Women's Health Taskforce - Summary of evidence supporting the Women's Health Action Plan 2022-2023
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Women’s Health Taskforce Summary of evidence supporting the Women’s Health Action Plan 2022-2023 March 2022
Women’s Health Action Plan 2022-2023 – Evidence Summary
A note on the language used in this Action Plan:
This Action Plan uses the word “we” to refer to the Government and particularly the health
sector. It signifies the partnership required between the Department of Health, its agencies
- in particular the Health Service Executive, and organisations across the sector to implement
this Action Plan.
When this plan talks about “women” it is intended in the most inclusive sense of the word.
It is used as shorthand to describe all those who identify as women as well as those that do
not identify as women but who share women's biological realities and experiences. In using
this term, we seek to include not exclude. Using gender to inform health policy is just one
way of creating more targeted, personalized health services for all people in Ireland.
We will commit to keep our language under constant review so that all those for whom this
plan and programme are relevant see themselves reflected in it.
——
2Women’s Health Action Plan 2022-2023 – Evidence Summary
Overview
Who we are affects our health, health-related behaviours and access to health services, this
includes our personal history and identity, socioeconomics, and environment.1–3 For example,
young people have different health needs to older people,3–5 and people in rural areas have
different challenges for accessing health services compared to people in cities.6–8
In the same way, women have different health journeys than other genders: they experience
different health shocks and face different supports and challenges to their health.9–11 So while
overall, women living in Ireland experience good health12, there is, nevertheless, a lot we can do
to improve health outcomes, behaviours and services for women across Irish society.
The Women’s Health Action Plan 2022-2023 complements the existing activity underway for men,
including the National Men's Health Policy.13 By examining women’s health separately, we can see
where we can improve, in a targeted and effective way. For example, there is evidence that
targeted initiatives, for example on breast cancer, have led to consistently improving outcomes
for women,14 including survival rates in Ireland.15
What determines our health?
Lots of factors, independently and together, affect our health.1 In turn, our health affects how
we live.4,16,17 Major determinants of health, including some examples,1,2,18,19 are:
Personal history & identity Access to services
Genetics, childhood, family, Availability, cost, waiting
age, culture, gender, sexual Health
times, quality and
identify, health history, How we feel and how experiences of care
disability that affects our
activities, illnesses, life
expectancy, life
satisfaction
Socioeconomics & Behaviour
environment Smoking, alcohol and drug
Financial situation, education, use, exercise, road use, hand-
community, job, the economy, washing, medication
the physical environment adherence, health literacy
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3Women’s Health Action Plan 2022-2023 – Evidence Summary
These factors all contribute to our health, and in turn our health affects what we do and how we
view life. The determinants of health also interact in important ways.1
Women experience events such as periods, pregnancy and menopause. Some issues that affect
everyone, such as autoimmune conditions,20,21 affect women disproportionately. Supports and
challenges also arise in health services and behaviours. Comparing women to men in Ireland,
women visit the GP more12 but have fewer positive experiences in hospital22 and women are less
likely to exercise but are also less likely to smoke.12 Women also have differing health and access
to services depending on their background. For example female carers, who form the majority of
carers in Ireland, are more likely to have worse health and to live with financial disadvantage than
the general population;23 this group experienced disproportionate challenges to their resources,
resilience and human capital during the COVID-19 pandemic.24
Key Findings: What does the evidence say about women’s
health in Ireland?
The Department of Health and the National Women’s Council of Ireland commissioned
“Evidence Base for the Development of the Women’s Health Action Plan”, published in August
2019.11 This document accrues available evidence from surveys, academic papers, and
governmental and international agency reports. It establishes what is known about women in
Ireland in terms of demographics, health, and engagement with health services. Its key findings
(KF) are:
KF1. Ireland’s demography is changing, and this should be reflected in health planning
The proportion of older women in Ireland is increasing relative to other age groups.
Fertility rates are declining and labour force participation is increasing. Women from
diverse ethnic backgrounds form an increasing proportion of our population. Women’s
health should be considered across life-cycles and backgrounds.
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4Women’s Health Action Plan 2022-2023 – Evidence Summary
KF2. Vulnerable groups require extra consideration
In Ireland, there is a socioeconomic gradient in health, health behaviours and health
service use: gender, geography, poverty, age and ethnicity are among the important
intersecting determinants of health that have complex effects.
KF3. Targeted initiatives should focus on some particularly important facets of health
Areas that require specifically targeted initiatives for women include chronic disease,
mental health, sexual health, health behaviours, domestic, sexual and gender-based
violence (DSGBV), ethnic background and minority status and socioeconomic inequality.
KF4. Look beyond health outcomes: experience of health services should be prioritised
Women’s positive engagement with health care services should be focused on as an area
for improvement, although the report does not highlight major themes directly relevant
to Ireland. (This has been supplemented through subsequent further work.25)
KF5. Women’s health is more than reproductive health during pregnancy
Women’s health policy, as it stood at the time of the report’s publication, prioritised
reproductive health, particularly reproductive health during pregnancy, compared to
other facets of women’s health.
What did we do, based on the evidence?
