Introduction
The Australian Women's Health Summit, Women's Health: the New National Agenda, was attended by over 100 delegates from around Australia representing a cross section of government departments, both at the Federal and State/Territory level, peak women's organizations, Aboriginal leaders from around the country, and community organisations.
The Summit followed the release of the AWHN discussion paper, Women's Health: the New National Agenda, which was the focus of the day. The Summit was addressed by a range of key leaders in various aspects of women's health who stimulated lively discussion and debate.
Aboriginal leaders, who had come together as the Indigenous Women's Talking Circle the day before the Summit, tabled their support for the discussion paper and their wish for Aboriginal women's health issues to be included in the New National Agenda.
Following the Summit, further feedback on the discussion paper is being sought. A final version, incorporating comments from across Australia and a plan of action, will be released early next year.
The Program
Welcome to country
Louise Brown, Ngunawal Elder, welcomed the gathering to her country.
Background and Overview of Women's Health
Dr Gwendolyn Gray, Political Science Program, Australian National University
Dr Gwendolyn Gray provided a sweeping overview of Women's Health in Australia over the past 30 years or so, aptly illustrated with a range of cartoons. Gwen outlined the development of the women's heath movement in Australia from the establishment of the first women's health centres in the early ‘70s through the various national conferences and advocacy movements leading up to the development of the National Women's Health Policy and Program in the 1990s, to the current day and the need to collaborate in getting women's health profiled again on the national policy agenda.
Discussion
Margaret Heffernan, Vic:
- What lobbying is happening nationally regarding the election? Speaker expressed some alarm that there is no robust commenting in the media or more action happening.
- How can we get a really strong women's health voice into the media?
- How to maintain momentum?
Dr Gwen Gray and Marilyn Beaumont responded to these questions:
Marilyn Beaumont clarified the fact that AWHN is a volunteer organisation with no national funding – It does not have huge resources to get things happening. Its volunteer base comes fro the States and Territories and there is a need to build up this base if we are to get the momentum up for national action.
She also commented on the lack of political understanding of women's lives; that there is still a tendency to equate women's health with body parts. Leading into 2010, we need to get a much better understanding of women's health into the media.
Dr Gwen Gray commented on the need to present the media with a new angle if they are to take up on women's health issues.
Kate Lamb, Sydney West Area Health, NSW
Comment - The new story next time we meet will be what women in the House (Parliament) are doing for women. We need cross-party support, women politicians working together... eg. RU486.
Helen Keleher, Dept of Health Science, Monash Uni, Vic
Comment – We need to be careful that we don't end up with knee-jerk, cracky policy developed without consultation. We need to be savvy and strategic; policy entry points need to be thought through.
Sue Carrick, National Breast Cancer Foundation, NSW
An immediate issue for the agenda is the National Action Plan for Breast Cancer Research and Funding. Help is needed to implement this.
Betty McClellan, Queensland Women's Health Network
Thanks to Gwen for a reminder of our history...
We need to get back our passion for women's health. We need to lobby women politicians on a regular basis in order to get back on the agenda.
Deanna Eades, Heart Foundation, WA (Aboriginal Leader)
We need to get Indigenous health on the agenda. This always gets thrown on the shelf. This forum can get Aboriginal health issues brought out in the open.
Helen L'Orange, Women's Electoral Lobby, NSW
We need to get women's organisations pushing for the paid maternity leave campaign. WEL has a national election strategy and we need to get other organisations behind this.
Inescapable Complications of Gender
Professor Dorothy Broom, ENCEPH, ACT
Professor Dorothy Broom provided and erudite address on how gender complicates the business of collection evidence in health research. How we think about gender and women's health underpins the process of developing an evidence base and need to be considered upfront as factors in this activity. Dorothy referred to some of the changes that are occurring at the international and national levels affecting how we view gender (eg. The recent WHO document on Gender and Health, the rise of consumer culture, the dominance of neoliberalism, the rise of post-feminism and the emergence of ‘raunch-culture'. She illustrated her concepts with a case study of the portrayal of women and smoking in the media since the 1920s and suggested that we need to view gender as an intrinsic and relational component of culture. She also cautioned on the dangers of being too successful in promoting women's health – that this can result in the impression that ‘we've done gender'.
