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Seeds of
Change
A Six-Year Review
Cecile Gousseau
and Prairie Women's Health Centre of Excellence
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Introduction
The Prairie Women’s Health Centre of Excellence (PWHCE) is one of five
research centres announced by the federal government as part of a national
strategy to address women’s health in 1995. The Centres of Excellence
Program for Women’s Health (CEWHP), co-ordinated by the Bureau of Women's Health and Gender Analysis of Health Canada, is dedicated to the development of community-based
research and policy advice which will make the health system more aware
of, and responsive to, women’s health needs. The Centres focus on the
social factors in women’s lives which affect their health.
At the outset, all Centres within the CEWHP were given a five-fold mandate:
generating new knowledge, addressing information gaps in current database
collections, communication and dissemination of information, network
building and strengthening, and policy advice to government and service
providers. Each Centre has developed its own structures and priorities
to address this mandate. At the PWHCE, emphasis has been placed on innovative
approaches to research, including the promotion of partnerships between
representatives and researchers in the community and in universities
and other institutions, the development of close links to policymakers,
and the promotion of community involvement in research (for example,
through participatory action research (PAR)).
Our Mission
The mission of the Prairie Women’s Health Centre of Excellence (PWHCE)
is to improve women’s health through high quality women-centred, action-oriented
research and policy analysis. The Centre supports and fosters research
designed to increase knowledge of the factors which influence women’s
and girls’ health and well-being. Building on this research and analysis,
the Centre develops gender-sensitive policy and program recommendations
which promote women’s and girls’ health.
Our Vision
Since the initial planning sessions of 1996, the supporters of PWHCE
have had a clear vision for the health of women and girls and of the
Centre’s role in helping achieve that vision. The text of this vision
has had only minor modifications, as a result of strategic planning
sessions of the Board in 1999, and again in 2001, and currently reads
as follows:
All women and girls will lead healthy lives, empowered
with the knowledge and resources necessary to promote personal, family,
and community health and wellbeing. Gender-sensitive, health-promoting
public policies will help to create a healthier, more equitable society.
In achieving this Vision, the Prairie Women’s Health Centre of Excellence
will become an important source of research, analysis, and policy advice
on women’s and girls’ health issues. The Centre will be strengthened
by the support and active participation of diverse communities of women
and girls.
Values statements
and Guiding Principles flowing from the Mission and Vision complete
the framework for PWHCE.
Our History
How we came to be
The proposal for the PWHCE was developed in 1996 as part of a competitive
federal process. A consortium of women’s health advocacy groups in Manitoba
and Saskatchewan was instrumental in coordinating a series of planning
and visioning processes which shaped the prairie submission. The Centre
proposal received approval in 1996, and its operations began in the
spring of 1997.
While the PWHCE is supported by numerous community organizations and
researchers in Saskatchewan and Manitoba, it is legally based on a formal
partnership among six of its founding members:
- Fédération provinciale des
fransaskoises,
- Prairie Region Health Promotion
Research Centre, University of Saskatchewan
- University of Regina
- University of Manitoba
- University of Winnipeg
- Women’s Health Clinic (Winnipeg)
From the outset,
the PWHCE established three program sites in Saskatoon, Regina, and
Winnipeg, with the administrative centre attached to the Winnipeg office.
The three program offices are housed and hosted at the University of
Saskatchewan, the University of Regina, and the University of Winnipeg,
respectively. While additional space requirements for the Winnipeg program
and PWHCE administrative office have since necessitated a relocation
to leased space offsite, the University of Winnipeg as host institution
continues to provide invaluable in-kind contributions of administrative
support, accounting support, technical support and program advice.
Governance
How We Conduct Our Affairs
PWHCE is governed by a policy board with input from a number of advisory
committees. Membership on these governing structures is representative
of the Centre’s six signatory partner organizations as well as organizations
reflecting a wide range of interests of Saskatchewan and Manitoba women
- including the academic, community, and policy sectors. A number of
Board positions have also been designated to be filled by rural, aboriginal,
northern, senior, and immigrant women.
The Centre has been fortunate in having the same Board Chair for the
first six years of its existence, as well as considerable stability
in Board membership. This continuity has enabled the Centre to pursue
its mandate in a consistent manner, while adapting its processes as
required within a known historical context. The Board holds one or two
in-person meetings per year, alternating among the three program cities,
and meets by teleconference three to four times per year, as needed.