Based on this evidence, the Women’s Health Taskforce26 carried out in-depth research using an
open-policy approach with women, their representative groups, and important stakeholders to
establish (1) additional information where there are evidence gaps, for example on how health
services should be improved, and (2) how action on women’s health should be prioritised and
implemented.27 Details on the open policy method and radical listening are available in the
Women’s Health Taskforce Process and Methodology.25,28
——
5Women’s Health Action Plan 2022-2023 – Evidence Summary
Evidence supporting Women’s Health Action Plan Priorities 2022, linked to key findings (KF)
from the Evidence Base11 (see p2)
KF Motivation and Support
Pillar One: Listen
We will keep listening to those 5 Ensure the needs of women are properly considered.
planning, delivering, and Meaningful collaboration can help ensure that the
experiencing care health response is aligned with patient preferences
and deliver outcomes that are important to both the
clinician and patient.29–31
Introduce an annual Women’s 2,4 Health promotion improves women’s health
Health Week outcomes,14,32,33 with particular consideration
needed for vulnerable groups,11 who face more
barriers to promotion uptake.34,35
Pillar Two: Invest
We will align investment and 3 The strategic approach to investment in women’s
priorities in women’s health health improves health with knock-on effects across
society36 and increases governmental efficiency.37
Pillar Three: Deliver
Spotlight Programme 4
Contraception 2,5 Contraception is an essential support for sexual and
reproductive health and self-determination, however
access is inequitable.38 Groups such as older teens
and young adults (17-25s) can experience greater
barriers to access and greater risk of pregnancy
complications and reduced human capital.39–44
Menopause 1,5 Menopause can be a significant health shock. Its
occurrence and treatment can have large, long-term
physical, mental and human capital effects for those
experiencing a challenging menopause,45–51 with calls
for enhanced health services, education and
workplace supports to support this population
group.51
——
6Women’s Health Action Plan 2022-2023 – Evidence Summary
Gynaecology and Women’s 1 Increasing access and pathways to women’s health
Health Services services like gynaecological care allows patient-
directed care and efficient service use,52–56 including
eHealth, which can improve effectiveness and
education.57
Spotlight Programme: 4
Culture of Care 4, 5 Healthcare quality can be helped through a
supportive culture,58 benefiting both those delivering
and receiving care, and supporting people-centred
care as a coordinated, comprehensive care that
accounts for broad determinants of health.10,59–61
Accessibility of Information 2,4,5 Information inaccessibility reduces service delivery
use and quality, patient safety and satisfaction.62–64
Vulnerable sub-groups are particularly at risk of
barriers to information access, for example sex
workers, traveller, migrant and LGBTI+ communities,
including trans women.65–70
Support for women in key groups 2,4,5 Service access and quality for women from minority
and other key groups, who are at higher risk for poor
health outcomes, is often worse than for the general
population and requires specialisation.61,65–71
Core Programme: Policy &
Legislation
Assisted Human Reproduction 1,2,5 Fertility rates are declining72 with large potential
(including surrogacy) welfare effects.73–75 Assisted human reproduction is
under-regulated76 and current access models are
inequitable.77,78
Reviewing access to HPV 2,5 HPV vaccine has proven effectiveness in reducing
Vaccination cervical cancer risk,79 and is currently provided
through a school-based immunisation programme.80
Support for Carers 2,5 Carers have worse health and life satisfaction than
non-carers,23,24 the COVID-19 pandemic has further
increased their burden in a setting where home-care
is under-regulated.24,81
Period Poverty 1,5 Period poverty affects a significant minority of the
population.82 Clear vulnerable groups are identified71
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7Women’s Health Action Plan 2022-2023 – Evidence Summary
and wider provision of period products is justified on
equity grounds.82
Women affected by social 2,5 Women affected by social exclusion have additional
exclusion or different health needs that require consideration,
above and beyond that for the general population,
such as women accessing supports for addiction,83
Traveller84 or Roma85 women, and homeless
women.86
Innovation Programme: New 3
evidence & initiatives
Research 1 There remain significant gaps in knowledge on
women’s health.87–90 Better understanding of sex and
gender differences on health issues and impacts can
help inform and target health interventions.91,92
Postnatal women 1,2,3 There are barriers to access for post-natal care such
as specialised physiotherapy93 and mental health
services94,95 that provide care for issues with
enduring health effects.96,97
Midlife & older women 1,2,3 Midlife is a period of major health shocks,
determining health and human capital over the
following decades,45–51,98 evidence supports
specialised services for this group.99 Older women
experience particular health challenges to a greater
degree than men.100
Adolescent and young women 1,2,3 Adolescence is a crucial developmental period for
developing a good foundation for health through the
rest of life101; however, adolescent girls face
particular challenges in areas such as body image,
bullying, identity and periods.43,102
Nursing, midwifery and allied 1 Nursing, midwifery and allied health professionals
health professional led solutions play an important role in improved health outcomes
and health experiences for patients.103–105
We will model and lead the Nationally and internationally, there is increased
changes we want to see evidence to support equality initiatives such as
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8Women’s Health Action Plan 2022-2023 – Evidence Summary
equality budgeting,106 gender representation107 and
gender mainstreaming of policies.108,109
We will work together more 1,2,5 People-centred care coordinates across agencies to
effectively across the health ensure consistent, integrated care where healthcare
sector to drive progress for workforces can assess wider factors influencing
women women’s health.10,59,60
——
9Women’s Health Action Plan 2022-2023 – Evidence Summary
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