Discussion
Patsy Molloy, Midland Women's Health, WA
Commented on post-feminist culture - raunchy aspects of young women and sexuality and the concept that we've ‘done gender'.
Dorothy Broom, NCEPH
Emphasised the fact that the concept of gender is relational [to the prevailing culture].
Helen Keleher, Monash Uni
Commented that the National Women's Health Policy has never been formally withdrawn, but a senior bureaucrat in the Australian Government stated in a phone conversation that ‘we don't support it anymore' and that it was a ‘Labor initiative'.
Gwen Gray, ANU
Commented on the support received from two minor parties for a renewed national policy.
Jeanette Purse, Uni of Sydney
How do we get the Policy back on the national agenda? Suggested that we flip the question and ask all parties for their policy statements on mental health, reproductive health etc, post these on the AWHN website and direct the media to these (or the lack thereof).
Opening Minds to Women's Mental Health
Professor Jayashiri Kulkarni, Alfred Research Centre, Melbourne
Professor Jayashiri Kulkarni opened a very insightful discussion on the impact of gender and biology on women's mental health. Jayashiri said that medical view works on the assumption that the population is comprised of 70kg males, and tends to deny the influences of gender and sex. Mental health has always been the poor cousin in the health arena, receiving only 6.14% of the overall health budget. Within the mental health area, issues for women tend to go unrecognised, with the National Mental Health Strategy only acknowledging perinatal issues. Jayashira called for a new understanding of women's mental illness, amply illustrating this with the case study of ‘Jenny', a shocking tale of a young women with schizophrenia who failed to get the assistance she needed through the health system.
Discussion
Chris Richards, Australian Reproductive Health Alliance, ACT
Commented on the need for a national strategy, with everyone having a unified voice rather than all scratching around for scarce resources.
Marilyn Beaumont, Women's Health Victoria
Commented on the push for gender to appear throughout the National Mental Health Strategy but it didn't appear. There was a lack of understanding of the evidence around gender.
It was noted that the National Mental Health Strategy is being revised, opening up opportunities to include a focus on gender issues.
Implementing Gender, Making it Work
Professor Jane Ussher, Professor of Women's Health Psychology, Culture and Health Research Unit, University of Western Sydney
Professor Jane Ussher proposed that a gendered approach to health is necessary as women's health issues still tend to be marginalised and regarded as ‘soft'. Biomedical research assumes norms men as the standard. A gendered approach views gender as a socially constructed behaviour, historically and culturally located, and takes account of issues such as power differentials. Professor Ussher proposed that we need to acknowledge the constructed nature of health and demonstrate the importance of a gendered analysis in order to get women's health on the agenda.
Discussion
Helen L'Orange, Women's Electoral Lobby, NSW
Commented on the need to be wary of gender mainstreaming.
Working in Partnership and Collaboration
Heather D'Agnes, Bureau of Global Health, USAID
Heather D'Agnes discussed a population - environment partnership that had occurred in the Philippines. This was based on the intrinsic links between population dynamics and ecological systems and the idea that synergies would occur when both approaches were integrated. She commented that women are disproportionately impacted by environmental degradation and population pressures. As part of the work of USAID, field projects implementing family planning and environmental protection were developed, as well as leadership and capacity building strategies and targeted media campaigns. This approach was very successful in engaging men and boys and in involving women in economic activities as well as natural resource management. It was also instrumental in developing coordinated policy and establishing cross-sectoral collaboration.
Discussion
Margaret Heffernan, Vic:
What information was provided regarding sexual health, STIs, etc? Was there a decrease in STIs?
