Promoting Equalities And Human Rights Through The National Women’s Health Policy 2010 – An Analysis

HSH728 Health Equity and Human Rights

Impact of the policy on health

Discuss about the Promoting Equalities and Human Rights.

The first National Women’s Health Policy was implemented in Australia in 1989 to address the challenges faced by women in maintaining health. With the complex work demand and life circumstance, maintaining good health has become a serious challenge for women in the 21^st Century. The National Women’s Health Policy 2010 aimed to provide a strategic 20 year plan to improve health of women particularly those who are at greater risk of poor health. Health challenges like access to health service and disease risk factors are experienced by both men and women, however as women have a higher life expectancy, their burden of chronic disease also increases (Thorogood & Crowther 2015). This was main reason for the implementation of Women’s Health Policy and planning strategies specifically for the health of women. The report by Martin (2017) also proves that women have higher life expectancy than men as new born girls born in Australia are expected to live for 84.5 years and boys are expected to live up to 80.4 years. The patterns of disease and risk factors of disease and ill health also vary in women according to the different age group. This paper particularly provides human rights analysis of the National Women’s Health Policy 2010 to find out how policy driven mechanism promoted health and well-being for Australian women.

From the Human Right approach, the purpose of a policy is effective if it aims to improve the health of specific target people or seeks to improve outcome in specific health issues. Such policies should be inclusive, recognizing the rights of target group particularly vulnerable groups (Parken 2010). Such specific intended purpose was also present in the National Women’s Health Policy 2010 as the policy statement specified the purpose of the policy, which was to improve and promote health and well-being of all Australian women particular those vulnerable to poor health (National Women’s Health Policy 2010). The focus and scale of the program is also understood from its dual priorities which is to develop health services and prevention programs targeting chronic health issues which will affect health in the next two years and address health inequities across different social groups. The review of the aim and dual priorities in the policy shows that the policy has wider focus as it aims to transform of health infrastructure both for immediate and future health issues (Lewin et al. 2015). This also shows how decision making occurs during policy making process.

Human right elements affect by the policy

The priority of addressing health inequity is also an important focus in the National Women’s Health Policy 2010 as certain groups of women face socioeconomic disadvantages, which contribute to health inequity. The difference in lifestyle, employment housing, race and access to health care service particularly increases the likelihood of poor outcomes in specific group of women . For example, the health statistics of aboriginal women living in Australia show geographic difference in determinants of health. The health disparities in women is seen due to the social determinant factor of socioeconomic status, age, disability, employment , ethnicity and geographic location (Eades 2015). For instance, the Aboriginal and Torres Strait Islander women have poorer health than indigenous women due to socioeconomic disadvantage, poor housing and poor access to health service. All this translates to high rate of disease incidence, morbidity and mortality and behavioral health issues (Women’s Health – 2014. 2017). Hence, the aim of the policy from the human rights approach is commendable as it is employing social model of health approach to promote health equity between women.

The National Women’s Health Policy 2010 is likely to have positive impact on health as it has prioritized key action areas based on evidence-based data. They have identified the health priority areas of preventing chronic disease and promoting mental health and well-being, promoting sexual and reproductive health and healthy ageing. Managing chronic disease is crucial to improving health status (Zwar et al. 2017) The rate of chronic disease in Australian women is high. The policy was implemented in 2010 and at that time cardiovascular disease (CVD) was regarded as a major threat to health of Australian women. CVD lead to more deaths than any other chronic diseases. The risk factors such as lack of physical activity, obesity and poor consumption of fruits and vegetables were also high in females (Women and Heart disease 2017). The National Health Survey report 2010 also shows that 1 in every 2 Australians live with one prominent chronic disease like CDV, cancer, asthma, COPD, diabetes or mental illness. The survey also suggested that addressing behavioral and biomedical risk factor is important to reduce the burden of chronic disease (Department of Health | Chronic Conditions 2017). In accordance with such evidence based data, the National Women’s Health Policy 2010 was also found to focus on preventing modifiable risk factors of chronic disease. The policy proposed improving health through gender analysis, education and health service delivery in remote areas. They also focused on preventing obesity, using alcohol and other drug use among women.  Hence, use of these strategies suggest that such preventive health measures is likely to improve the health of women in 20 years.

