This essay will outline Women’s Health Care Policies in Ireland and to which extent they met the target to improve the experience of health services for women. Firstly, an introduction into women’s health needs will be delivered. Then an overview of important former policies will be discussed before two important contemporary policies will be examined in more detail.
Course Title:Social Science
Module Title:Social Policy Contemporary Implementation
Assignment Title: Women’s Health Care Policies in Ireland
Word Count: 2242
This essay will outline Women’s Health Care Policies in Ireland and to which extent they met the target to improve the experience of health services for women. Firstly, an introduction into women’s health needs will be delivered. Then an overview of important former policies will be discussed before two important contemporary policies will be examined in more detail.
Women’s bodies differ from men’s bodies in needing specific health services. This leads to different ways of accessing and experiencing health services (National Women’s Council (NWCI), 2019). Women are also treated differently regarding being heard and their medical treatment. In comparison to men’s health care, women’s needs have often not been met by services. Even though in Ireland women tend to live longer than men, women have poorer health and suffer more often from chronical disease during their later years than men (NWCI, 2006).
The interplay of various factors and roles of women has an impact on the way they are being discriminated throughout their lives. Regarding their childbearing responsibilities, they need specific services in reproductive and maternal health and make use of a high amount of counselling. Since the 1970s the active management of birth had increased significantly but women-centred childbirth and choices are not freely available to women (NWCI, 2006). Also, the representation of women in the health care sector increased which is important due the fact that for women it takes longer to be diagnosed, but being treated by a woman can lead to a quicker diagnosis. But a point of disadvantage is that a higher proportion of women occupy low paid work positions. In combination with their childbearing and household responsibilities they spent a long time outside of work life and are more likely to be affected by poverty. Therefore, the two-tier system is hindering appropriate access through these social determinants.
Furthermore, the relationship between women and those in charge of their health is imbalanced. The American study The Girl Who Cried Pain (2001) gave evidence that women are more likely to be treated inadequately by healthcare providers and are rather given sedatives to shush pain in contrast to men who are given actual pain medication. Women are referred to as ‘overdramatising’, which leads to not being believed on the basis of a lack of medical awareness. Women’s pains are indeed different which leads to the concern that there has to be a rise in awareness of an integrated approach to meet the needs of both genders in equal terms but with recognition of the different needs. The following text will be examining how Irish health policies have targeted and set goals against discrimination.
The first time to integrate women’s health into health care agenda was under the lead of the Working Party in Irish Women. Agenda for Practical Action , (1985) which discussed women’s health issues and the most relevant services. The focus was on women’s childbearing role but there was also acknowledgement of their housewife roles and the development of home help services (Finnegan, R.B., 2005). But at those times the target groups were not very precisely differentiated and had only poor outcomes. But one of the first documents that had a positive impact on ’gender proofing’ was formed by the National Economic and Social Forum had successful outcomes in terms of introducing legislation prohibiting discrimination and an establishment of Equality Authority (Finnegan, R.B., 2005).
A document that has been considered as a blueprint of modern health strategy is Quality and Fairness–A Health System for You (2001), by the Department of Health and Children. To put it briefly the key points were to realise an increase the support and empowerment of women, their families and communities; achieve full health potential; and create a trusty and encouraging health system. The Health Report Women's Health in Ireland: Meeting International Standards mentioned that despite many references to women’s health, inequalities are not sufficiently mentioned. This is problematic because it means that a fundamental starting base, from what has been lacking for women so far to make a difference, cannot be guaranteed. Indeed, there is appropriate awareness of attention towards recognizing women’s needs. Still a strategic approach to address specific issues has failed.
The female gender was taken into account more specifically in The National Health Plan set off by the Department of Health, A Plan for Women’s Health (1997-1999). It was a reaction to the concern that women’s health needs were not always being met by health services. The publication of the Discussion Document was done through an integrative process in inviting women to work out the main key issues: ’access on information on health and health services, lack of structured counselling and complementary health services, and services not being women-friendly’ (Finnegan, R.B., 2005). Even though the approach was unique the results were quite unsatisfactory. The research initiative, the Millenium Project, between 1999 and 2001, revealed ’that promises made in the Plan had not resulted in change for women’. Also criticised was the paternalistic relationship between women client and service providers and more specifically, there had mostly been no timeframe and no indicators properly set (Finnegan, R.B., 2005). Furthermore, international commitments were not mentioned. Still this policy is considered as the current political statement that needs to be considered for the next policy framework.
