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Building Effective Programs: Coping with the Patchwork Quilt of Women's Health Issues
Wanda Jones, Dr.P.H., Deputy Assistant Secretary for Health and Director of the Office on Women's Health, U.S. Department of Health & Human Services (HHS).
Marcy Gross, Senior Advisor on Woman's Health, Agency for Healthcare Research and Quality (AHRQ).
Wanda Jones provided an overview of the HHS Office on Women's Health (OWH), specifically focusing on the idea that the approaches taken by HHS may work for States whether or not they have their own women's health offices.
OWH works to redress inequities in research, health care services, and education that have historically placed the health of women at risk. Specifically, OWH works to promote women's health by:
- Coordinating HHS women's health activities. OWH serves as the coordinating office for women's health initiatives across the HHS agencies, including the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), among others.
- Developing public/private partnerships to support and advance women's health. OWH brings together Federal agencies, the scientific community, professional organizations, and consumer groups to support and advance women's health issues.
- Promoting health care education and outreach. OWH develops, coordinates, and monitors communication efforts to bring women in every region of the country reliable information on a myriad of health topics. It also develops mechanisms to give consumers and the private sector a voice in women's health policy.
- Developing and implementing model initiatives in women's health care. OWH promotes the development and implementation of model initiatives in communities all over the country to address the health needs of women across different ages, cultures, races, and ethnicities. These initiatives focus on issues such as how women receive care and how health care practitioners are educated on women's health.
- Working to eliminate racial and ethnic disparities in health status. OWH promotes comprehensive and culturally appropriate prevention, diagnostic, and treatment services for women across the lifespan, as well as the integration of culturally sensitive practices in medical education and research.
- Providing regional support. OWH supports Regional Women's Health Coordinators (RWHCs) in each of the 10 regions of HHS. The RWHCs coordinate activities to promote a greater focus on women's health issues at the regional, State, and local levels,
including programs in health care service delivery, research, and the education of the public and health professionals. RWHCs identify regional needs in high-priority health areas, establish networking relationships, and implement initiatives that address regional
women's health concerns.
- Developing policies to advance women's health. OWH stimulates the development and implementation of effective women's health policies at the highest levels of national, State, and local governments.
Dr. Jones posed the following questions:
- "How well have we understood the real needs and concerns of the populations we serve?"
- "Are we making the appropriate strategic decisions that account for their needs?"
She offered a three-pronged strategy for State and local policymakers to ensure that women's health issues are heard in their States:
- Infiltrate public meetings and cultivate allies and partners, to understand what's going on and raise the voice of the people you serve.
- Insinuate into the chain of review for policies and service delivery decisions.
- Integrate. Do not make any decision without full consideration of the real needs of the population being targeted, and coordinate with partners at other service sites to ensure that information is brought back and used in a feedback mechanism.
Marcy Gross of AHRQ provided an overview of the Agency's activities in women's health. The mission of the Women's Health Program at AHRQ is to ensure that women's health issues are integrated into all aspects of the Agency's research portfolio by:
- Serving as a conduit for ideas from stakeholders.
- Undertaking special initiatives.
- Providing expertise and acting as a catalyst for ideas.
- Providing technical assistance.
The Agency has funded a broad range of research, both intramural and extramural, relating to women's health, including:
- Alternatives to hysterectomy.
- Breast cancer treatment decisions.
- Health care costs, access, and quality (e.g., Medical Expenditure Panel Survey).
- Gender differences in cardiovascular disease.
- Maternal health care and pregnancy outcomes.
Among the Agency's special initiatives on women's health are to develop a research agenda in each of the following areas:
- Women and heart disease.
- Maternal health care.
- Domestic violence and sexual assault.
Gwinner, V., et al. Implementing a new model of integrated women's health in academic health centers: lessons learned from the National Centers of Excellence in Women's Health. Journal of Women's Health and Gender-Based Medicine 2000;9(9):979-85.
Mazure, C., et al. Multidisciplinary women's health research: The National Centers of Excellence in Women's Health. Journal of Women's Health and Gender-Based Medicine 2000;9(7):717-24.
Scholle, S.H., et al. Women's satisfaction with primary care: a new measurement effort from the PHS National Centers of Excellence in Women's Health. Jacobs Institute Report 2000.
About the Office on Women's Health. Fact Sheet. http://www.4women.gov/owh/about/
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