Preventing obesity and alcohol usage in women are part of behavioral health promotion and they are likely to give positive results because such health promotion strategies directly address behavior that cause risk to health. Disseminating and giving education to public about health risk factors and benefits associated with positive health behavior can motivate people to modify their behavior and lifestyle (Eldredge et al. 2016). However, one limitation of this approach is that it cannot reduce inequities in health behavior. This is because the policy is for a universal population that includes both people from high and low socioeconomic group. Hence, educational interventions and social marketing campaigns will have little impact on people with poor social and economic resources (Baum & Fisher, 2014). They will not be able to modify their health behavior despite knowing about it. This evidence implies that population health outcome is dependent not just on behavioral and biological factors, but also on environmental, cultural, economic and political setting (Berkman, Kawachi, & Glymour 2014). Therefore, the National Women’s Health Policy 2010 can be considered effective for improving health if it has used broad based approach to consider health impact for women living in poor socioeconomic condition too. However, while evaluating this element in the policy, it has been found that the Australian Government focused on improving social, economic and environmental conditions of women too (National Women’s Health Policy 2010). Use of this approach is considered beneficial because it is likely to improve long term health of women too and promote health ageing.

The examination of the policy also revealed strategic action areas of improving social determinants of health and priorities women with highest risk of poor health. The policy makers employed life course approach to health, which is a commendable step as it will help to address health issues in women across different stages of life. Evidence also points out that life course approach is essential in preventative as it will support delivering age appropriate interventions which will maximize well-being in them (Halfon et al. 2014). The cost effectiveness of interventions and the policy will depend on the utility of risk assessment and continuity of services for high-risk group. National Women’s Health Policy 2010 also validated the purpose of reducing poor health in high-risk women by engaging in consultation with Australian Women’s Health Network Talking Circle to find out issues faced by Aboriginal women throughout Australia. As gap in services and health status is severe in this group, the Government prioritized the health of Aborginal and Torres Strait Islander women (National Women’s Health Policy 2010).

The core purpose and intention of the National Women’s Health Policy 2010 clearly shows that they are working to address human right element of gender equity and health equity too. For instance, this policy paid special attention to women only because gender and gender relations also had an impact on women’s health. Evidence in society proves that gender interacts with social determinants and such social realities shape opportunities for health and vulnerability to illness in women (Krieger 2014). This is also relevant to the United Nations Human Right document for women’s rights and gender equality which states that gender equality is the foundation of human right and equal rights of men and women is the core responsibility of all states (OHCHR | Women’s Rights and Gender Section (WRGS) 2017). However, the irony is that despite such documents, women still have poor access to housing, property and they face discrimination in life choices further rendering them to vulnerabilities and health issues. They often experience conflicting situations because their peace and security is compromised. In response to gender related impact on health of women, the National Women’s Health Policy 2010 has taken action in the right area by focusing on providing equal rights to women. Although the core focus of the policy is mainly address and improve health outcome, however social determinant of health influenced the health status too, they aimed to mitigate inequities within the health care and social system too. Hence, this is indicative of the potential to address right of women in society.

From a legal perspective too, discriminating against people on the basis of gender, sexuality or marital status is in violation of the law according to the Sex Determination Act 1984. The Convention on the elimination of all forms of discrimination against women has played a key role in changing people’s attitude towards women and advancing gender equity in all countries (Thornton 2013).  While reviewing Australia’s progress in gender equity after the implementation of the National Women’s Health Policy 2010, it has been found that the improvement is not massive. Women comprise about 46% of the all Australian employees, however there average earning is lower than men. Secondly, women account for 92% primary carer responsibility according to 2013 statistics. While evaluating incidences of sexual harassment at workplace and gender discrimination too, about 50% women has been found to face such issues. However, some positive developments have occurred too. For instance, women are now getting protection from domestic violence and men and women contribute equally in parenting responsibilities (Gender Equality | Australian Human Rights Commission. 2017).  Hence, it can be said that in the coming years more improvement is likely to be seen because post National Women’s Health Policy 2010, the Australian Government is also coming up with new women’s health policies and education and training programs for people in different sectors to reduce health risk to women.

The policy recognized the restriction of human rights particularly in the areas of disparities in gender equity and health equity for Australian women. As part of the United Nations obligation for gender equity, women’s right should not be restricted in areas of life. However, the policy makers of the National Health Policy found that certain sections of women like Aboriginal and Torres Strait Islanders were not getting equal opportunities both in life as well as access to health services. They were particularly vulnerable to high risk of health issues such as diabetes, kidney problem, cancer, heart disease and much other chronic disease. In all areas, the rate of such disease was high for indigenous group compared to other group because of poor environmental conditions, smoking and exposure to harmful chemicals in workplace (Summary of Aboriginal and Torres Strait Islander health « Health facts «2017). Hence, the aboriginal women experienced poorer health than other women mainly due to their life circumstances. Racism, marginalization, exposure to violence and limited access to health services deteriorated their health. They also had a greater responsibility in looking after the health of their family members. The age at death for indigenous females was also very low ranging from 50.3 years to 66.2 years (Summary of Indigenous women’s health 2017). The Australian government advocated for the health of indigenous women as the National Women’s Health Policy prioritized health of the aboriginal women.