Original Structures
The Centre’s original committee structure was fairly complex and reflected
our organization’s developmental stage and the work we wanted to do:
The Executive Committee acted on behalf of the Board
in situations where timely action was necessary.
The Program and Directions Standing Committee (PDC)
co-ordinated the overall program priorities and directions of the
Centre.
The Research Policy Standing Committee (RPC) served
as an advisory committee to the Board of Directors on matters related
to the goals and priorities of the Centre’s research program.
Theme Advisory Groups (TAGs) were appointed by the
Board of Directors to establish and oversee the research and policy
advice programs for theme areas across the program continuum. Five
TAGs were established initially; these were subsequently merged to
the following three:
- impacts of selected determinants
of health on women,
- effects of health reform
on women, and
- policy and program models
to improve women’s health.
The Diversity Ad Hoc
Committee’s role was to provide advice to assist the Board
in carrying out its value statement of diversity and inclusiveness.
Research Review Teams conducted the review of Stage
2 research project proposals.
Current Structures
In 2001/02, our committee structure has evolved to reflect the Centre’s
different developmental stage and its new directions and challenges. While
the leadership role of the Executive Committee is ongoing, other committees
have been realigned as follows:
The Research Advisory Committee makes recommendations
on ongoing and new research.
The Policy Strategy Committee makes recommendations for ongoing
and new policies for government as well as service providers. The Policy
Strategy Committee and the Research Advisory Committee are in constant
communication, to inform the new program directions of the Centre.
The Sustainability Committee is pursuing alternate
funding sources and research models for the Centre beyond the funding
commitments of the Bureau of Women's Health and Gender Analysis.
Administrative Organization
Our Staff
The three program offices were established to ensure an ongoing presence
at all program sites and to permit the Centre to capitalize on existing
expertise in both Manitoba and Saskatchewan. At the outset, each program
site was staffed with a half-time Program Coordinator, with the full-time
Executive Director and Administrative Coordinator based in the administrative
office. Program Coordinators had broad responsibilities coordinating communications,
supporting research teams, and managing the local office; responsibilities
extended beyond their geographic area to the national level, and/or to
specific themes within the Centre. The expanding workload at all levels
of the organization, combined with uncertainty over the Centre’s long-term
sustainability, resulted in considerable staff turnover at both staff
and management levels.
Within the three program sites, staff roles gradually evolved to reflect
the lessons learned over the past five years and the changing focus over
time. Staff responsibilities have recently been realigned to better meet
changing needs of the Centre and to match emerging priorities, and to
allow a greater inclusion of the diverse skills and expertise of the staff
members. We anticipate that this restructuring will make workloads more
manageable and focused, and will enhance opportunities for staff skills
development
The staffing complement in 2002 consists of:
- Executive Director (1.0)
- Administrative Coordinator
(1.0)
- Policy Analyst (1.0)
- Research Manager (1.0)
- Program and Community Development
Coordinator (0.5), and
- Administrative Assistant
(0.75).
This staffing is supplemented
and complemented by contract workers as required for work on specific
projects. Over the years PWHCE has developed a network of other associates.
Some have joined in specific projects, and continue to take an interest
in the work of the Centres.
Others are allies through common issues and collaboration on committees
in the community.
Despite the changes, PWHCE enjoys good working relationships with local
and provincial governments, ministerial and Federal/Provincial/Territorial
advisory groups. PWHCE staff are active in a number of local steering
and advisory committees in Winnipeg, Saskatoon and Regina.
The PWHCE Research Program
Funding Women's Research
The philosophical basis of the Centre’s research program is the development
of community/academic research partnerships. Within this model, PWHCE
supports feminist, community-based research, including participatory
action research (PAR) - an approach which allows for development interpretation
of research through the lens of women’s life experiences. In addition,
we are interested in how all health research can be systematically analyzed
for gender and racial inequities.
Funding Mechanisms
PWHCE has provided a range of mechanisms to fund research capacity and
knowledge generation since 1997:
Capacity-building workshops: Four workshops were held
in 1997 in Manitoba and Saskatchewan to discuss community-academic partnerships
and to orient new researchers to PWHCE research requirements and processes.
