_Hlk4598617

—A human rights-based approach to women’s —

health;

281 World Health Organisation Europe. (2016). Strategy on women’s health and well-being in the WHO European Region.

282 Department of Health (2016) The National Maternity Strategy 2016-2026: Creating a Better Future Together.

283 Department of Health, Healthy Ireland. (2017). General Scheme of the Assisted Human Reproduction (AHR) Bill 2017.

284 Health Service Executive, Healthy Ireland, Breasfeeding.ie. (2016). Breastfeeding in a Healthy Ireland: Health Service Breastfeeding Action Plan 2016-2020.

285 Health Service Executive. (2017). Women’s Health Project. Retrieved from: https://www.hse.ie/eng/services/list/5/sexhealth/whp/

next five years to improve breastfeeding supports,

1 – The National Maternity Strategy 2016-2026: Creating a Better Future Together286

to enable more mothers in Ireland to breastfeed

and to improve health outcomes for mothers and

This strategy produced by the Department of

children in Ireland.

Health in 2016,which is the first of its kind,

endorses a health and wellbeing approach

The Action plan outlines the actions needed to enhance breastfeeding rates and provide skilled support to mothers, through maternity services, hospitals, primary care services and in partnership with voluntary breastfeeding organisations and other stakeholders.

which seeks to support and empower mothers

and families to improve their own health and

wellbeing as a strategic priority, in addition

to access to safe, high quality woman centred

maternity care, and facilitation of a woman’s

choice of care pathway.

Implementation of the Strategy is led by

the HSE National Women and Infants Health

Programme (NWIHP). NWIHP developed a

Figure from page 67

detailed Implementation Plan in 2017 with 77

Actions under the four strategic priorities. The

Implementation of the plan is overseen by the

National Director of the NWIHP and a steering

group. A maternity forum has been created

to engage with partners in the voluntary /

community sector. The National Strategy for Women

and Girls supports the implementation of the

National Maternity Strategy 2016-2026287 in

Action 2.19.

2 – The General Scheme of the Assisted Human Reproduction (AHR) Bill 2017288

This bill seeks to provide for legal regulation

of AHR services to safeguard the interests

of women, couples, children and healthcare

4 – HSE Women’s Health Project

professionals. The development of this regulatory

This project is run by the HSE Women’s Health

framework will also support the state to fulfil its

Service (WHS) and the Anti-Human Trafficking

commitment to provide publicly-funded access to

Team (AHTT) is a statutory service. The WHS

AHR.

operates sexual health clinic services and

outreach support to women/trans women involved

3 – Breastfeeding in a Healthy Ireland: Health Service Breastfeeding Action Plan 2016-2020289

in sex industry while the AHTT has responsibility

for care planning for both female/male victims of

The promotion, support and protection of

trafficking in all areas of exploitation.

breastfeeding is a key element of the HSE Healthy

Childhood Policy Priority Programme and the Nurture

– Infant Health and Wellbeing Programme. This Plan

sets out the priority areas to be addressed over the

286 Department of Health (2016) The National Maternity Strategy 2016-2026: Creating a Better Future Together.

287 Ibid.

288 Department of Health, Healthy Ireland. (2017). General Scheme of the Assisted Human Reproduction (AHR) Bill 2017. Retrieved from: https://health.gov.ie/wp-content/uploads/2017/10/AHR-general-scheme-with-cover.pdf

289 Health Service Executive, Healthy Ireland, Breasfeeding.ie. (2016). Breastfeeding in a Healthy Ireland: Health Service Breastfeeding Action Plan 2016-2020. Retrieved from: https://www.hse.ie/eng/about/who/healthwellbeing/healthy-ireland/publications/ breastfeeding-in-a-healthy-ireland.pdf

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

1 – Connecting for Life – Ireland’s National Strategy to Reduce Suicide 2015-2020299

4.3 Health policies, services and initiatives that are relevant to women

Connecting for Life is Ireland’s national strategy

to reduce suicide 2015-2020. It sets out a vision

There are a much larger number of health policies

of an Ireland where fewer lives are lost through

that while they do not have a specific gender focus

suicide, and where communities and individuals

are very pertinent to meeting the health needs of

are empowered to improve their mental health and

women. See Table 4.2 for details.