The following contemporary Cardiovascular Health Strategy(Women’s Health Council (WHC), 2005) will be examined to the extent of taking gender into account. This strategy had become a target to international comparison, when the Women’s Health Council took part in an international project for an investigation of how gender is considered in nowadays health policy (WHC, 2005). The research group of this study had been led by twelve members from different fields in health care to develop a policy with both genders equally represented. The report was published in 1999 by the Department of Health and Children and had a timeframe for two years.
Firstly, the guiding study Building Healthier Hearts (1999) stated that cardiovascular disease is the ‘single largest cause of death among women and men in Ireland, representing 40% of all deaths in 2011’. Even though both genders are equally affected, women are considered to have differing symptoms in contrast to men, whose symptoms are described as ‘standard’. Historically the focus had been on the provision for men which results in a gap of knowledge and provision of services to women. The aim of a national strategy was therefore to provide equal opportunities for both genders to achieve better health conditions. The basic principles consisted of the factors: health and social gain; equity of access; quality; effectiveness and efficiency; accountability and audit. To deal with the high levels of mortality was important due to relatively undeveloped services at that time.
The findings of the study were that gender was not taken into account as a common theme but rather as one of various factors. At that time there were more important priorities: the key concern had been that the geographical access to health services had been very undeveloped and needed immediate improvement. Therefore, the language of this study remained mostly gender neutral and did not actively made differences between men and women. What indeed had been taken into account in the progress reports Building Healthier Hearts and Ireland’s Changing Heart was the provision of gender specific data on mortality and morbidity rates, for example: ‘that in 1997 cardiovascular disease was the main cause of death for men under the age of 65 and the second highest cause of death in women under 65’ (WHC, 2005). Also, detailed data on different experiences between the genders were given. Otherwise, the implications and consequences of the disease were left out. There was no mentioning of practical solutions or delivering recommendations.
The reason for a lack of integration of a gender perspective could be related to the fact that the disease was rather dealt with from the point of view that the male symptoms were ‘typical’, while female symptoms would often be described as to deviate from the norm. This shows that the view point of a male perspective was dominant and resulted in a lack of a sensitive approach and awareness of appropriate reaction towards the female gender. To sum it up, the basic principles had more to deal with developing a strategic improvement of access to services in different areas and improving the quality of those services. For a new strategic approach, gender should be considered as a fundamental basis throughout the whole report. The different symptoms of both genders should be recognized without hierarchical attributions and there should be more concern on women’s health consequences and practical recommendations.
On the other hand, there has been a recent political development regarding the reproductive health of women. Over many decades the conservative abortion law under the 8th amendment had been criticised for not meeting international standards. It had been criticised for even being ‘inhuman’ and too restrictive and Ireland stood under pressure to ensure meeting international human rights standards. Numerous scandals and external pressures had led to the repeal of the 8th amendment on 25 May 2018 which had been replaced by the thirty-sixth Amendment of the Constitution.
The following text will investigate the concern about the 8th amendment and the impact on women’s health after it had been repealed. Historically, the abortion law had restricted the rights of a pregnant woman to access abortions to protect the life of the unborn. The right of the unborn to the equal right to life of the woman had been standing in conflict. Abortion had been seen as a criminal act under the dominance of the Catholic Church. This caused thousands of women to travel abroad for abortion services from the 1980s on, with the majority of them getting abortions in England and Wales (NWCI, 2006). Another less favourable option was taking illegal abortion pills. To underline the importance of a policy change of this restrictive health area to women, a denial of abortions does not mean a decrease in abortions but rather the tendency for women to die earlier.