Heather D'Agnes
There was not a high incidence of STIs in rural areas but in urban centres where rates were higher, there was a large decrease in incidence rates.
? NSW
Commented that the previous National Women's Health Policy was public policy; social policy across domains. If we are thinking about a new national policy, we need to think broadly and involve those outside the health area. It should be launched by the Prime Minister, not the Health Minister.
Kathleen Maltzahn, Women's Health in the North, Vic
Commented on the major issues faced by coastal people in the Philippines – as a result of resource exploitation by wealthy foreign countries. Cuts in access to contraception are exacerbating situation for women.
Heather D'Agnes
In the UNAID work in which she was involved, a community development process was used to identify barriers, not a top down approach. At a national level in the Philippines, population growth is the problem; at a local level, barriers to contraception are the issue.
Report from Indigenous Women's Talking Circle
Indigenous Women Leaders, facilitated by Dot Henry
The Indigenous Women's Talking Circle called for a collaborative women's health policy to include all women, not splinter off areas such as disability, youth, etc. They would like Indigenous issues to be part of an overarching women's health policy. Important areas for action that were identified included:
- Economic development
- Mental health
- Violence
- Access to public health services
- Strengthening primary health care provision.
Discussion
Margaret Heffernan, Vic:
Looks forward to ongoing collaboration with Aboriginal women.
Helen Hookings, Pt Lincoln Health Service, SA
Commented on the value of collaboration between AWHN and Indigenous women's coalition. Aboriginal women's issues need to be up front in the new national women's health policy.
Profile and Strength of Indigenous Women's Health and Wellbeing
Kerrie Tim, Head of Leadership Program, Office of Indigenous Policy Coordination, FaCSIA.
Kerrie Tim suggested that with regard to Indigenous women's health, we need to start from a position of strength and develop leadership capacity at all levels of family, community and nationally. She outlined the Indigenous Women's Leadership Program which trains groups of women from around the country to become agents of change.
She noted that risk and resilience are important factors for Aboriginal people. She commented on the difficulties faced by Aboriginal women from different areas in trying to work better together as many do not have access to computers, making it hard to stay in touch. Enhancement of women's leadership, and local level meetings are crucial. The women's business/men's business model seems to function well but the concept of gender is not a term that will work in Aboriginal communities.
Kerrie read the poem, The Invitation.
Discussion
Megan Howitt, Dept of Health & Human Services, NT
How can we get information on what's happening in Aboriginal communities, from Indigenous women's perspective, through proper pathways to those in power?
Kerrie Tim
It's blooming hard! Networking is a challenge. We need a grassroots movement of people working out good lives for themselves and bringing others together. We need to sit and take the time to listen to people.
Betty McClellan, Qld
Thank you [to Kerrie]. We need to say that our focus is on women's health and that we support men's health; NOT gendered health.
Margaret Heffernan, Vic
Indigenous and non-Indigenous women need to work in partnership. All need to work in partnership.
Kerrie Tim
Yes, we need to back each other up and work against divisiveness. Reconciliation Australia is trying to do this. We need to stop dumping on each other.
Gender Equity and the Social Determinants of Health
Dr Helen Keleher, Head, Department of Health Science, Monash University
Dr Helen Keleher provided a compelling address on the need to use a social determinants approach as the basis for a new women's health policy in Australia She noted that the evidence base regarding the social determinants of health is now much stronger and more convincing than it was 20 years ago when the Ottawa Charter was formulated.
Helen provided some background to the establishment in 2005 of the WHO Commission on the Social Determinants of Health (CSDH). It includes 20 Commissioners (one being Fran Baum whose work is very familiar to many people working in public health/health promotion areas in Australian) and 9 Knowledge Networks. The final report of the CDSH is due next year. The Commission considers health systems as a determinant of health their own right and has established a knowledge network to advise governments and politicians on future directions. A central premise of this work is that health systems need to take a much more active role in reducing inequities and must work intersectorally. Finance models need to be designed to prevent people from being forced into greater poverty.
