_Hlk4599505

‘Strengthen the partnership work with the National Women’s Council of Ireland in identifying and implementing key actions to address the particular physical and mental health needs of women and girls in order to advance the integration of their needs into existing and emerging health strategies, policies and programmes through an action plan for women’s health’.

2 – Better Outcomes, Brighter Futures: The National Policy Framework for Children and Young People (2014-2020)338

Better Outcomes Brighter Futures: The national policy

framework for children and young people 2014-2020

(DYCA, 2014) is a whole-of-Government approach

to deliver on Transformational Goals and National

Outcomes for children and young people. The

policy frameworkprovides commitment to

advancing child health and supports. In relation

to early years, it focuses on early healthy

development prioritising under-2-year-olds, and

commits to strengthening prenatal and antenatal

supports, addressing maternal health and

This new plan will only be the second Women’s

wellbeing, and raising breastfeeding rates in line

specific health plan. The previous plan The Plan for

with international norms. The Strategy contains

Women’s Health (1997-1999) published in 1997, set

actions and indicators in relation to: breastfeeding

out four main objectives for the health services in

(Aim 1.1. Action 1); Mortality rates (by cause and

relation to women:

age) (Aim 1.1. Action 6); Teenage Pregnancy (Aim

1.3 Action 12); and Positive Self-Perception (Aim

1. to maximise the health and social gain of Irish

2.2 Action 21).

women;

2. to create a woman-friendly health service;

3 – First 5 Strategy: A Whole-of-Government Strategy for Babies, Young Children and their Families 2019-2028339

3. to increase consultation and representation of

women in the health services; and

4. to enhance the contribution of the health

This strategy designed to support babies, young

services to promoting women’s health in the

children and their families in the first five years

developing world.

of their life was launched in Autumn 2018. The

strategy which will be operational for 10 years will

This plan was supported by the establishment

provide:

of the Women’s Health Council, as the relevant

statutory advisory body. The Women’s Health

—A broader range of options for parents to —

Council was integrated into the Department of

balance working and caring

Health and Children in 2009. It was particularly

—A new model of parenting support —

important in terms of its recognition that there

—New developments in child health, including a —

are major demographic variations in health status

dedicated child health workforce

particularly related to gender, age, and social

class. The four objectives can all be seen to remain

—Reform of the Early Learning and Care (ELC) —

relevant to the current women’s health agenda.

system, including a new funding model

—A package of measures to tackle early —

childhood poverty

Actions specific to women within the plan

particularly relate to pregnant women and all

women of reproductive age as follows:

338 Department of Children and Youth Affairs. (2014). Better Outcomes, Brighter Futures: The National Policy Framework for Children and Young People (2014-2020)

339 Government of Ireland. (2018). First 5 Strategy: A Whole-of-Government Strategy for Babies, Young Children and their Families 2019- 2028.

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

—Continue progress towards the breastfeeding —

4 – National Action Plan on Bullying340

target rate set out in the National Breastfeeding

This Plan details all grounds for harassment

Action Plan (i.e. annual 2% increase in

under the Equal Status Acts should be listed

breastfeeding duration rates over the period

in anti-bullying policies i.e. gender (including

2016– 2021). To meet this target, continue

transgender), civil status, family status, sexual

to support mothers to breastfeed through

orientation, religion, age, disability, race and

the PHN service, implement standardised

membership of the Traveller community.

breastfeeding policies and provide clinical

specialist posts in both primary care and

5– National Carers’ Strategy - Recognised, Supported, Empowered341

maternity hospitals as per the key actions

of the National Breastfeeding Action Plan.

Extensions to this target will be considered at

This strategy was published by the Department

the end of year three review of First 5 in 2021.

of Health in 2017. It sets the strategic direction for

future policies, services and supports provided by

—Enhance weaning support to parents through —

Government Departments and agencies for carers.

the National Healthy Childhood Programme.

It details:

—Provide access to comprehensive family —

planning and reproductive healthcare services,

—Guiding Principles; —

including information and advice for people

—Goals and Objectives Addressing Priority —

considering pregnancy and carry out a

Areas (Income Support, Health, Information,

national information campaign to promote the

Respite, Housing, Transport, Training,

importance of pre-conception health.