These workshops were attended by 124 women in all, including researchers
and representatives from women’s groups. PWHCE encouraged the formation
of multi-disciplinary teams among participants; 31 Stage 1 proposals
were submitted by such workshops, of which six went on to be funded
at Stage 2.
Developmental Grants: Six developmental, or seed grants were
funded for Participatory Action Research projects to develop background
work, bringing new research teams together to formulate research questions.
Of the six (6) developmental grants funded, two (2) went on to receive
funding from PWHCE for Stage 2 research proposals, and one went on to
receive full funding elsewhere.
Calls for Proposals: Three separate calls for grant funding
were made in 1997, 1998, and 1999. Each call used a 2-stage approval
process as discussed above, and reflected one of the research themes
established by the Theme Advisory Groups within their broader areas
of focus.
PWHCE research projects funded through this grant mechanism have covered
far-reaching topics including:
- Aboriginal women’s health
- Health reform
- The health of immigrant
women
- Informal caregivers’ health
- Lesbian health
- Literature reviews
- Low-income women’s health
- Older women’s health
- Rural women’s health
- Women’s mental health
- Women, violence, and abuse
- Women-centred health programs
& services
Commissioned Research: In the early years, topics for
specific, commissioned research were identified within the Theme Advisory
Groups; more recently, the Centre Board and staff have defined such
projects. Commissioned projects have included such topics as:
- Health issues for Aboriginal
women
- Gender and health planning
- Gender-specific program
evaluation frameworks
- Literature reviews on women’s
health
- Models of women-centred
care
- The service needs of pregnant
and addicted women (funded by Manitoba Health)
- Social housing policy
- The effects of health care
privatization.
PWHCE anticipates that commissioned
work may remain one of the centre’s preferred research funding mechanism
for the future because it provides additional opportunities to focus
the research agenda and to build a cohesive body of research.
Research Output
The PWHCE has provided direct support for over 50 policy-oriented research
projects since 1997. Every one of these research projects has individually
contributed to the growing body of knowledge and evidence on women’s
health. Furthermore, this impressive array of research has directly
contributed to the Centre’s growing credibility and to the planning
and priorities for the years ahead. Following are some highlights of
the uptake and impact of a few of the research projects funded by PWHCE.
The full listing of PWHCE project publications and uptake can be found
in the accompanying PDF file (see bottom of page).
Research Grants
Women Survivors of Childhood Sexual Abuse: Knowledge
and Preparation of Health Care Providers to Meet Client Needs
S. Tudiver, L. McClure, T. Heinonen, C. Scurfield and C. Kreklewetz
This study found that health care providers across all professions were
largely unprepared to cope directly with issues of childhood sexual
abuse (CSA) and either avoided the issue altogether or tried to work
around perceived problems. The study makes specific recommendations
for curricula development, referral networks, policy formulation, and
practice guidelines to meet the needs of women survivors. As a result
of this study changes have been made to curricula for dentists and doctors
in Manitoba. Educational pamphlets have been developed for both providers
and CSA survivors as a resource for helping CSA survivors get through
medical examinations (available through the PWHCE or online at www.cwhn.ca/resources/csa
).
Prairie Women, Violence and Self-Harm
C. Fillmore, C. A. Dell and The Elizabeth Fry Society of Manitoba
This study focused on the support and service needs of incarcerated
women offenders who injure and harm themselves; an area of health behaviour
which has not been well understood or researched. After interviewing
women who have a history of self-harm and corrections personnel, a new
model for care was developed. This report generated much interest across
the country, from advisory groups to the corrections system, and has
led to multiple publications. The Elizabeth Fry Society, one of the
research partners, have taken on national distribution of the report.
PWHCE helped to fund a plain-language brochure with ideas for coping
behaviours which was also developed and widely distributed.