Historically there has been a direct policy reaction to an event where the 8th amendment had been seen as the result to a failed treatment of an endangered women. The case of Savita Halappanavar showed that the current policy framework had to be renewed. The woman had been 17 weeks pregnant when a miscarriage was approved but an abortion, due to her circumstance being at risk of life, was not allowed because of the Irish law which forbid abortion when there was a foetal heartbeat. In reaction to this case the Protection of Life during Pregnancy Act had been passed in 2013 which allowed abortions when the life of a woman was endangered as well as her being at risk of suicide. This political change has been a huge step towards actually recognizing the right of women to life but gave women only little power of control over their bodies.
There was an even further political development needed to meet international human rights obligations because ‘Ireland [is considered] to be in violation of the International Covenant on Civil and Political Rights (ICCPR)’. But there existed the conflict in Citizen’ Assembly wanting a repeal, whilst the Committee favouring a constitutional provision with authority of decision making. The new law that passed was the thirty-sixth Amendment to the Constitution to replace the 8th amendment. Under this new law, ‘provision may be made by law for the regulation of termination of pregnancy’ (Thirty-sixth Amendment).
As a result, women’s rights to decide over their own bodies are taken fully into account. The fundamental human right to be able to decide over their body gives them power for healthy decision making and the ability to take many factors into account. Especially when pregnancy is a result of rape or sexual assault, to decide over their pregnancy gives them dignity and helps them to strike back out of a non-consensual situation. Also, in socio-economic terms women can decide whether they are able to guarantee prosperous living quality for the unborn or rather make a decision in regards to factors that would not ensure a stable situation for all directly affected people. Furthermore, the repeal is an act of decriminalisation of abortion to instead recognize decision making sovereignty of women. This means that they are no longer faced with pressure and being oppressed by external forces. A new path is being laid out for legal access to contraception, sex education and obstetric care and counselling.
To conclude, women are not given the same and equal recognition in legislation from a baseline on which leads to unequal access and treatment of women still now. As a result, health care provision for women is not something they could trust in or rely on, which leaves them in an unstable and disadvantageous position. Especially the most recent framework, A Plan for Women’s Health , which has been seen as a key development, has so far only been a statement that would need further consideration in the next policy implementation. The lack of awareness of gender sensitive approaches results in the failure of a strategy for practical solutions in regards to gender inequality. The repeal of the 8th Amendment can be viewed as a prosperous step towards reaching an international human rights target but has only been reconsidered under enormous political pressure. For the future, Ireland will have to take gender into account as a fundamental basis and orientate more around international standards.
References:
o Considine, M., Dukelow, F. (2010). Irish Social Policy: a critical introduction. Ireland: Journal of Social Policy
o Finnegan, R.B. (2005). Women and Public Policy in Ireland. Ireland: Irish Academic Press
o Department of Health and Children (2001). Quality and Fairness–A Health System for You. Retrieved from: http://hdl.handle.net/10147/46392
o National Women’s Council of Ireland (2012): Equal but different: a framework for integrating gender equality in Health Service Executive. Retrieved from: https://www.nwci.ie/download/pdf/equal_but_different_final_report.pdf
o National Women’s Council of Ireland (2019). A briefing on Women’s Health in Ireland. Retrieved from: https://www.nwci.ie/images/uploads/Womens_Health_briefing_-_NWCI_Dept_Health_HSE_2019.pdf
o National Women’s Council in Ireland (2006). Women's Health in Ireland: Meeting International Standards. Retrieved from: https://www.nwci.ie/download/pdf/healthreport06.pdf
o Report of the Joint Committee (2017). On the Eight Amendment of the Constitution. Retrieved from: https://data.oireachtas.ie/ie/oireachtas/committee/dail/32/joint_committee_on_the_eighth_amendment_of_the_constitution/reports/2017/2017-12-20_report-of-the-joint-committee-on-the-eighth-amendment-of-the-constitution_en.pdf
o Women’s Health Council (2005). Integrating the gender perspective in Irish Health Policy: a case study. Retrieved from: http://hdl.handle.net/10147/45116
- Citar trabajo
- J. Sieber (Autor), Women's Health Care in Ireland, Múnich, GRIN Verlag, https://www.grin.com/document/1273875
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