wellbeing. The strategy follows on from Reach Out:

National Strategy for Action on Suicide Prevention

2005-2014. Connecting for Life emphasises different

Table 4.2 Health policies, services and initiatives that are relevant to women

policy approaches aimed at:

1. Connecting for Life- Ireland’s National Strategy to

—Improving the Overall Health and Wellbeing of —

Reduce Suicide 2015-2020290

the Population;

2. Healthy Ireland Framework291

—Reaching Individuals and Groups Vulnerable to —

3. National Cancer Strategy 2017 – 2026292 (This has a

Suicide; and

specific focus within it on women)

—Providing Targeted Treatment and —

4. National Sexual Health Strategy (2015-2020)293

Programmes for Groups Most Vulnerable.

5. Obesity Policy and Action Plan: A Healthy Weight for

The strategy identifies the priority demographic

Ireland (2016- 2025)294

cohorts, in terms of vulnerability to suicide, as

6. Reducing Harm, Supporting Recovery: A health-led

middle-aged men and women, young people and

response to drug and alcohol use in Ireland 2017-

economically disadvantaged people. There are

2025295

no actions specific to women, but sex/gender

7. Sláintecare Implementation Strategy 2018296

are included in annual indicators for principal

outcomes.300

8. The Irish National Dementia Strategy297

9. Tobacco Free Ireland (2013 - 2025)298

290 Department of Health, Healthy Ireland, National Office of Suicide Prevention, HSE. (2015). Connecting for Life: Ireland’s National Strategy to Reduce Suicide 2015-2020.

291 Government of Ireland. (2013). Healthy Ireland – a framework for improved health and wellbeing.

292 Department of Health. (2017). National Cancer Strategy (2017-2025).

293 Department of Health, Healthy Ireland. (2015). National Sexual Health Strategy (2015-2020). Retrieved from: https://health.gov. ie/wp-content/uploads/2015/10/National-Sexual-Health-Strategy.pdf

294 Department of Health, Healthy Ireland. (2016). Obesity Policy and Action Plan: A Healthy Weight for Ireland (2016- 2025). Retrieved from: https://health.gov.ie/wp-content/uploads/2016/09/A-Healthy-Weight-for-Ireland-Obesity-Policy-and-Action- Plan-2016-2025.pdf

295 Department of Health, Healthy Ireland. (2017). Reducing Harm, Supporting Recovery: A Health-Led Response to Drug and Alcohol Use in Ireland 2017-2025.

296 Department of Health. (2018). Sláintecare Implementation Strategy. Government of Ireland. Retrieved from: https://www.gov.ie/en/ campaigns/slaintecare-implementation-strategy/

297 Department of Health (2014). Irish National Dementia Strategy. Retrieved from: https://health.gov.ie/wp-content/ uploads/2014/12/30115-National-Dementia-Strategy-Eng.pdf

298 Department of Health, Healthy Ireland. (2013). Tobacco Free Ireland (2013-2025). Retrieved from: https://health.gov.ie/wp-content/ uploads/2014/03/TobaccoFreeIreland.pdf

299 Department of Health, Healthy Ireland, National Office of Suicide Prevention, HSE. (2015). Connecting for Life: Ireland’s National Strategy to Reduce Suicide 2015-2020.

300 These indicators include standardised annual incidence of intentional self-harm deaths (‘definite suicide’) and standardised annual A&E self-harm rates: Proportion of persons readmitted to A&E following self-harm in subsequent 12 months overall and Proportion of persons admitted to A&E following self-harm who have had previous such admissions (all of these are provided in overall terms and by each of the following comparison groups: gender, age group, socio-economic status.

