated antenatal and post-natal services; pregnancy support and safe termination services; culturally appropriate, sensitive and safe services; immediate access to information about safe sex, healthy relationships, sexuality, sexually transmitted infections and reproductive issues; and information on practical parenting assistance. Health Services, while responding to the full range of women s health issues, will ensure that women s reproductive and sexual health issues are consistently and comprehensively addressed through well-coordinated networks of care. Women and Disability No Obstacle for Women s Health Women with disabilities are entitled to the full range of services and opportunities available to all people. The health system must adapt its services and strategies to ensure that this right is guaranteed. All Health Services will: identify and eliminate practices that are discriminatory; redesign policies, programs and facilities to ensure that services are accessible for people with disabilities; increase employment opportunities for women with disabilities; and report progress on initiatives that target women through Disability Action Plans.
11 9 Priorities For Women s Health Women s Health Mental Health The reform of the mental health system will take into account the particular needs and circumstances of women. Mental Health Services will be sensitive to the needs of women and will listen to and will involve women in planning and program delivery. There will be an emphasis on early intervention and a holistic approach to women s mental and emotional health that recognises the connection between physical, social and mental health. Services will be available to women who are: well; at risk of developing a mental health issue; and experiencing mental health issues or mental illness. There will be a focus on developing local responses, so that women have earlier access to services in the community such as counselling and support. Health Services will work with Aboriginal and Torres Strait Islander women to increase their responsiveness to mental health and social and emotional well being issues. Health Services will reach out to refugee women and women survivors of torture and trauma. Our health system must not add to their trauma and dislocation. Health Services will be provided in ways which respect their culture, acknowledge their circumstances and help them to rebuild their strengths. Women s Health Women s Lives This South Australian Women s Health Policy is primarily focussed on women and their health and on changing the health system to better match their needs. It also recognises women take on many roles that have a major impact on other people. Women are both the greatest users of health services and the greatest proportion of the health workforce. Women work in paid and unpaid work, as volunteers and carers. Women are the principal carers of children, the frail and elderly, people with a disability and people with a mental illness all groups who are significant users of health services. Getting women s health right is therefore good for the whole community.
12 10 Priorities For Women s Health Many women are doing double duty in workplaces, communities and at home, and need services provided in ways, at times, and in locations that make it possible for women to use them. Women s child care responsibilities, transport needs and hours on the job, both formal and informal, must form part of the planning for health service delivery. Health Services will ensure that their activities and services accommodate the demands and circumstances of women s diverse roles. Women s Health Stronger Together This Policy is different because it requires Health Services to ensure the active participation of women. Women will be: leaders drivers, and contributors to changing health care and health strategies to achieve better health for all women. Health Services will make spaces for women and promote their capacity to engage in and lead health reform strategies. This will include: provision of accessible information about women s health issues and evidence based health interventions; women s leadership development strategies; mentoring programs which foster women s skills; opportunities for women to connect with each other and develop innovative approaches for improving women s health; and ensuring Aboriginal and Torres Strait Islander women are actively encouraged and supported to participate in leading these strategies.
13 11 Priorities For Women s Health Women s Health Women Speak for Themselves Women will have a say in their own health care and will be encouraged to speak for themselves about the issues that are important to them, including how Health Services are provided. Health Services will have mechanisms in place for women to influence how health strategies and health care are delivered. Women s views will be actively sought in debates around health issues that directly affect them, their families and their communities. Health Services will ensure that women are active in all that they do, by assertively recruiting, training and supporting women to undertake decision-making roles in organisations. Women will be appointed to Health Boards and Committees to fulfil the Government s goals of 50% women members on all Boards and Committees and 50% of all Chairs of Boards and Committees being women.
14 12 Women s Health - Let s Get Moving Women s health affects everyone. Women s voices will be strengthened and will provide leadership to drive change. Health Services will create opportunities for women to: access health services; shape and transform health services; and realise health benefits today and into the future. The South Australian Women s Health Policy is here and it is now it is a tool for us to use today and a tool to help us build a healthier future for South Australian women. So let s get moving!
15 13 Drivers For Change Change must be led, and it must be driven. A number of key actions will drive the changes we need. These are critical to the successful implementation of the South Australian Women s Health Policy. Population Health We will use a population health approach. Strategies for women s health include: the way we fund health services; addressing the social determinants that affect women s health and understanding women s experiences; basing our decisions on evidence; increasing prevention and early intervention; strategies that operate at the individual, family, community and population level; and a continuum of interventions which span promotion, prevention, primary health through to tertiary treatment, recovery and palliative care. Health Service Agreements All Health Service Agreements will be accountable for women s health in meaningful and measurable ways with real and achievable outcomes, and will make women s health a priority for action. Legislative and Constitutional Reform We will advance changes to Health Service constitutions and legislative reform to drive change and ensure that the health system is responsive to women s needs.
16 14 Drivers For Change Women s Leadership There will be leadership development for women in the community and for women employed in the health system. Participation structures and processes will take account of women s needs and circumstances and will achieve gender balance at decision-making levels. We will identify and eliminate discriminatory practices which prevent women taking on leadership roles. Health Service and Regional Plans All health plans will include specific actions that implement the South Australian Women s Health Policy and improve the health of women. Annual Progress Reports Each Region and Health Service will publicly report on an annual basis on: efforts made to improve women s health and reduce inequities; strategies implemented to drive change, consistent with this Policy; evaluation of the changes and measurement of their effectiveness; transparent accountability mechanisms for women in their communities; and progress toward improving Aboriginal and Torres Strait Islander women s participation in health.
17 15 Next Steps The Women s Health Ministerial Advisory Council will: continue to provide advice to the Minister for Health on emerging women s health issues; monitor the implementation of the South Australian Women s Health Policy in local, regional and statewide health planning and service delivery; and monitor the impact of health reform on the health of South Australian women. The Children, Youth and Women s Health Service and the Department of Health will lead the translation of this Policy into action at the local level, at the regional level and across the State. In spite of lead agency roles, it remains critical that leadership and responsibility for advancing women s health is shared at all levels and throughout the health system. Processes that regularly seek advice and feedback from women will be developed. Changes and trends in issues that concern women will be monitored to ensure that reform directions taken by the health system remain current and responsive to the changing needs of women. Partnerships will be developed with other government departments, non-government agencies, public and private service providers and women health consumers. The Department of Health will produce an annual report card on progress of implementation of the South Australian Women s Health Policy.
18 16 Guiding Principles The following principles underpin this Policy and its implementation. CONTINUUM OF CARE so that health strategies, programs and services respond to women s needs throughout their life stages. A HOLISTIC APPROACH that considers factors such as income, education, social support and other health determinants is critical to improving women s health status. GENDER ANALYSIS of all health policies and programs is an important part of service delivery. STRENGTHENED primary health care services that are locally available are the foundation for a strong health system. REPRESENTATION of women in decision-making roles is vital. PARTICIPATION of women in informing health policy, priorities, planning, review and service delivery is essential. SOUTH AUSTRALIAN WOMEN NEED ACCESS to a range of health services regardless of their place of residence. RESPECT FOR DIVERSITY in gender, race, age, cultural background, disability and sexual orientation underpins efforts to improve women s health. IMPROVING WOMEN S HEALTH REQUIRES PARTNERSHIPS with women, public and private service providers, researchers, government and non-government agencies. INFORMATION AND RESEARCH that reflects the diversity of women s experience will inform the development of service models.
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