Domestic Violence and the Experiences of Rural Women in East
central Saskatchewan
D. Martz and D. Saurer
This project gave voice to the difficulty faced by rural women seeking
assistance from police and health care workers after they have experienced
some form of abuse in the home. Women in rural Saskatchewan were invited
to discuss domestic violence in a safe environment and to make recommendations
for appropriate care in their local region. The project addressed the
benefits of inter-sectoral collaboration and the need to develop policies
and protocols for a variety of service providers who interact with women
experiencing violence. The report has had tremendous exposure. The Catholic
paper Prairie Messenger of the Centre for Rural Studies and Enrichment
of St. Peter’s College printed a story on this research project, as
did the Western Producer. The report has also received support from
the Provincial Association of Transition Houses in Saskatchewan, which
posted the report on their web site.
A number of policy developments have emerged from this research. The
health district which was a partner to the project discovered that women
who have experienced violence were encountering barriers to getting
appropriate mental health services, and they have since
changed their policies, even before the report was released.
As a direct result of the study, there are
now new guidelines regarding intake for women who present to the mental
health services in the region.
We Did It Together: Low-Income Mothers Working Toward a Healthier Community
and Telling it Like it Is: Realities of Parenting in Poverty
Kathryn Green
The purpose of this project was to bring together low-income mothers
of preschool-aged children who wanted to learn more about making their
community a healthier place to live. Participants identified the factors
that typically lead to a woman becoming a low-income parent; often,
but not always, it began with her own upbringing. Community factors
such as schools’ support for pregnant and parenting students, access
to childcare, and levels of social assistance provided to parents of
young children without paid employment, can strongly influence whether
or not an individual’s circumstances lead her to‘parenting in poverty’.
The report makes recommendations for women’s health policy in the areas
of financial support, recognition for and respite from parenting, access
to childcare, safe and healthy housing, addictions prevention and treatment,
and lessening the stigma associated with being poor. The women went
on to write a book, Telling it Like It Is: Realities of Parenting
in Poverty, which is a collection of their stories on living in
poverty. The book had a successful launch, attended by the mayor of
Saskatoon, representatives of the Saskatchewan government, and numerous
agencies and individuals. Some of the women went on to present their
work to municipal and provincial housing and social authorities.
Commissioned Research
Invisible Women: Gender and Health Planning in Manitoba and
Saskatchewan and Models for Progress
Tammy Horne, Lissa Donner and Wilfreda Thurston
This commissioned research was initiated to examine the degree to
which gender sensitivity and women’s health issues were reflected
in the planning processes of new regional health bodies in Manitoba
and Saskatchewan. Eight (8) of (then) 11 regional health authorities
in Manitoba and 17 of 32 Saskatchewan health districts participated
in the study. The researchers found little evidence of gender-oriented
strategies among regional health bodies in either province. This was
attributed to a number of factors, including a lack of understanding
of the importance and relevance of gender as a determinant of health.
Invisible Women makes 10 recommendations to address specific
priority issues and process deficiencies. These touch on the need
for resource expertise in gender analysis and women’s health; the
need to incorporate gender analysis throughout the whole planning
process; the collection and reporting of gender disaggregated data;
and the provision of access to educational materials and events to
develop skills in gender analysis.
Invisible Women has received extensive attention from the
media and policymakers, and the report is widely cited in literature
reviews of health planning and health reform. Presentations have been
made to multiple groups on the report and its implications. Ministers
of Health in both Manitoba and Saskatchewan met with PWHCE to discuss
the study’s findings and its practical applications. In addition,
the Federal/Provincial/Territorial Ministers responsible for the Status
of Women subsequently commissioned PWHCE and the research team to
conduct a gender-based analysis of Toward a Healthy Future: Second
Report on the Health of Canadians and three other key federal documents
to determine to what degree women’s health needs and concerns had
been addressed by the documents.
Invisible Women, Phase 2
The high level of interest generated by Invisible Women has led to
Invisible Women, Phase 2, to develop practical applications of gender-based
health planning and programming at the regional level. Development
of this project has been a long-term, intense collaborative effort
with the governments of both provinces, and has resulted in close
working relationships. In addition to the $10,000 PWHCE contribution,
Manitoba Health committed $20,000 for this project and the Women’s
Secretariat of Saskatchewan contributed $10,000.
- In Manitoba, PWHCE documented
a successful women’s health project to demonstrate an effective
example of gender-sensitive health programming: A Rural Women’s
Health Program: The Experience of the South Westman RHA (L.
Donner).
- In Saskatchewan, gender-based
training has been offered to the health districts to promote gender-sensitive
health and gender-specific programming and planning in health services
delivery.