Helen proposed that gender and culture are central determinants that cut across all others. Women have become the shock absorbers of health system reforms. To address women's needs we must focus on programs targeted towards women who are most marginalised.
Discussion
Renee Kyle, University of Wollongong
How can we get States and Territories in Australia to look at the Social Determinants of Health?
Helen Keleher
We need to shape policy options in a way that political leaders and health systems will pick up on them – eg. housing, employment, training and education but targeting more intermediate determinants is often more do-able.
Marilyn Beaumont, AWHN
We need to talk about joined up policy – look at what percent of GDP is going to housing, education etc and contributing to health. The health budget is a treatment budget.
Women's Health Rights are Human Rights
Dr Jocelynne Scutt, Barrister and Human Rights Lawyer.
Dr Jocelynne Scutt pointed to the need to look at women's health in context, referring back 100 years to 1908 when women in Victoria first got the vote. She commented that hospitals today that do not provide access to terminations are arguably in breach of the Constitution. Gender has replaced the notion that we, as women, have rights. The new citizenship test will have a disproportionate effect on women. When possibilities close down, it is women who bear the brunt.
Discussion
Marilyn Beaumont, AWHN
We need to work on advocacy and our journey forward till 2010; tell women's stories to illustrate the vulnerabilities and strengths of women; gather 100 stories by 2010.
Helen Keleher, Monash Uni, Victoria
Agreed that women's stories are necessary to illustrate powerlessness and oppression. We need to call on politicians to release resources nationally to enable conversations to happen across Australia as a basis for a new national policy. We also need resources to keep the Network alive. Claire Moore, Lynn Allison, Nicola Roxon and others have shown a commitment to facilitate the coming together of women across political spheres.
Marilyn Beaumont, AWHN
Commented that the role of minor party senators is very important and we should not forget their leadership in pushing through changes. Sho posed the question: ‘What will the new policy look like and how can it influence across government?'
Summing Up
Chris Richards, Australian Reproductive Health Alliance
As $20 million was spent of the Pope's visit, the government should be able to release some funding for the development of a new women's health policy.
First thing last government did was de-fund NGOs and overseas development. If Labor gets in at the election, we need important NGOs to be re-funded.
Commended Kerry Nettle, Natasha Stott Despoja, Lyn Allison and Nicola Roxon as hard workers who get things done.
Marilyn Beaumont, AWHN
Those who wish to feedback on the Discussion Paper should do so to an AWHN Committee member.
Marilyn referred back to earlier conversation regarding using the media and suggested that we need to be strategic in how and who we collaborate with.
Kerry Silcock, Women's Centre for Health Matters
Commented that Kerrie Tucker, Greens senate candidate for ACT, would be worth engaging with.
Kathleen Maltzahn, Women's Health in the North, Vic
Environmental concerns need to be included in the Policy. Effects of global warming.
Men's approach is very technical rather than social.
Jocelynn Scutt
Commented that environmental crimes are crimes against humanity.
Robin Gregory, Women's Health West, Vic
Commented that we need to gather women's stories.
Suggested that with regard to environmental concerns, that Local Government ‘Environments for Health' framework for Victoria, provides a good model for action.
Celia Karpfen, AWHN Convenor
Celia closed the Summit and thanked everyone for their participation. She extended special thanks to the speakers and acknowledged assistance from:
- The ACT Government for funding assistance
- OATSIH in assisting Indigenous women to attend
- Dr Mal Washer for his support.
The day ended with a rendition of Bread and Roses, followed by a joining of hands around the room.
The Australian Women's Health Network acknowledges with gratitude:
The ACT Government for assistance with funding
OATSIH for a grant to bring Indigenous participants to the Summit
Dr Mal Washer for his support
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