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Building Effective Programs: Coping with the Patchwork Quilt of Women's Health Issues
A Workshop for State Health Policymakers
The goal of this workshop was to provide participating State and local officials with a forum for discussing issues and strategies for promoting more effective programs and policies to address women's health issues. The workshop was held March 12-14, 2001, in Atlanta, Georgia.
About the Workshop Sponsor.
At the completion of this workshop, participants were expected to be able to:
- Describe the issues, opportunities, and challenges associated with designing
effective strategies for improving women's health.
- Understand the latest health services research in identifying promising
approaches to address specific women's health issues.
- Identify promising policy and programmatic initiatives designed to better
address women's health needs.
- Select alternative measures for assessing individual States' and localities'
performance with respect to women's health.
- Describe alternative models for sustaining an emphasis on women's health
issues in ongoing State and local policymaking.
- Identify available research issues and strategies that promote more effective
women's health care programs.
The sessions included:
Context and Framework
Many factors make the organization and delivery of women's health care unique.
The critical question is to what extent health care systems can account for these characteristics
and design programs to mitigate their negative effects on women's health. While women's
health has received increasing attention over the past few years, there remain several key areas
for improvement. Policymakers can play a large role in bringing about
change in these areas that will impact on women's health in the future.
Coverage and Access Issues
There is growing concern regarding the increase in health care disparities between men and women, especially for women of color. Research indicates that many health care disparities are a result of a lack of health insurance that limits access to health care services. Some States have taken steps to expand Medicaid coverage for low-income populations that may not typically be eligible, while others have tried to improve access laws pertaining to specialists or contraceptives.
The Department of Health and Human Services (HHS) Office on Women's Health (OWH) has a mission to promote women's health in several ways, including coordinating with other Federal agencies, developing public/private partnerships, and promoting health care education and outreach. Many of OWH's approaches may be adapted by States whether or not they have their own women's health offices. The Agency for Healthcare Research and Quality (AHRQ) works to integrate women's health issues
into all aspects of its research portfolio, and has developed special research agendas
in several areas specific to women's health.
Women's Health Across the Lifespan
Women have unique health needs at different times in their lives, so service delivery and
payment systems and long-term care options should be designed to address these changing
needs. A number of innovative programs at the Federal and State level have been designed to implement a more integrated approach to women's care.
Research on domestic violence in the past ten years has found that the health care
system can play a significant role in identifying and intervening on behalf of victims of
domestic violence. Model State programs and legislative initiatives have been designed to
improve the health care system's response to domestic violence: the National Health Resource
Center Initiative and the Pennsylvania Domestic Violence Healthcare Response Act, which has had a positive impact on providers and patients after just one year of implementation.
Indicators of State Performance
A number of different measurement tools have been developed to help States and localities
conduct assessments of their women's health programs, establish benchmarks, and measure the
success of their initiatives over time. Two of these information sources are the Healthy People initiative, as well as State-level and national-level report cards.
Coordinating Women's Health Programs
A fundamental challenge in designing effective women's health strategies is ensuring that
policies and activities are coordinated across State and local organizations to avoid unintended
negative effects. The experiences of the States of Ohio and Illinois provide examples for how to foster collaboration across State agencies and between the public and private sector to improve women's health.
Sustaining Focus on Women's Health
To sustain States' focus on improving women's health, coordinated strategies must be undertaken which include social marketing to heighten key target audiences' awareness of the issue, and alternative organizational models, similar to Indiana's, to maintain the focus within and across public programs.
Research and Data Needs
To address some of the unanswered questions concerning women's health needs, further
research is needed on the effectiveness and cost-effectiveness of different
interventions. Furthermore, States can take the lead in moving the women's health
agenda forward in several ways, such as exploring partnerships between State health
departments and other sectors, with the support of Federal agencies like AHRQ.
AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.
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