- PWHCE is developing a
guide on gender-sensitive health planning to coincide with new guidelines
for Manitoba RHAs conducting community needs assessments. Examples
of GBA of existing health utilization data highlight the value and
breadth of information that can be hidden in gender-neutral data
sets. The guide includes checklists and tools for examining barriers
for equitable participation from diverse populations of women.
Left In the Cold: Women, Health and The Demise of Social
Housing Policies
Darlene Rude and Kathleen Thompson
The relationships among gender, health, income, and other socio-economic
factors are explored in the study, in the context of the housing situations
of women who have lived in social housing and also women who have
rented low-cost housing in the private housing market in the cities
of Regina, Saskatchewan and Winnipeg, Manitoba.
The report finds that gender is a variable that appears to be significant
in increasing a person’s risk of living in unsuitable housing. Changes
in housing policies and programs over recent years have had specific
gender effects, particularly for women with children, who report particular
difficulties in affording and getting into suitable housing. The current
housing system is insensitive to gender-specific housing issues, and
there are not adequate processes and mechanisms for women to deal
with harassment or abuse by landlords. Key recommendations are made
relative to i) health and housing issues; and ii) gender-specific
process issues. One of the main messages is the need to address the
shortage of adequate and affordable housing for women, particularly
women raising young children. As a corollary, a mechanism is required
to ensure that basic health and safety rules and regulations are followed
in all areas of rental housing, especially in the private housing
market.
At the time of writing, the Women’s Secretariat in Saskatchewan is
currently acting on the recommendations from Left In The Cold. Social
housing policy is under serious review in light of the findings of
the study, and follow-up studies are planned.
Evaluating Programs For Women: a Gender-specific Framework
(2000 Revised Edition)
Joan McLaren
In 1999, the PWHCE published a report from research commissioned to
set out the goals, purposes, approach and principles of a gender-specific
framework for evaluating programs for women. The evaluation framework
was subsequently pilot-tested in two sites providing services to women
- one in Saskatchewan and one in Manitoba - and revised accordingly.
The framework is based on a set of ten generic steps, each of which
has specific considerations to ensure gender-sensitive and woman-centred
processes and results.
This gender-specific evaluation model has been used in further studies
such as Invisible Women, discussed elsewhere in this report. Health
Canada’s Health Promotion and Programs Branch has also reported borrowing
heavily from the concepts, approaches, and framework of this model
in their own internal work.
A Study Of The Service Needs Of Pregnant Addicted Women In
Manitoba
Caroline L. Tait
Manitoba Health commissioned the PWHCE to undertake research on the
service needs and experiences of pregnant and addicted women, resulting
from a much-publicized human-rights case in Manitoba which went to
the Supreme Court. The commissioned report provides a critical analysis
of available information and data, and existing effective program
models and “best practices”; The writer provides 49 recommendations
to revise program and service components to meet identified and quantified
needs of pregnant addicted women. PWHCE currently sits on the working
group which is addressing the recommendations.
National Projects
Health Reform and Women
The PWHCE has participated extensively in this endeavour. In 1999, as
part of the National Coordinating Group on Health Care Reform and Women,
PWHCE conducted provincial and regional scans of policies and research
related to privatization in health reform and its impacts on women.
There have been and continue to be positive outcomes from this national
project on health reform:
- The 8 reports from these
studies have recently been compiled and published in a book entitled
Exposing Privatization. Two of the eight reports in the book were
commissioned by PWHCE.
- The National Coordinating
Group sponsored a national think tank on unpaid caregiving, which
brought together policy-makers and researchers to examine unpaid caregiving
with a gender lens.
- The Coordinating Group made
a representation to the Kirby Senate Commission, drawing on its work
from the previous 3 years on health reform.
- The National Coordinating
Group developed a popular format document entitled Women and Health
Care Reform, which was widely distributed across the country. This
piece was co-ordinated and co-authored under separate contract by
Kay Willson, PWHCE’s Saskatoon Program Coordinator.
- Multiple presentations
have been made on the findings of this policy scan, including one
to the Canadian Commission on the Future of Health Care in Canada.