The report regarding health disparities in Aboriginal and Torres Strait Islanders women mainly suggested that health status of indigenous women can be improved by reducing health risk factors and improving prevention and early detection of disease in this group. Secondly, to improved health outcomes, focusing on their culture and life experience was also important (Campbell et al. 2017).. The National Women’s Health Policy also took similar measures to promote health equity in aboriginal women. For example, after consulting with the Aboriginal women Talking circle, they looked at addressing gaps and barrier to health services and delivering holistic strategies to improve the health status of indigenous women. The Australian Government also emphasized on funding because to reach out to indigenous women, huge reorientation in health service delivery was required. Secondly, strategic measures were also taken to mitigate barrier to delivering health message of women. As language was the main barrier to health education, alternative forms of communication and cultural competency skills training were extended to health care staffs (Truong, Paradies & Priest 2014). The key strength of the plicy is that it took action i(n all areas not just health service, but also for the nutritional needs, physical activity, alcohol consumption, mental health and pregnant women too  (National Women’s Health Policy 2010). This is the core strength of the policy that comprehensive action was taken for women who were at severe risk to health issues.

There are many criteria that justified the restriction of human rights groups of people in the community. In case of Australian women, the provision was not to restrict right but to provide all rights to women. However, the policy identified indigenous women were restricted from basic human rights and all actions were taken by the government to promote gender and health equity for all women in Australia (Wronka 2016). The policy targeted holistic approach to well being of all women and it encompassed action across area of women’s lifespan. It empowered women to become better decision makers by raising health awareness campaigns. All issues of importance in women’s health was covered in the policy. This included range of health areas such as reproductive healthy and sexuality, health of ageing women, emotional and mental health, occupational health and safety, health needs of women cares, violence and sex role stereotyping (National Women’s Health Policy 2010). As the country move towards ageing population, commendable actions were taken to promote health ageing in women Dobson et al. 2015). For instance, all support mechanism were directed to provide counseling, ambulation and incontinence support to elderly and fulfill their nutritional needs (Kendig et al. 2014). Health lifestyle teaching and program to promote physical activity were also implemented.

The main challenge in implementing the plans of the National Women’s health policy was that it required reorientation and restructuring the entire health care system. This meant changing not only the process of care but also health care professional’s attitude towards delivering care (Raman et al., 2017).  Hence, the Government had a massive task in hand. They had to modify the health infrastructure and process of health care delivery too. The review of the policy document also revealed working mainly for the health improvement of the Aboriginal and Torres Strait Islander people. As they belong to culturally diverse group, the main action that was required was to modify the health care system to embrace cultural sensitivity in care. The policy  statement mentioned that health issues and experience of women may differ according to their culture and religious views too (National Women’s health policy 2010). Hence, in such situation, developing culturally sensitive care was the most important priority to promote participation of women in health improvement. Since, the implementation of the National Women’s policy, Australia has witnessed massive changes in the delivery of care. Health care system has been developed and minimum standards of language and culture has been maintained. The cultural competency documents and programs have also been implemented to promote health of women (Clifford et al., 2015).

As the National women’s health policy aimed to achieve improvements in health within 20 years time frame, appropriate monitoring and evaluation system was also present to check the progress of the policy compare to key goals and priorities. For instance, all interventions and their outcome were evaluated and accurate and comprehensive data were collected to see treatment response and progress made in women health. Research work were also collected to understand the challenges in the process, and bring improvement in existing health promotion methods. It was also planned to give annual report to the Australian Health Minister’s Conference to see whether the policy was successful in improving women’s health and protecting their right or not (Women’s Health – 2014 2017). Current, many progress has been seen in identify and responding to the needs of particular groups of women, however lot more things and approaches is required to completely eliminate health disparities (Freeman et al. 2014). In different areas such as ageing or mental health service, the policy proposed reporting to the Department of Health and Ageing about progress of women’s health.

Conclusion:

The review and analysis of the National Women’s health policy 2010 summarized the key goals and intentions of the policy. By prioritizing women’s health issue and looking to improve the health of indigenous women, the policy reflected use of human rights approach too. This is because the policy recognized the right of women to be treated equally and pledged for both gender and health equity in Australian women. The policy led to the implementation of many policies, health promotion programs and interventions for protecting the health of Australian women. The improvement in lives of indigenous women was also seen with better provisions for health care service and development of culturally competent health care.

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