Policy and Planning

Investing in Women’s Health

There is no doubt that substantial efforts are being made to support increased investments in the well-being and health of women. The link between women’s health and community wellbeing is well researched.

Compared with current trends, (increased investment scenario)... estimates that a total of 5 million maternal deaths, 147 million child deaths, and 32 million stillbirths can be prevented in 2013–35 in 74 high-burden countries.1

Investment and Planning for Women’s Health in Victoria

In Australia we know that addressing women’s health through a gendered lens has economic and social benefits to our community including greater social cohesion, increased productivity and GDP . The Victorian Government has four significant policy areas that impact the work of WHISE. These are:

Victorian public health and well being plan

Setting out priorities and vision to improve the health and wellbeing of Victorians over the long term. For the purposes of this scan, the plan defines the key challenges that the Government anticipates2:

  • increases in some risks to health and only limited or no improvement in others
  • the increasing impact of chronic disease
  • persistent inequalities in health status
  • demographic trends require new approaches
  • environmental sustainability and health protection

Safe and Strong: A Victorian Gender Equality Strategy

Setting out a framework for enduring and sustained action over time to reduce violence against women and deliver gender equality. Founding reforms of the Strategy3are:

  • Reducing violence against women
  • Develop our gender equality baseline and set gender equality targets
  • Measure progress against preliminary Gender Equality targets to lift women’s leadership
  • Embed strong governance structures
  • Commit to legislative change
  • Model gender equality in public sector workforce
  • Progressively introduce gender impact analysis in policy, budgets and service delivery
  • Leverage purchasing and funding power to influence change
  • Address the economic dimensions of gender inequality
  • Advocacy to the Commonwealth

Free from Violence – Victoria’s Strategy to prevent family violence and all forms of violence against women.

‘Free from Violence'4fulfils Recommendation 187 of the Royal Commission into Family Violence. It is a key priority of the government’s 10-year plan to reform the family violence system under Ending family violence: Victoria’s plan for change.

Identifying the causes social conditions and reinforcing factors of family violence and violence against women, the strategy commits government to:
  • Focus on the drivers of violence
  • Act on the Reinforcing factors
  • Work with the whole community
  • Reach people in a range of places
  • Connect and coordinate prevention efforts
  • Build continuity with the response system
The strategy also commits action:
  • Establishing the Prevention Agency with long term funding
  • Support development of an expert workforce
  • Create local level partnerships for effective implementation
  • Create new and innovative approaches
  • Evaluate process and outcomes to inform future practice

Women’s sexual and reproductive health: key priorities 2017-2020

The Victorian Government’s plan to improve the sexual and reproductive health of all Victorian women5. The plan focuses on the following 4 key priority areas:
  1. knowledge and awareness of factors that affect the ability to conceive a child
  2. access to contemporary, safe and equitable fertility control services to enable Victorians to exercise their reproductive rights
  3. early diagnosis, effective treatment and management of specific reproductive health issues, such as endometriosis, polycystic ovary syndrome and menopause, to reduce their impact on women’s health, wellbeing and social participation
  4. prevention, early diagnosis and treatment of sexually transmissible infections (such as chlamydia) to reduce their impact on women’s sexual and reproductive health
The four strategy and policy areas connect together to provide a broad framework for defining the work of WHISE. Together with understanding our region, its dynamics and region WHISE can align its activities to:
  • Place based approaches that are people centered
  • Improve sexual and reproductive health
  • Prevent violence against women
  • Promote gender equality as a key social determinant to improve the health and wellbeing of women in the region

Primary Prevention

WHISE recognizes that the practice of health promotion and primary prevention are evolving. To continue to be relevant health promotion can’t ignore the realities of community,the individual’s need for agency in their own lives, and the causes of health and social problems 16 from which risky behaviors arise.

Other risks to successful health promotion and primary prevention include siloed approaches from policy makers and policy structures, moving emphasis on short-term planning (as challenge when outcomes of primary prevention work are often over the long-term), a lack of coherence in approaches (sustained and multifaceted), sporadic national leadership on illness prevention and health promotion , and ongoing habit to focus on “health problems” rather than “health promotion” 19 and ubiquitous view of the overriding agency of individuals at the expense of appreciating the social determinants of health.

In terms of health promotion and primary prevention, current researchers and thinking are moving to a form of practice that recognizes the increasing levels of complexity in health inequality and, that the once simple pathways and equivalence where health equaled economic inequality need to now consider culture, psychosocial processes and the socio-political6.

health promotion workers will need to create integrated strategies that actually tackle “wicked problems” of which health inequity is one. These wicked problems often defy logic and are characterized by “having innumerable causes, (are) tough to describe, and (don’t) have a right answer”7.

This environmental scan observes that many of the risks identified to better health outcomes 10 years ago are still present.

However, what is also clear from our region, is that the dynamics of social and economic change will mean that practitioners will be confronted with more wicked problems. Health Promoters and Primary Prevention practitioners will need to build connections between policy, research and practice to generate better ways of building knowledge and skills for practice, response and policy8.

Collaboration will be key and the creation of meaningful equal partnerships of practice that achieve wide ranging social impact will be the mainstay of primary prevention work at the regional level.

Notes:

  1. Karin Stenberg, Henrik Axelson, Peter Sheehan, Ian Anderson, A Metin Gülmezoglu, Marleen Temmerman, Elizabeth Mason, Howard S Friedman, Zulfiqar A Bhutta, Joy E Lawn, Kim Sweeny, Jim Tulloch, Peter Hansen, Mickey Chopra, Anuradha Gupta, Joshua P Vogel, Mikael Ostergren, Bruce Rasmussen, Carol Levin, Colin Boyle, Shyama Kuruvilla, Marjorie Koblinsky, Neff Walker, Andres de Francisco, Nebojsa Novcic, Carole Presern, Dean Jamison, Flavia Bustreo, Advancing social and economic development by investing in women's and children's health: a new Global Investment Framework, The Lancet, Volume 383, Issue 9925, 2014, Pages 1333-1354[]
  2. State of Victoria September 2015 Victorian public health and wellbeing plan 2015–2019[]
  3. State of Victoria, 2016 Safe and Strong: A Victorian Gender Equality Strategy, Melbourne[]
  4. State of Victoria, 2017 Free from Violence: Victoria’s strategy to prevent family violence and all forms of violence against women, Melbourne[]
  5. State of Victoria, 2017 Women’s Sexual and Reproductive Health: Key Priorities 2017-2020, Melbourne[]
  6. Eckersley, R. (2015). Beyond inequality: Acknowledging the complexity of social determinants of health. Social Science & Medicine, 147, 121-125.[]
  7. Camillus, John C. Strategy has a Wicked Problem Harvard Business Review, May 2008[]
  8. Liamputtong, P. (2016). Public health : Local & global perspectives / Pranee Liamputtong, editor[]