Employment, Children and Young People With

—Develop mechanisms to improve folic acid —

Caring Responsibilities); and

intake among all women of reproductive ages.

—A Roadmap for Implementation containing 42 —

—Review the content and scope of Maternity —

Actions to be achieved on a cost-neutral basis

and Infant Care Scheme, standardise the six-

in the short to medium term.

week post-natal check-up for the mother and

In its profile of Irish Carers, the strategy identifies

the six-week check of the baby (as part of the

64% of carers as women but does not contain

Newborn Clinical Examination) and consider

actions specifically targeted at female carers.

extending coverage of this Scheme to include

to a pre-conception consultation and beyond

six-week post-natal check-up of the mother.

6 – National Disability Inclusion Strategy (2017–2021)342

—As resources allow, make the antenatal visit by —

the Public Health Nurse more widely available

This strategy produced by the Department of

to expectant mothers in line with need.

Justice and Equality takes a whole of government

approach to proving the lives of people with

—Increase the use of antenatal care in the first —

disabilities both in a practical sense, and also in

trimester, particularly among vulnerable

creating the best possible opportunities for people

groups.

with disabilities to fulfil their potential.

—Increase uptake of vaccinations during —

pregnancy by promoting the influenza vaccine

The Strategy comprises the following eight

during pregnancy, raising awareness of the

themes

importance of the pertussis vaccine during

—Equality and Choice —

pregnancy and exploring mechanisms to effect

administration of the vaccine.

—Joined up policies and public services —

—Education —

340 Department of Education and Skills. (2013). National Action Plan on Bullying

341 Department of Health. (2012). National Carers’ Strategy - Recognised, Supported, Empowered

342 Department of Justice and Equality. (2017). National Disability Inclusion Strategy (2017-2021).

—Employment —

Table 4.6 Health and well-being actions from the National Disability Strategy

—Health and Wellbeing —

We will continue to coordinate the implementation of the Healthy Ireland Framework

—Person centered disability services —

—Living in the community —

We will invest in the development of early intervention services which specifically target the mental health needs of infants, young children and their families.

—Transport and access to places —

There are nine actions within the health and

wellbeing section plan, with one specific reference

We will develop the intellectual disability and mental health service capacity as set out in A Vision for Change.

to women with disabilities as follows: ‘We will

proof all new Government policies and programmes

against their potential impact on women with

We will examine the need to establish statutory, national advocacy services for children and adults with mental health difficulties in hospitals, day centres, training centres, clinics, and throughout the community, building on existing services.

disabilities. As a first step, consideration will be

given to whether a new Impact Assessment should

be developed to support this action, or whether the

current (separate) Disability and Gender Impact

Assessments are sufficient.’ See Table 4.6 for details

We will ensure through targeted measures that health services provide care on an equal basis to people with mental health difficulties.

of the nine actions.

We will amend legislation under the review of the Mental Health Act 2001 to deal in a more complete and comprehensive manner with the operation of advance healthcare directives in the area of mental health in the longer term.

Figure from page 77

We will continue to develop services. In common with previous years, the Health Service Executive’s Service Plan 2017 emphasises recovery as central to quality, evidence–based and person-centered services.

We will further develop the capacity of mainstream Health Service Executive funded services to provide accessible services and information to people with disabilities.

We will develop policy advice for consideration by relevant Government Departments based on international research, to guide the development and implementation of a national programme for vocational rehabilitation, with due regard to the neuro-rehabilitation strategy and other medical rehabilitation programmes as appropriate.

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

Sport’s 20@20 If she can’t see it, she can’t be it

7 – National Physical Activity Plan for Ireland: Get Ireland Active343

campaign also supports women’s participation in

sport.

Get Ireland Active the National Physical Activity Plan

includes eight actions areas, including a focus on

9 – National Traveller and Roma Inclusion Strategy (2017-2021)345

getting children and young people more active.