2 – Healthy Ireland Framework301

Table 4.3 Health policies under the Healthy Ireland Framework that are relevant to women

Healthy Ireland – A Framework for Improved Health

and Wellbeing 2013-2025 which was launched

A Healthy Weight for Ireland; Obesity Policy and Action Plan, 2016-2025302

in 2013 sets out the vision for a country where

all people can enjoy health & wellbeing and

Get Ireland Active! National Physical Activity Plan for Ireland, 2016-2020303

that wellbeing is valued, supported and the

responsibility of all. It has a whole-of-government

National Sexual Health Strategy, 2015-2020304

and whole-of-society approach to improving

health and wellbeing, with a focus on prevention,

Healthy Ireland Fund305

reducing health inequalities and keeping people

Healthy Ireland Survey306

healthier for longer. It also seeks to address the

National Nutrition Standards for the School Meals Scheme307

many social and environmental determinants

that can impact on health and wellbeing, such as

education and employment. The Framework is

Healthy Workplace Framework308

an “umbrella” policy, covering a range of other

Healthy Ireland Outcomes Framework309

subsequently published policies, structures and

Warmth and Wellbeing pilot scheme310

initiatives as follows. See Table 4.3 for details.

Healthy Cities and Counties311

Healthy Campuses

Public information campaigns; Healthy Ireland Campaign 2018312, START campaign313.

301 Government of Ireland. (2013). Healthy Ireland – a framework for improved health and wellbeing.

302 Department of Health,Healthy Ireland. (2016) Obesity Policy and Action Plan: A Healthy Weight for Ireland (2016- 2025).

303 Department of Health, Department of Transport, Tourism and Sport, Healthy Ireland. (2015). Get Ireland Active! National Physical Activity Plan for Ireland, 2016-2020. Retrieved from: https://www.getirelandactive.ie/Professionals/National-PA-Plan.pdf

304 Department of Health, Healthy Ireland. (2015). National Sexual Health Strategy (2015-2020).

305 Department of Health, Healthy Ireland. Healthy Ireland Fund. https://www.pobal.ie/programmes/healthy-ireland-fund/

306 Department of Health, Healthy Ireland. (2014). Healthy Ireland Survey. Retrieved from: https://www.gov.ie/en/collection/231c02- healthy-ireland-survey-wave/

307 Department of Health, Department of Education and Skills, Department of Employment Affairs and Social Protection. (2017). National Nutrition Standards for the School Meals Scheme. Retrieved from: https://www.welfare.ie/en/downloads/ NutritionalStandardsForSchoolMeals.pdf

308 Department of Health, Healthy Ireland. (2019). Healthy Workplace Framework. Retrieved from: https://www.gov.ie/en/ publication/445a4a-healthy-workplace-framework/

309 Healthy Ireland. (2018). Healthy Ireland Outcomes Framework 2018. Retrieved from: https://health.gov.ie/wp-content/ uploads/2018/12/Healthy-Ireland-Outcomes-Framework-2018.pdf

310 Department of Communications, Climate Action and Environment, Department of Health, HSE. (2011). Warmth and Wellbeing Pilot Scheme. SEAI. https://www.seai.ie/grants/home-energy-grants/free-upgrades-for-eligible-homes/warmth-andwellbeing/

311 Department of Health, Healthy Ireland. (2019). Healthy Counties and Cities. Retrieved from: https://www.gov.ie/en/publication/ d4fa22-healthy-counties-and-cities/

312 Department of Healthy (2018) Healthy Ireland Campaign. Retrieved from: https://www.gov.ie/en/campaigns/healthyireland/?referrer=/

313 Department of Health, Safefood. (2019). START Campaign. Retrieved from: https://www.safefood.eu/START/Welcome.aspx

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

The vision of a Healthy Ireland, is a place ‘where

3 – National Cancer Strategy 2017 – 2026316

everyone can enjoy physical and mental health and

The National Cancer Strategy 2017 – 2026 seeks

wellbeing to their full potential, where wellbeing is

to meet the needs of cancer patients in Ireland

valued, and supported at every level of society and is

over the next decade. It also seeks to reduce

everyone’s responsibility’ (p 5)314. It will achieve its

the incidence of cancer through preventative

vision by increasing the proportion of people who

measures and improve outcomes by providing

are healthy at all stages of life; reducing health

screening and assisting in early diagnosis.

inequalities; protecting from threats to health and

In addition, it outlines actions in relation to

wellbeing and creating environments to support

provision of optimal care; maximising patient

a healthy Ireland. The Framework recognises

involvement and quality of life; enabling and

the impact of social determinants of health and

ensuring change through governance, workforce

inequities in health. Particular risks to health for

planning; and measuring performance, quality &

women including higher prevalence of smoking

outcomes. It has a focus on the specific needs of

and self-harm, inactivity and weight gain were

women dealing with cancer and the cancers that

identified.

particularly affect women.