- PWHCE continues to participate
in the ongoing work of the National Coordinating Group on Health Care
Reform and Women, fostering collaboration and encouraging other health
researchers and women’s health organizations to take up the challenge
of monitoring the impacts of health reforms on women and women’s responses
to health reforms. Kay Willson of the Saskatoon office plays a vital
part on the national group.
Research Synthesis
Group In May 2000, the PWHCE agreed to take the lead in a national
initiative by the Centres of Excellence for Women’s Health Program to
review and synthesize research findings in selected key areas from the
work to date. This Synthesis Group also serves as an advisory group
to the editor of the CEWHP Research Bulletin. Kay Willson, Saskatoon
Program Coordinator, chairs the Synthesis Group, and the PWHCE provides
administrative support to the group on behalf of all Centres. This national
project has been fruitful and demonstrates the value of PWHCE’s extensive
resource contribution.
- A synthesis of current Canadian
research on aboriginal women’s health was commissioned by the Research
Synthesis Group; this was followed by a national workshop on aboriginal
women’s health in March 2001. The project has led to the establishment
of a new Aboriginal Women’s Health network of organizations and individuals
interested in aboriginal women’s health research. The network is seeking
further support from the Bureau of Women's Health and Gender Analysis, and PWHCE is committed
to actively providing support to the group as it evolves.
- A second synthesis work
has been commissioned for internal purposes on the works to date by
all Centres on sexual and reproductive health. PWHCE has been instrumental
in co-ordinating this project.
National Project on
the Health Issues for Women Living in Rural and Remote Canada
PWHCE is a partner with the other Centres of Excellence for Women’s
Health on a national initiative which will set a research agenda and
policy framework for health and health care delivery to Canadian women
living outside urban centres. This is especially timely as the health
care crisis and researchers projects begin to understand the particular
implications for the many Canadians who do not live in a large city.
The Centres of Excellence have a vital role to help ensure that women’s
health is included in research and policy agendas. The four-phase project
includes sample focus groups with women across the country in many,
varied rural, remote and northern communities. In January 2003, PWHCE
will co-host a National Community Symposium where the results of this
initial project will be presented.
Additional partnering opportunities
PWHCE partners with other Centres of Excellence in the development and
implementation of research projects with far-reaching implications.
For example:
- The Healthy Balance Research
Program is a 5-year program of research funded by the CAHR, bringing
together 25 researchers from universities, public policy, health organizations,
and community and government partners to investigate the relationships
between women’s health and wellbeing, family life, and earning a livelihood.
The lead organizations are the Atlantic Centre for Excellence in Women’s
Health and the Nova Scotia Advisory Council on the Status of Women,
and PWHCE has been invited to participate.
Milestones
PWHCE
Successes
In 6 short years, PWHCE has had many successes, in terms of research
publications and credibility within policy and research circles. Some
of the milestones in the Centre’s coming of age are highlighted below:
Our Health In Our Hands Conference
In October 2000, the PWHCE hosted the national conference, Our Health
in Our Hands. Over 250 people attended from Manitoba, Saskatchewan,
and across Canada to share knowledge and experience on women’s health
issues. Researchers addressed a variety of topics in women’s health,
including women’s occupational health and safety, the health of Aboriginal
women, immigrant and refugee women, rural and remote women, health reform
in the prairie provinces, and other key issues in women’s health. The
focus of the conference was the review and endorsement of the draft
Action Plan (discussed below), which was based on current literature
and consultations with women across Manitoba and Saskatchewan. Over
200 conference participants participated in workshops to help refine
and strengthen the Action Plan.
Action Plan for Women’s Health
In January 2001, the PWHCE Board released the Action Plan for Women’s
Health in Manitoba and Saskatchewan. The Action Plan highlights
12 overriding priorities in women’s health and makes recommendations
for change in each of the policy areas. The Action Plan provides
direction to government and community policymakers on the factors affecting
women’s health and on proposed strategies for change. It refers to actions
that can be taken within the health system, while encouraging advocacy
in sectors outside the health system related to health determinants.
Endorsements from community organizations were included in the last
version of the Plan, and a number of other agencies have publicly endorsed
the Action Plan since its release. The Action Plan
has been widely distributed to health planning bodies, has received
much positive attention, and is already having an impact on public policy.
For example:
- The Action Plan
was presented at the Women’s Secretariat conference in Regina.
