The document discusses issues around rural women's access to sexual and reproductive health services. It notes that anecdotal evidence suggests rural women have difficulty accessing these services due to issues of availability, travel requirements, privacy, and cost of services. Data from surveys of rural women found that the top barriers to accessing contraception, emergency contraception, pregnancy counseling, and abortion were availability of services, travel requirements, and privacy concerns. The document recommends focusing on improving access to information, privacy, availability of local services, client choice, out-of-hours services, referral pathways, and confidential practices like access to female doctors.
1. Striving for optimal sexual and
reproductive wellbeing for
rural women Presenter: Shannon Hill, Women’s Health Grampians
A project of the rural services
of the Women’s Health
Association of Victoria
2. population health data
rarely represents
facts about access to
family planning services
how can we measure
rural women’s access to
family planning services?
issues remain
anecdotal evidence suggests
rural women experience
difficulty accessing sexual
and reproductive support
‘invisible’ and are not
catered for in planning or
resource allocation
4. the key issues impacting rural women’s access to:
condoms
privacy
48%
availability
25%
travel
18%
contraception
availability
37%
travel
23%
cost
16%
emergency contraception
availability
31%
privacy
31%
travel
17%
pregnancy counselling
availability
35%
privacy
20%
travel
19%
abortion
travel
28%
availability
27%
privacy
20%
96% r7Se2efer%vrr ioecefd srt eaosr pseoe nrnvoditce eansltw sin ac oyMns esAildbVeoAruIeLrdAn eBP LR(E5I V0inA% Ca) Y ot irtm oo eubltey o amfn at oinswnsuener( 46%)
5. the key themes and recommended action areas:
information
privacy
availability
client
choice
local
services
service
providers
community
awareness
out of
hours
referral
pathways
confidential
practice
female
doctors
6. Women's Health Grampians
(03) 5322 4100
www.whg.org.au
Gippsland Women's Health Service
(03) 5143 1600
www.gwhealth.asn.au
Women's Health Loddon Mallee
(03) 5443 0233
www.whlm.org.au
Women's Health Goulburn North East
(03) 5722 3009
www.whealth.com.au
Women's Health and Wellbeing Barwon South West
(03) 5564 5786
www.womenshealthbsw.org.au
Striving for
optimal sexual and
reproductive wellbeing
for rural women
Editor's Notes
Today I wanted to share the results of the Victorian Rural Women’s Access Family Planning Survey
The project has been a collaboration between the 5 rural Women’s Health Services of the Women’s Health Association of Victoria including: Women’s Health Grampians, Gippsland Women’s Health Service, Women’s Health Loddon Mallee, Women’s Health Goulburn North East and Women’s Health and Wellbeing Barwon South West
This project represents our commitment to the women of rural Victoria, striving for optimal sexual and reproductive wellbeing
The data contained within this report acknowledges the reality for women accessing family planning services in regional, rural and remote areas, and, provides vital evidence needed to improve access to timely, accurate, confidential and respectful services.
The data was gathered by asking Health and Community Service Providers across rural Victoria to complete an online survey, sharing what they know about women’s access to contraception, pregnancy counselling, abortion and the professional development needs of service providers.
This collection of data was the first of its kind in Victoria and provides us with baseline information about the barriers rural women face when accessing family planning services, and also identifies potential strategies to overcome these barriers.
We would like to acknowledge Women’s Health Victoria, The Royal Women’s Hospital and Springtech Services for their expert advice and support throughout the process
And also the dedicated Service Providers who took the time to participate in the survey
Over 20+ years of existence, women’s health services have received a constant flow of anecdotal information about the barriers and lack of access to family planning services in rural Victoria.
Despite the constant stream of evidence collected and passed on to successive governments the situation for rural women has not improved.
In addition, population health data rarely captures facts about women’s access to family planning services which makes it difficult to assess the situation, to plan for improvement or measure change.