Healthy Ireland in the Health Services National

Women specific objectives/actions within the plan include: Ensuring that Rapid Access Clinic and Symptomatic Breast Disease Clinic targets are met; Maintaining target uptake rate for BreastCheck; and Achieving target coverage for Cervical Check.

Implementation Plan (HSE, 2015)315 identified policy

priority areas including:

—Tobacco Control; —

—Healthy Eating and Active Living (HEAL); —

—Sexual Health; —

—Mental Health and Wellbeing; —

—Alcohol; —

—Healthy Childhood; and —

4 – National Sexual Health Strategy (2015-2020)

—Positive Ageing. —

The National Sexual Health Strategy2015-2020317

takes a life-course approach. It aims to improve

sexual health and wellbeing and reduce negative

sexual health outcomes by ensuring that everyone

living in Ireland has access to high quality sexual

health information, education and services

throughout their lives.

Figure from page 70

The Strategy is set out under three overarching

goals:

—Goal 1 – Sexual health promotion, education —

and prevention: Everyone living in Ireland will

receive comprehensive and age-appropriate

sexual health education and/or information

and will have access to appropriate prevention

and promotion services;

314 Government of Ireland. (2013). Healthy Ireland – a framework for improved health and wellbeing.

315 Health Service Executive, Healthy Ireland. (2015). Healthy Ireland in the Health Services National Implementation Plan 2015 – 2017. Retrieved from: https://www.hse.ie/eng/about/who/healthwellbeing/healthy-ireland/healthy-ireland-in-the-health-servicesimplementation-plan-2015-2017.pdf

316 Department of Health. (2017). National Cancer Strategy (2017-2025).

317 Department of Health, Healthy Ireland. (2015). National Sexual Health Strategy (2015-2020).

—Goal 2 – Sexual health services: Equitable, —

5 – Obesity Policy and Action Plan: A Healthy Weight for Ireland318

accessible and high-quality sexual health

services that are targeted and tailored to need,

The Obesity Policy and Action Plan: A Healthy

will be available to everyone;

Weight for Ireland 2016- 2025 sets out 10 Steps

—Goal 3 – Sexual health intelligence: Robust and —

forward to achieving a healthy weight for

high-quality sexual health information will be

Ireland. Plan implementation is supported by a

generated to underpin policy, practice, service

number of cross-sectoral Implementation Groups

planning and strategic monitoring.

including representatives of a range of relevant

Government Departments and agencies, and

Women specific actions within the Strategy relate

academia. Specific actions for women and girls

to the HPV vaccine and crisis pregnancy as follows:

include: review and implement the HSE–ICGP

weight management algorithms for children and

—Provide accessible crisis pregnancy supports, —

adults and their healthy weight management

STI/HIV testing and other supports and

guidelines before, during and after pregnancy

counselling for all sexually active adults

(Step Action 6.6); implementation and monitoring

(Action 3.14);

of the forthcoming breastfeeding action plan

—Maintain and promote the HPV vaccination —

(implementation will require investment in whole-

programme for adolescent girls in line with

time equivalents, Action 6.11); and the development

national immunisation guidelines (Action

of programmes to improve healthy eating for

3.24);

mothers, preconception, and for infants and

children up to two years across acute and primary

—Assess the effectiveness (including cost —

care settings in addition to enhanced training,

effectiveness) of extending the HPV vaccine

provision of supports to mothers

to other groups and develop appropriate

(Action 9.3).

guidelines (Action 3.25);

—Continue to build on the existing evidence —

base to understand emerging trends relating

to crisis pregnancy and sexual health and

undertake new research initiatives to address

knowledge gaps. (Action 5.1);

—Systematically monitor crisis pregnancy —

indicators and emergent trends related to

crisis pregnancy nationally and internationally

(Action 5.12).