- A request for a presentation
was received from the Canadian Federation of University Women (Regina).
- In Manitoba, the Women’s
Health Unit has incorporated the Action Plan into its Women’s
Health Strategy.
- A presentation was made
to the Council of Saskatchewan Nurses in Saskatoon.
- The Action Plan
was enclosed in a mailing by a regional office of Health Canada, as
a resource document to inform decisions about funding community projects
on population health.
- Articles about the release
of the Action Plan were published in both the Winnipeg Sun
and the Winnipeg Free Press, regional papers and were picked up by
the CBC and several other radio stations.
- RHAs in Manitoba were encouraged
by the Minister of Health to use the Action Plan in helping identify
local priorities.
- Presentations were made
at public consultations held by Manitoba Health and the Status of
Women to hear about women’s health concerns.
- The Action Plan
was distributed to all participants of the 2000 conference Our Health
in Our Hands.
- The Action Plan
was presented by Margaret Haworth-Brockman, Executive Director of
PWHCE, at a conference at the University of Saskatchewan in Saskatoon,
The Lived Environments of Girls and Women: An Interdisciplinary Conference.
- The Centre has also developed
a plain language brochure on the Action Plan, outlining the
key priorities and strategies for action.
Presentation to House of Commons and Senate Committees on
the Proposed CIHR
In 1999 the PWHCE was invited to appear before the House of Commons
Standing Committee on Health, and the Senate Committee on Social Affairs,
Science, and Technology to give testimony regarding proposed legislation
to establish the Canadian Institutes for Health Research (CIHR). The
presentation was based on a Working Group proposal, which advocated
for the establishment of a Women’s Health Research Institute as well
as a systematic program for the integration of sex and gender across
the CIHR. The decision was subsequently taken to establish an Institute
of Gender and Health as one of thirteen “virtual” institutes. PWHCE
has collaborated on research proposals submitted to the Institute and
looks forward to receiving positive responses.
Lessons
Learned
In establishing itself as a recognized Centre of Excellence over the
past six years, the PWHCE set high goals and undertook an inordinate
amount of work. Along the way, the Centre has had many successes as
highlighted in this review, and has also learned some important lessons
which will inform our ongoing operations.
Manageable Workloads
In its 1996 proposal, the PWHCE established an ambitious research program
with five theme areas. The workload and coordination requirements were
very demanding for the volunteers and staff, and in its 1998 Strategic
Planning session, the Board recognized the need to streamline its efforts
and focus its resources more narrowly. The 5 themes and 13 strategic
goals were collapsed into three main theme areas in a program continuum
of: Research, Communication, and Policy Advice.
During strategic planning sessions during 2001-2002 the Centre has refined
the focus of the program further, with increased emphasis on policy
relevance and uptake.
Internal Evaluation
This process evaluation, completed in 2000, assessed the ground covered
by the PWHCE in a few short years. Due to the early stage of the program,
the Research agenda was understandably found to be better advanced than
Communication or Policy Advice. Major findings and impacts of the internal
evaluation were as follows:
- A need for additional emphasis
on policy implications was identified and more emphasis has been placed
on these areas in subsequent projects.
- The internal evaluation
noted the heavy demands placed on Board, committee members, and staff
by the Centre’s broad objectives, pointing to the need for a focused
research program, streamlined committee structures, and manageable
priorities. These findings have contributed to the further refinement
of priorities and the recent restructuring within the Centre.
- Board and committee members
stressed the fact that success is based in part on relationships and
networks, and requested additional opportunities for face-to-face
meetings and interaction. This will be facilitated by the streamlined
committee structure.
- The challenge of community-academic
partnerships was highlighted, with research teams reporting varying
levels of satisfaction with relationships and processes. More information
on community-academic partnerships below.
- Commissioned research projects
were found to allow for a greater degree of control over the product
and its dissemination. Commissioned research may become the PWHCE’s
primary method of research funding.
Mid-Program Review
PWHCE participated in the mid-program review sponsored by the Bureau of Women's Health and Gender Analysis in 2000. The review recognized the extensive progress
made by the Centres to date, while pointing to the need for more focused
research and to the potential for more coordination of efforts among
the Centres on several fronts. The report made general recommendations
for action, which, while pertinent to the PWHCE, tended to be national
in scope. Recommendations included:
- Additional efforts to build
unity and coordination across Centres.