To give you some examples
while abortion is legal in Victoria, access to abortion services is often limited or non-existent in rural and regional areas, meaning women may need to travel over 200kms to Melbourne to access these services
Our teenage birth rates are consistently higher than urban and metro areas
And even though access to STI screening may be limited, we have pockets where Chlamydia rates are extremely high
In essence, we have heard and understood the stories of women in our regionsbut have been frustrated by the lack of data and a distinct feeling that this cycle will continue until we can clearly demonstrate the need to improve rural women’s access to family planning services
By gathering and publishing this data we have started capturing the attention of local governments, primary care partnerships, hospitals , community health centres and Medicare Local
At a time where these organisations are drafting their strategic plans for the years ahead, I’m pleased to report that this data is helping us open doors and start conversations about planning for improvement in response to these issues.
So the first goal of the project was to gather the baseline data. We knew it was an ambitious task! But I’m pleased to report that the women’s health services were determined not to let the enormity of the task become yet another barrier
Coming together in partnership, we were able to share our resources, knowledge and ultimately the cost of such a large project
Being the first data collection of this type, we invested time to get design of the survey right, and enlisted the help of a contractor to build the online questionnaire, invitation and registration process, and compile the data.
The CEOs of the 5 women’s health services sent invitations out their network of stakeholders to participate in the survey
We had 225 responses in total, which included representatives from community health, local government, school nursing, family support services and general practice.
The coloured shading on this map shows we had responses spanning across All 5 of the rural Victorian Department of Health Regionscovering all 48 Local Government Areas within those regions
This level of participations was better than we had hoped and I believe is a demonstration of the strength of our connections across our regions, and also a display of the passion and commitment of the service providers who saw this as an opportunity to improve the situation
Collecting the data in a uniform way across the state has also allowed us to compare our results.It was interesting to find that there was little variance between the results for each of the different regions.
This left us with 1 clear message, rural women, no matter where they are located, face a number of barriers when trying to access family planning services.
The second goal of the project was to identify those barriers.The survey confirmed the key issues are: PRIVACY AVAILABILITY and TRAVEL
Privacy: including concerns about a lack of anonymity when requesting services,or that those requests might not be treated confidentially
72% of respondents considered privacy to be an issue in their local area
this was rated as the key issue for buying condoms
comments captured in the survey remind us that purchasing condoms or emergency contraception in a small town can mean being served by someone you know, or in the case of young people, someone who knows your parents
the Availability of services: including access to female GPs, limited access to local services, waiting times and opening hours of clinics and/or pharmacies
availability was rated as a key issue for access to contraception, emergency contraception and pregnancy counselling
comments in the survey described challenges for accessing these important services in a timely manner where GPs, the local chemist or supermarket may not be open on certain days, or where they were available, it was not possible to get a appointment with a female doctor, out of hours, or to try and fit and appointment into a lunch break where clinics may tend to run late
Travel: including difficulties with distance & and the lack of either public or private transport options
This was rated as the key issue for women accessing abortion
Where access to surgical abortion was not available locally 96% of respondents referred to services in Melbourne (50%) or out of town (46%)
A quote from the survey described the fact that women are ‘shipped off’ to Melbourne for pregnancy counselling and abortion services as ‘archaic’
The third goal of the project was to identify strategies or ideas about good practice to improve the situation
the theme of Information was consistently raised as an issue throughout the surveythis includes the knowledge and education available to both the community and service providers
This ranges from people and/or service providers not knowing what services are available, or how to access them
To the challenges for service providers in keeping knowledge up to date, or having the time or staff cover available to access professional development opportunities
Overall the results and strategies indicate a strong need to advocate for:
a continued culture and practice of confidentiality to alleviate privacy concerns
local services considering options that will improve availability
clear referral pathways with an emphasis on client choice, and
improving access to information, knowledge and education to service providers and the community
By gathering and publishing this data we have captured the attention of local governments, primary care partnerships, hospitals, community health centres and medicare local
This data is helping us open doors and start conversations about planning for improvement that will support the family planning needs of rural women
As a women’ health services working in a collaborative partnership, we will share ideas, develop initiatives, and build the evidence of successful strategies, specifically for a rural setting
Using the strength of this statewide piece of work, we have been able engage in strategic partnerships with The Royal Women’s Hospital and Family Planning Victoria
We are really pleased with the outcome of this work so far, and we’re feeling optimistic, but know there is much work in continuing to strive for optimal sexual and reproductive wellbeing for rural women.
To anyone who is looking for a strategy to improve access to services in a rural setting, we would recommend this approach.
If you would like more information please feel welcome to contact any of the 5 women’s health services involved in this project
Thanks for listening