Interestingly, no reference is made to menopause

within this Strategy despite the fact that this is

intimately linked to the sexual health of women as

they age.

318 Department of Health, Healthy Ireland. (2016). Obesity Policy and Action Plan: A Healthy Weight for Ireland (2016- 2025).

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

6 – Reducing Harm, Supporting Recovery: A health-led response to drug and alcohol use in Ireland 2017-2025319

Table 4.4 Main elements of Sláintecare

Entitlement for all Irish residents to all health and social care.

This strategy sets out the Government’s

No charge to access GP, primary or hospital care and reduced charges for drugs.

response to addressing the harm caused by

substance misuse in our society over the next

Care provided at the lowest level of complexity, often outside of hospital, in an integrated way.

eight years. It identifies a set of key actions to be

delivered between 2017 and 2020, and provides

an opportunity for the development of further

eHealth as a key tool for developing a universal health system and integrated care.

actions from 2021 to 2024 to address needs that

may emerge later on in the lifetime of the strategy.

Strong focus on public health and health promotion.

It does not examine the issue of harm from a

Waiting times guarantees with a maximum: (4 hour wait time for Emergency Departments, 10 days for a diagnostics test, 10 weeks for an outpatient appointment & 12 weeks for an inpatient procedure).

gendered perspective. Women specific actions

within the plan include: expanding addiction

services for pregnant and postnatal women

(2.1.20); responding to the needs of women who

Private care phased out of public hospitals.

are using drugs and/or alcohol in a harmful

Significant expansion of access to diagnostics in the community.

manner (2.1.21); and improve the range of problem

substance use services and rehabilitation supports

for people with high support needs who are

Earlier and better access to mental health services.

homeless (2.1.25) in line with Rebuilding Ireland

An expanded workforce including allied health professionals, nurses and doctors. The importance of addressing recruitment and retention issues of all healthcare staff and the development of integrated workforce planning is emphasised in the report.

(the development and provision of gender and

culturally specific step down services, particularly

housing, for women and their children progressing

from residential rehabilitation treatment who are

at risk of discharge into homelessness is sub-

A new HSE Board, to be established promptly.

action 2 of Action 2.1.25).

Accountability and clinical governance, to be legislated for.

7 – Sláintecare320

A National Health Fund set up to ring-fence funding for a transitional fund and expansion of entitlements.

Sláintecare is a vision for a new health service in

Ireland detailed in the report from the Oireachtas

Committee on the Future of Healthcare published

The report details specific costings for

on 30 May 2017.

the expansion of entitlements and system

development and timelines for implementation,

It is the first time there has been political consensus on a health reform plan for the next ten years and cross-party support on delivering a universal health system in Ireland321.

recommending the establishment of an

Implementation Office to drive the reform. It is for

a ten-year period but many of the key actions will

be implemented during the first six years. The plan

specifically highlighted the under-resourcing of

community mental health services and reliance

on medication over psychological and counselling

See Table 4.4 for details of the main elements of

services.

Sláintecare.

319 Department of Health, Healthy Ireland. (2017). Reducing Harm, Supporting Recovery: A Health-Led Response to Drug and Alcohol Use in Ireland 2017-2025.

320 Department of Health. (2018). Sláintecare Implementation Strategy.

321 Centre for Health Policy and Management, Trinity College Dublin. (2017). Sláintecare – a pathway to universal healthcare in Ireland. Retrieved from: https://www.tcd.ie/medicine/health_policy_management/assets/pdf/policy-brief-on-the-slaintecarereport-19122017.pdf

If implemented, Sláintecare will develop single-tier access to healthcare services, based on need not ability to pay. A greater proportion of the Health Budget would be spent on mental health services, with significant investment in the community supports and therapeutic interventions sought by women.