Plan implementation is supported by a number of

cross-sectoral Implementation Groups including

This strategy, launched by the Department of

representatives of a range of relevant Government

Justice and Equality in June 2017, contains 149

Departments and agencies, and academia. This

actions. Action 72 is focused on supporting ‘Roma

plan does not contain any women specific actions

women to access maternal health services in a timely

but women specific actions are identified as an

and appropriate manner’. Other actions (97, 98 ,99

important element in the more recent National

and 100) focus on supporting Traveller and Roma

Sports Policy (see bullet 8 below), with co-

women to tackle disadvantage, while several

ordinated implementation of both policies.

actions (105, 107 and 108) are focused on removing

the barriers that prevent Traveller and Roma

women accessing domestic violence supports when

8 – National Sports Policy (2018-2017)344

they are needed. Specific actions include:

‘Addressing women’s participation at all levels in

sport’ is identified as an ‘important element’ of

‘Acknowledging the results of the National Roma Needs Assessment for Roma in Ireland, the HSE will support Roma women to access maternal health services in a timely and appropriate manner’ (Action 72) and the action that ‘All relevant Departments will resource the development and implementation of local Traveller and Roma women’s forums/groups to provide support in health, education, training, employment and accommodation issues’ (Action 99).

this policy. The policy also considers the issue

of women in leadership positions including as

National Governing Body Board members and

CEOs. Actions with the plan that are specifically

relevant to women’s health include:

—The elimination of the active sport —

participation gradient between men and

women. (This is a key performance indicator)

—The setting of gender diversity targets —

and development of equality action

plans by National Governing Bodies with

support provided for dedicated leadership

training programmes for women including

governance-related and technical training

(coaching, refereeing and team management).

Sport Ireland will monitor their progress in

delivering on these and report annually. If

sufficient progress is not being made, it will

engage further with all stakeholders on the

matter (Action 32).

This Policy also references a number of actions in

the National Strategy for Women and Girls relating

to enhancing women’s visibility and participation

(2.5, 3.5-3.7, 4.4) in sport. The Federation of Irish

343 Department of Health, Department of Transport, Tourism and Sport, Healthy Ireland. (2015). Get Ireland Active! National Physical Activity Plan for Ireland, 2016-2020.

344 Department of Transport, Tourism and Sport. (2017). National Sports Policy (2018-2027).

345 Department of Justice and Equality. (2017). National Traveller and Roma Inclusion Strategy 2017-21

10 – Positive Ageing - Starts Now! The National Positive Aging Strategy (2013)346

11 – Second National Action Plan to Prevent and Combat Trafficking in Human Beings in Ireland347

The National Positive Ageing Strategy was published

This plan produced by theDepartment of Justice

in April 2013. It is a high-level document outlining

and Equality in 2016 identifies seven goals as

Ireland’s vision for ageing and older people and

follows (p33):

the national goals and objectives required to

—Prevent trafficking in human beings. —

promote positive ageing. The strategy has four

goals. Goal 2 has a specific health focus to ‘Support

—Identify, assist, protect and support victims —

people as they age to maintain, improve or manage

of trafficking in human beings. Ensure an

their physical and mental health and wellbeing’ (P19).

effective criminal justice response.

This goal is underpinned by three objectives as

—Ensure that Ireland’s response to human —

follows (p20):

trafficking complies with the requirements

of a human rights-based approach and is

—Prevent and reduce disability, chronic —

gender-sensitive.

disease and premature mortality as people

age by supporting the development and

—Ensure effective co-ordination and co- —

implementation of policies to reduce

operation between key actors, both nationally

associated lifestyle factors.

and internationally.

—Promote the development and delivery of a —

—Increase the level of knowledge of emerging —

continuum of high-quality care services and

trends in the trafficking of human beings.

supports that are responsive to the changing

—Continue to ensure an effective response to —

needs and preferences of people as they age

child trafficking.

and at end of life.

—Recognise and support the role of carers by —

The plan outlines 65 actions to combat this crime,

implementing the National Carers’ Strategy

primarily affecting women and young girls. It

(2012).

identifies that over the period 2009-2015 75% of

trafficking victims were female.