- Consolidation around key
strategic themes and issues where there is the greatest potential
for impact. • Greater cross-Centre sharing of results.
- A research synthesis mechanism
to aid in shaping new research directions and dissemination in the
most strategic manner.
- A focused cross-Centre
communication strategy with CWHN playing a major role.
- Greater national coordination
for research dissemination, communications, and policy advice. PWHCE
has participated in the successful implementation of many of these
recommendations, as discussed throughout this document.
Community-Academic Partnerships:
Lessons Learned
In 2001-02, the Centre commissioned a study to obtain feedback and insight
on the successes and challenges encountered by the community-academic
research partnerships. Input was sought from Board and committee members,
individual members of research teams, and staff, through a combination
of surveys and telephone interviews. Overall, respondents reported a
high across-the board satisfaction with the quality of research output,
despite dissatisfaction with such factors as communications within the
team. While the value of community-academic research partnerships was
recognized, there was considerable variation in satisfaction between
community and academic respondents on issues such as PWHCE processes,
the report review process, and the clarity of expectations of teams.
Key findings and participant recommendations include the following:
- The major challenge faced
was in the formation of effective teams. Most successful teams had
joint interests and commitments, and often a history of collaboration;
forced partnerships led to fragmented teams.
- Time and funding for face-to-face
meetings are of the essence to shape a project, develop a sense of
team, and ensure that all skills are utilized successfully (especially
so for geographically dispersed research teams).
- There is a role for the
PWHCE in clarifying team roles and on the broad dissemination of research
findings.
- PWHCE should provide ongoing
communication and feedback to participants during the course of a
project.
- A mechanism is required
to help align community members residing outside university centres
with an academic researcher.
- Care should be taken to
match the size of research grants to the efforts required in applying
for said grants.
- There is a need to create
opportunities for networking between researchers / teams, e.g. conferences,
casual lunch meetings.
- Larger grants and multi-year
projects were broadly supported to look at broader issues.
The Board and staff of PWHCE are using this valuable
information to make policy and practice changes in light of these findings.
Looking Ahead
Future Directions
At the March 12, 2001 meeting, the Board of PWHCE reaffirmed its commitment
to long-term sustainability, and passed a motion stating “That the
Board is in favour of sustaining the Centre beyond the year 2002 with
the same values, similar strategies, commitments, and guiding principles.”
Since that time, considerable effort has been expended in considering
alternate funding mechanisms and in lobbying the federal government
for ongoing core funding of the Centres of Excellence. The PWHCE is
delighted with the recent commitment to continuation of the Centres,
and looks forward to working collaboratively with the Bureau of Women's Health and Gender Analysis in developing the details of future mandates, funding mechanisms,
and terms and conditions.
Later in 2001, the Board of PWHCE approved a new committee structure
to better suit its emerging needs. Changes implemented in administrative
structure and roles reflect the change from grant funding to commissioned
research and the increased focus on national projects, collaboration
between Centres, with a heightened emphasis on policy and dissemination.
While seeking opportunities for participation in national or shared
research projects with greater depth and wider applicability, we remain
committed to identifying and pursuing local gaps in women-centred health
research, focusing specifically on these 4 areas in the next few years:
- Women and poverty
- The health of women in
rural and remote areas
- Issues of aboriginal women,
including a focus on racism
- Policy implications of research
completed on caregiving.
The PWHCE remains committed to having staff and offices in three sites
across Saskatchewan and Manitoba, and to maintaining its working relationship
with researchers and the community sector on the prairies and across
Canada.
As the PWHCE adapts to meet future opportunities and challenges, we
will build on our strengths and experience. The skills and networks
developed over the past 6 years will serve us well in furthering the
cause of women-centred health research. We look forward with anticipation
to the future before us.
This
publication comes in two parts, the main report which is on this
webpage, followed by the details on our Projects and Publications
which can be viewed and printed off in PDF format...
Download Full
Report (including Projects & Publications)
in PDF Format. 519KB
Download PWHCE
Projects and Publications only, in PDF Format.
187KB
To order a printed copy of this publication, please call our office
at (204) 982-6630. |
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