—Offering help to people who want to quit; —

—Warning of the dangers of tobacco; —

—Enforcing bans on advertising, promotion and —

sponsorship;

—Raising taxes on tobacco. —

Tobacco Free Ireland seeks to de-normalise tobacco

within Irish society, reduce initiation rates,

assist smokers to quit, protect non-smokers,

especially children, from the effects of second-

hand smoke, by building a stable policy and

NWCI make the case that the Sláintecare

legislative framework. The Tobacco Free Ireland

universal care package for women should include

Programme was one of the first priority area

‘entitlement to maternity services, contraception,

programmes to be established. The main aim of the

and infertility services. Additional resources must be

new programme is to take responsibility for and

available for GPs, women’s healthcare providers and

systematically drive policy priorities in the area of

Obstetricians through the Maternity & Infant Scheme

tobacco control. The policy contains the following

for the provision of abortion care.’322

specific actions: ‘Undertake targeted approaches

for specific groups, particularly young people, lower

8 – The Irish National Dementia Strategy323

socioeconomic groups, pregnant and post-partum

women and patients with cardiac and respiratory

This strategy was produced by the Department

disorders’ (9.9). This also includes provision for

of Health in 2014. The aim of the Strategy is

‘Specialist smoking cessation staff trained to deal with

to improve dementia care so that people with

specific groups. Referral pathways to support these

dementia can live well for as long as possible, can

groups via a “one-stop” model being developed’.

ultimately die with comfort and dignity, and can

have services and supports delivered in the best

way possible. The strategy is developed using a

4.4 Other policies that are relevant to the health of women

population-based approach with no reference to

the gender dimensions of dementia, despite the

fact that women are more likely to suffer with

There are a variety of other policies and strategies

dementia later in life.324 This is something that

that impact on women’s health and well-being.

could be addressed in the WHAP.

See Table 4.5 for details.

9 – Tobacco Free Ireland325

The Tobacco Free Ireland (TFI) Policy was developed

by the Department of Health in 2013. This

government strategy (2013 - 2025) has a number of

cross governmental actions which are based on the

six national standards:

—Monitoring of tobacco use and prevention —

policies;

—Protecting people from second-hand smoke; —

322 National Women’s Council of Ireland. (2018). Pre-Budget Submission 2019: Investing in Women’s Futures. Retrieved from: https:// www.nwci.ie/images/uploads/NWCI_PBS_2019-FINAL.pdf

323 Department of Health (2014). Irish National Dementia Strategy.

324 Kumar, P., Jethwa, R., Roycroft, G., Wilson, R. (Eds). (2016). Growing older in the UK. London: British Medical Association. Retrieved from: https://www.bma.org.uk/collective-voice/policy-and-research/public-and-population-health/ healthy-ageing, p.4-5

325 Department of Health, Healthy Ireland. (2013). Tobacco Free Ireland (2013-2025).

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

1 – The National Strategy for Women and Girls 2017-2020: creating a better society for all337

Table 4.5 Other policies and strategies that impact on women’s health and well-being

1. National Strategy for Women and Girls 2017-2020:

The current National Strategy for Women and

creating a better society for all326

Girls 2017-2020: creating a better societyfor all

was launched by the Department of Justice

2. Better Outcomes, Brighter Futures: The National Policy

Framework for Children and Young People (2014-

and Equality in April 2017. It has 6 high level

2020)327

objectives. Objective Two of the Strategy is

focused on Advancing the Physical and Mental

3. First 5 Strategy: A Whole-of-Government Strategy for

Health and Wellbeing of Women and Girls, while

Babies, Young Children and their Families 2019-2028328

Objective 5 is focused on combating violence

4. National Action Plan on Bullying329

against women.

