1.1.2 ms elly taylor
•Download as PPT, PDF•
0 likes•568 views
1.1.2 ms elly taylor
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to 1.1.2 ms elly taylor
Similar to 1.1.2 ms elly taylor (20)
More from Australian Women's Health Network - 7th Conference 2013
More from Australian Women's Health Network - 7th Conference 2013 (20)
Recently uploaded
Recently uploaded (20)
1.1.2 ms elly taylor
- 1. The social determinants of women’s sexual and reproductive health and wellbeing Women’s Health West Elly Taylor Women’s Health Promotion Coordinator
- 2. Overview  Examine how Women’s Health West conceptualises the social determinants of women’s sexual and reproductive health in a Victorian context  Explore the Sexual and Reproductive Health Promotion Framework 2012, which is a conceptual evidence-based guide for women’s sexual and reproductive health promotion planning
- 3. Women’s Health West Feminist women’s health service for Melbourne’s western metropolitan region Our work is informed by three conceptual frameworks:  health promotion  community development  a gender equity approach
- 4. Various conceptualisations of the social determinants of health Ottawa Charter World Health Organisation Health Canada Dahlgren and Whitehead Raphael et al. Peace Shelter Education Food Income Stable ecosystem Sustainable resources Social justice Equity Social gradient Stress Early life Social exclusion Work Unemployment Social support Addiction Food Transport Income and social status Social support networks Education Employment and working conditions Physical and social environment Healthy child development Gender Culture Agriculture and food production Education Work environment Unemployment Water and sanitation Healthcare services Housing Aboriginal status Early life Education Employment and working conditions Food security Gender Healthcare services Housing Income and its distribution Social safety net Social exclusion Unemployment and employment security
- 5. Phase one: Mapped service and program delivery and undertook a needs analysis of communities who are disproportionately affected by sexual and reproductive health inequity Mapping and Needs Analysis: Sexual and Reproductive Health in the ` HealthWest Catchment Report, 2010 Phase two: Conducted an in-depth analysis of the social determinants of women’s sexual and reproductive health Social Determinants of Sexual and Reproductive Health Report, 2011
- 6. Social determinants of women’s sexual and re p roductive health  Poverty and socio-economic status  Violence and discrimination  Gender norms  Public policy and the law  Cultural norms  Access to affordable culturally appropriate health services
- 7. Sexual and reproductive health promotion framework
- 8. Action for Equity: A sexual and reproductive health plan for Melbourne’s west 2013-2017 Objective 1: Increase access to affordable contraceptives and fertility management services Objective 2: Advocate for systemic and legislative reform that promotes equity, social inclusion and sexual and reproductive health rights
- 9. Mapping and Needs Analysis Sexual and Reproductive Health in the HealthWest Catchment Report, 2010 Social Determinants of Sexual and Reproductive Health Report, 2011 available at www.whwest.org.au Elly Taylor Health Promotion Coordinator Email: elly@whwest.org.au
- 10. Mapping and Needs Analysis Sexual and Reproductive Health in the HealthWest Catchment Report, 2010 Social Determinants of Sexual and Reproductive Health Report, 2011 available at www.whwest.org.au Elly Taylor Health Promotion Coordinator Email: elly@whwest.org.au
Editor's Notes
- Welcome everybody My name is Elly Taylor and I’m a Health Promotion Coordinator at Women’s Health West.
- Today I’m presenting on the Social determinants of Sexual and Reproductive Health Report and the subsequent Sexual and Reproductive Health Promotion Framework developed by Women’s health West in 2011 I will explore how WHW has conceptualised the social drivers of SRH in a Victorian context and provide an overview of our framework, which we have used to inform evidence-based SRH promotion planning in Melbourne’s west.
- For those of you who aren’t familiar with WHW, we are the feminist regional women’s health service for Melbourne’s western region. Our work is informed primarily by three conceptual frameworks – health promotion, community development and a gender equity approach. Women’s Health West is strongly committed to working to ensure that women and girls SRH rights are protected and promoted. We contribute to social policy and law reform debate (e.g. recent involuntary and coerced sterilisation of women with a disability in Australia) and currently lead various SRH promotion programs; a health promoting schools program called Girls Talk Guys Talk the Family and Reproductive Rights Education Program that works to prevent female genital mutilation/cutting in Melbourne’s west; a sexual and reproductive health community education program for newly arrived young migrant and refugee women recently developed Action for Equity, which is a regional sexual and reproductive health promotion plan that is designed to strengthen collaborative partnerships and is underpinned by the notion that health promotion efforts are most effective when coordinated and mutually reinforcing strategies target communities most in need. The work I’m presenting today forms part of our regional approach.
- As most of us know, the SDoH refer to the societal factors – and the unequal distribution of these factors – that contribute to health and wellbeing and existing health inequities. In recent decades, the Ottawa Charter and influential work from WHO and others has seen the concept and the need for action on the SDoH reach a prominent that has been difficult for policymakers, health researchers and professionals to ignore. Yet while there are numerous different conceptualisation of the SDoH, there is a solid theoretical understanding that social factors such as education, conditions of employment including income and housing, are responsible for a major part of health inequalities between and within countries. A strong body of international and Australian evidence also shows that poor health outcomes are preventable when action works to redress the social determinants of health; as opposed to focusing exclusively on lifestyles and behavioural risk factors. What is less clear is the evidence-base for the social drivers of specific health concerns such as SRH, which is a relatively new development in the pubic health field.