The Strategy makes a reference to the ‘differing

needs of older women and men, in terms of life

expectancy, employment, physical and mental

health and caring roles and responsibilities are key

considerations’ (p13)but does not expand on

these differences to any great extent. It does

however note that in relation to elder abuse 60%

of the referrals were women and that some of

the commitments in Future Health: A Strategic

Framework for Reform of the Health Service 2012-2015

are relevant to improving access to health services

for older people, including Breast Check screening

for 65-69-year-old women from 2014.

346 Department of Health. (2013). Positive Ageing- Starts Now! The National Positive Ageing Strategy

347 Department of Justice and Equality. (2016). Second National Action Plan to Prevent and Combat Trafficking in Human Beings in Ireland.

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

In relation to violence against women, Ireland

4.5 Assessment of how Ireland’s current health policy framework takes into account women’s specific health needs

ratified the Council of Europe Convention on

preventing and combating violence against

women and domestic violence (the Istanbul

Convention) in March 2019350. Countries who

ratify the treaty are obligated to protect and

There are a variety of strategies and plans

support victims of such violence, this includes

relating to, or incorporating women’s health that

establishing services such as refuge, medical

government departments, the HSE, other state

services, and counselling351. In order to ratify the

agencies and partners are committed to and many

Convention, Ireland had to introduce a suite of

of these are referred to in the National Strategy for

new laws to tackle different forms of violence

Women and Girls 2017-2020.

against women, including domestic violence and

psychological violence.

With the exception of the few strategies

(The National Maternity Strategy 2016–2026,

the National Cancer Strategy 2017–2026,

the General Scheme of the Assisted Human

Figure from page 80

Reproduction (AHR) Bill 2017 and the Heath

Service Breastfeeding Action Plan 2016-2020)

most national health strategies focus on a

population health and/or life-cycle approach,

without a specific focus on the needs of women.

Development of an overarching Women’s Health

Action Plan can support integration of a gender

focus into all health policy development.

Within the HSE, women’s health is currently

addressed through acute hospital and primary

care services; through mental health, social

inclusion and older people’s services; through

specific strategies and plans; and the policy

priority programmes. There are few staff

nationally or indeed at CHO levels with a specific

remit for women’s health and Scally (2018)348

suggests that there needs to be ‘an exploration

of how women’s health issues can be given more

structured and consistent attention’ (p.21).

The HSE has recently launched domestic, sexual

and gender-based training programme349 to

support front-line staff to provide a responsive

service to women experiencing violence, including

guidance on brief interventions, child protection

and referral to social work services.

348 Scally, G. (2018). Scoping Inquiry into the CervicalCheck Screening Programme. Retrieved from: http://scallyreview.ie/wp-content/ uploads/2018/09/Scoping-Inquiry-into-CervicalCheck-Final-Report.pdf

349 Health Service Executive, Sonas. (2019). National Domestic, Sexual and Gender-Based Violence Training Resource Manual. HSE. Retrieved from: https://www.hse.ie/eng/about/who/primarycare/socialinclusion/other-areas/domestic-violence/dsgbvtraining-resource-manual.pdf

350 National Women’s Council of Ireland. (2019, 8 March). ‘Ratification of the Istanbul Convention marks a momentous International Women’s Day’ [Press Release]. Retrieved from: https://www.nwci.ie/learn/article/ratification_of_the_istanbul_convention_ marks_a_momentous_international_wom

351 Council of Europe. (2011). Convention on preventing and combating violence against women and domestic violence. Retrieved from: https://www.coe.int/fr/web/conventions/full-list/-/conventions/rms/090000168008482e

discrimination against women and girls in all

4.6 Models of practice in relation to Women’s Health Policy

forms by ensuring women’s equal access to,

and equal opportunities in, political and public

life, education, health and economic resources.

4.6.1 The WHO’s Strategy on Women’s health and wellbeing in the WHO European Region

It is also designed to promote the systematic

application of human rights standards,

including the United Nations Convention on

the Elimination of All Forms of Discrimination

The WHO launched its strategy on Women’s Health

against Women and the Convention on the

and Well-being in the European Region in 2016 based