5. National Carers’ Strategy - Recognised, Supported,

Empowered330

The outcome areas of this National Strategy

6. National Disability Inclusion Strategy (2017-2021)331

actions 2.2 – 2.29 include physical activity; social

7. National Physical Activity Plan for Ireland: Get Ireland

& emotional wellbeing; smoking; drug and alcohol

Active332

use; breastfeeding; nutrition; mental health; sexual

health; maternity care and inclusion. Current and

8. National Sports Policy (2018-2027)333

on-going national strategies, action plans and

9. National Traveller and Roma Inclusion Strategy (2017-

programmes are supported. There are also actions

2021)334

addressing the health needs of target population

10. Positive Ageing- Starts Now! The National Positive

groups through existing and forthcoming strategies,

Ageing Strategy335

including older women; Traveller & Roma women;

11. Second National Action Plan to Prevent and Combat

women & girls affected by FGM; LGBTQI+ people; and

Trafficking in Human Beings in Ireland336

women with disabilities.

Action 2.1 commits the Department of Health,

HSE and the National Women’s Council of Ireland

(NWCI) to develop a Women’s Health Action Plan

(WHAP):

326 Department of Justice and Equality. (2017). National Strategy for Women and Girls 2017-2020: creating a better society for all. Retrieved from: http://justice.ie/en/JELR/National_Strategy_for_Women_and_Girls_2017_-_2020.pdf/Files/National_ Strategy_for_Women_and_Girls_2017_-_2020.pdf

327 Department of Children and Youth Affairs. (2014). Better Outcomes, Brighter Futures: The National Policy Framework for Children and Young People (2014-2020). Dublin: The Stationary OfficeRetrieved from: https://www.dcya.gov.ie/documents/cypp_ framework/BetterOutcomesBetterFutureReport.pdf

328 Government of Ireland. (2018). First 5 Strategy: A Whole-of-Government Strategy for Babies, Young Children and their Families 2019- 2028. Retrieved from: https://www.dcya.gov.ie/documents/earlyyears/19112018_4966_DCYA_EarlyYears_Booklet_A4_v22_ WEB.pdf

329 Department of Education and Skills. (2013). National Action Plan on Bullying. Retrieved from: https://www.education.ie/en/ Publications/Education-Reports/Action-Plan-On-Bullying-2013.pdf

330 Department of Health. (2012). National Carers’ Strategy - Recognised, Supported, Empowered. Retrieved from: http://familycarers. ie/wp-content/uploads/2016/01/The-National-Carers-Strategy.pdf

331 Department of Justice and Equality. (2017). National Disability Inclusion Strategy (2017-2021). Retrieved from: http://www.justice. ie/en/JELR/dept-justice-ndi-inclusion-stratgey-booklet.pdf/Files/dept-justice-ndi-inclusion-stratgey-booklet.pdf

332 Department of Health, Department of Transport, Tourism and Sport, Healthy Ireland. (2015). Get Ireland Active! National Physical Activity Plan for Ireland, 2016-2020. Retrieved from: https://www.getirelandactive.ie/Professionals/National-PA-Plan.pdf

333 Department of Transport, Tourism and Sport. (2017). National Sports Policy (2018-2027). Retrieved from: http://www.dttas.ie/ sites/default/files/publications/sport/english/national-sports-policy-2018-2027/national-sports-policy-2018.pdf

334 Department of Justice and Equality. (2017). National Traveller and Roma Inclusion Strategy 2017-21. Retrieved from: http://www. justice.ie/en/JELR/National%20Traveller%20and%20Roma%20Inclusion%20Strategy,%202017-2021.pdf/Files/National%20 Traveller%20and%20Roma%20Inclusion%20Strategy,%202017-2021.pdf

335 Department of Health. (2013). Positive Ageing- Starts Now! The National Positive Ageing Strategy. Retrieved from: https://health. gov.ie/wp-content/uploads/2014/03/National_Positive_Ageing_Strategy_English.pdf

336 Department of Justice and Equality. (2016). Second National Action Plan to Prevent and Combat Trafficking in Human Beings in Ireland. Retrieved from: http://www.justice.ie/en/JELR/2nd_National_Action_Plan_to_Prevent_and_Combat_Human_Trafficking_ in_Ireland.pdf/Files/2nd_National_Action_Plan_to_Prevent_and_Combat_Human_Trafficking_in_Ireland.pdf

337 Department of Justice and Equality. (2017). National Strategy for Women and Girls 2017-2020: creating a better society for all.