- Since 2009, WHW has been the lead agency for the Western region SRH promotion partnership. In 2010, WHW and partner organisations, undertook a needs analysis of the SRH status of communities in Melbourne’s west. During this phases, 23 agencies contributed to a mapping exercise of health promotion programs and clinical service provision. A key finding of this work was that responding to the SD of SRH was out of the scope of many initiatives, which was in part due to the fact that we weren’t clear exactly what the specific SD of SRH were. In 2011, WHW wrote a report entitled Social Determinants of Sexual and Reproductive Health 2011. The work builds on the World Health Organisation’s report - Social Determinants of Sexual and Reproductive Health: Informing future research and programme implementation, which explored the complex way in which the social determinants of SRH influence and exacerbate global health inequities. The WHO report, which was one of the first of its kind, focused primarily on a developing nation context. Recognising that there would be limitations around how applicable this work would be to a Victorian context, WHW undertook a process of assessment and critique to determine which of the social determinants identified by WHO were relevant to Victoria, by sourcing extensive literature, research and evidence-based health promotion frameworks to determine necessary inclusions. This process also involved consultation with key experts in the field.
- We subsequently made a case for six social determinants of SRH that practitioners locally must work to redress to achieve sustainable and equitable health outcomes for women and girls. These are: Poverty and socio-economic status – Freedom from violence and discrimination – be that prevention violence against women, race-based discrimination, religious vilification and discrimination based on sexuality and ability Gender equitable norms – social meanings associated with masculinity and femininity and impact of these of SRH Public policy and the law – e.g. not having a national or state SRH policy, the role of the law in upholding and limiting SRH rights: abortion law reform, denial of marriage equality which continues to stigmatise SS couples and their families. Cultural norms – proliferation of pornography among young people and its impact on their sexuality, cultural norms that lead to practices such as female genital mutilation/cutting, cultural norms associated with parenting Access to affordable culturally appropriate health services In naming these six social determinants, we critiqued categories put forward by the WHO. While I don’t have time today to talk in detail about this process, many of these determinants we identified mirror those identified by the WHO – for instance: poverty and socio-economic status, violence and discrimination, access to appropriate health services. While we also decided to omit others as we deemed them less applicable to a developed nation context. A prime example of this was: WHO named education as a social determinant that significantly impacts on the global sexual and reproductive health status, specifically highlighting the gender gap in primary and secondary school participation. We concluded that in Victoria education is a less prominent or influential social determinant as we have compulsory education to the age of 17 for both sexes. So the decision was made not to name education as a social determinant, while recognising that advancing sexual healthy literacy in Victorian schools is essential. Another example: cultural norms
- After consolidating the evidence-base for the social determinants of SRH, it was acknowledged that we needed a conceptual framework for health promotion and primary prevention action. This saw the developed the Sexual and Reproductive Health Promotion Framework. Our work was modeled on prominent health promotion frameworks developed by VicHealth. As you can see it comprises five layers and recognises that factors influencing SRH lie at multiple and interacting levels of influence – individual, community and societal. The framework is informed by the understanding that opportunities to prevent SR ill health before it occurs are most effective when a range of coordinated mutually reinforcing strategies are targeted across these levels of influence. The framework begins with the six social determinants of SRH, which to be effective, sustainable and equitable health promotion interventions must work to redress. The second layer of the framework outlines the behavioral determinants of SRH, which is also informed by a review of key literature. SRH promotion strategies often concentrate on these by way of health education and behaviour change programs. While increasing women and girls capacity and autonomy to exercise healthy behaviours is vital focussing solely on lifestyle and behaviour change will not alleviate deeply entrenched health inequities. Hence, action needs to redress behavioural determinants in combination with integrated strategies that focus on the social determinants of SRH. The population target groups identified in the third layer of the framework are those experiencing the most significant SRH inequity in Melbourne’s western region. We recognise that these groups are not homogenises and that women can transition in and out of populations groups over their life course or as their circumstances change. The fourth layer of the framework draws on the work of VicHealth to outline seven evidence-based actions that are known to be effective in redressing other significant public health issues (such as tobacco reduction and the promotion of mental health and wellbeing). These are: Advocacy to foster attitudes, practices, policies and legislation conducive to optimal SRH Achieving policy and legislative reform to advance SRH rights Increase organisational capacity through sector and workforce development to strengthen understanding of health promotion theory and practice to build a trained and skilled SRH promotion workforce. Community development and capacity building activities Service and program delivery and coordination to ensure quality, comprehensive and integrated service provision Research, monitoring and evaluation to advance the evidence-base for what is deemed best practice in SRH promotion Communication and social marketing about SRH promotion priorities through local, regional and national media and other avenues such as social media. And in the final layer, there are six settings for action, which are informed by the increasing recognition that the social drivers of SRH sit outside the health sector and as such approaches must be coordinated across various sectors and setting to achieve sustainable change.
- We are currently in the process of finalising a western region SRH promotion plan that operationalizes the framework and its five layers of influence. The plan works to strength collaboration across a range of sectors and settings, using a mix of health promotion interventions and capacity building strategies to optimise SRH in Melbourne’s west. The development of a SRH framework that supports primary prevention and evidence-based health promotion within a social model of health is timely. We strongly believe that our framework and the approach we have taking in relation to the SDoSRH could be adapted for other regions and could be used to support the development of a Victorian or indeed federal SRH policy that works to redress the structural and gender inequities in order to prevent women's SRH ill health before it occurs.
- So if you are interested in this work or would like a copy of either of the WHW reports I discussed or our framework they can be downloaded from our website – or for further information please feel free to contact me. Thank you