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WOMEN-CENTREDCARE: WORKINGCOLLABORATIVELYTO DEVELOP GENDERINCLUSIVE HEALTHPOLICYMarcia Hills & Jennifer MullettPublished online: 10 Nov 2010.

To cite this article: Marcia Hills & Jennifer Mullett (2002) WOMEN-CENTREDCARE: WORKING COLLABORATIVELY TO DEVELOP GENDER INCLUSIVEHEALTH POLICY, Health Care for Women International, 23:1, 84-97, DOI:10.1080/073993302753428456

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Health Care for Women International , 23:84–97, 2002Copyright © 2002 Taylor & Francis0739-9332 /02 $12.00 + .00

WOMEN-CENTRED CARE: WORKINGCOLLABORATIVELY TO DEVELOP GENDER

INCLUSIVE HEALTH POLICY

Marcia Hills, RN, PhD, and Jennifer Mullett, PhDCommunity Health Promotion Coalition, Faculty of Human & Social Development ,

University of Victoria, British Columbia, Canada

We argue that policies for women-centred care ought to be developed to ad-dress the inadequacy of the current health system to recognize that womenare affected differently by health policies and programs and that gender isa determinant of health; furthermore, such policies must be created withrepresentatives from relevant health professional organizations so that thepolicies are translated and operationalized at the organizational and prac-tice level. A collaborative research process, co-operative inquiry, was usedto conduct the research. This process engages the participants in rigor-ous iterations of action and re� ection. The result was a clear de� nitionof women-centred care, a set of general guidelines for practice, and speci� cchanges to existing organizational policies. The process and the productof the research built a bridge between existing macro government policiesand the guidelines, standards, and ethical codes of the professional healthassociations.

The care women receive in the medical system is moulded by policiesthat are created by professional associations, government, and medical insti-tutions and that are enacted in everyday practices. These policies can eitherdiminish or improve the quality of care that women receive. Creating genderinclusive policies with and for health professional associations is one wayto ensure that women’s health needs are met.

Funded by the Women’s Health Bureau, British Columbia Ministry of Health and MinistryResponsible for Seniors.

Address correspondence to Dr. Marcia Hills, CHPC—University of Victoria, UH 2—Room107, P.O. Box 3060, STN CSC, Victoria, BC, Canada V8W 3R4. E-mail: chpc@uvic.ca

84

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Women-Centred Care: Gender Inclusive Health Policy 85

The aim of this research project was to develop such policies through acollaboration with 10 regional health professional associations. We addressedthe following research questions:

1) What are the essential elements of women-centred care?2) What guidelines need to be created to support women-centred care?3) What approach would facilitate the incorporation of women-centred

care guidelines into existing documents of professional organizations?

We describe why and how the research was initiated, the research processwe chose to achieve the objectives of the research, and the results of theprocess. Gender is a determinant of health (we use examples to show whyand how), so gender-centred policy is called for. But the mere creation ofpolicy without its implementation or operationalization is insuf� cient, so wemake the case for a research methodology that could be used to developand, coincidentally, integrate new gender inclusive policy. We introduce anddescribe the chosen methodology, co-operative inquiry. Subsequently, in themain part of the article, we detail it by describing the conduct of the co-operative inquiry by the researchers and the health associations in four phasesfrom start-up, through development of women-centred guidelines, throughan overlaying of the newly developed guidelines onto existing policies, andconcluding with developing strategies for the incorporation and endorsementof them. We include the � nal draft of the guidelines and examples of theirincorporation into various association policies in Tables 1 and 2.

Gender is a determinant of health. The simple fact that a person is bornfemale determines her health status to some extent, not just because of thebiological distinction of sex, but also because of socioeconomic differencesassociated with gender. Thus, women as a group not only experience differenttypes of health issues than men, they also experience the same health issuesdifferently than men. Women are more likely to be living on lower incomes(and heading lone parent families on those incomes), to be employed inlower paying and less stable jobs, and to be encouraged by societal genderexpectations to be the primary givers of support to others, even if this isdetrimental to their own needs and health (Graham, 1998; Janzen, 1998;Kaufert, 1996; United Kingdom Department of Health, 1998).

Also, women are confronted by barriers to the health care system. Povertyand lack of child care or transportation (particularly in remote locations) areall impediments faced by women (Broom, 1998).

Women tend to use the health care system more frequently than men.This is because women live longer than men, have a greater incidence ofchronic illness, and have more caregiving and child rearing responsibilities(Provincial Health Of� cer’s Report, 1995).

Discussions about women-centred care commonly raise questions aboutthe need for women-centred care as opposed to person-centred care. Person-centred care is similar to women-centred care; it values the person’s per-spective as primary rather than the priorities of the institution and/or its

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86 M. Hills and J. Mullett

staff. However, person-centred care remains gender neutral and assumes thatpeople are affected equally or in the same manner by health policy and pro-grams. Women-centred care recognizes that women and men are affecteddifferently by health policy and programs; that is, gender is a health deter-minant. Women-centred care is, therefore, gender inclusive.

Consequences of the Lack of Policy for Women’s Health

In the absence of policy for women-centred care, women’s natural lifeprocesses, such as reproductive health or menopause, are often overmedical-ized. Conversely, some women’s health issues are minimized or discountedas emotional or psychological. In either case, inappropriate medical care of-ten results (Gjisbers Van Wijk, Van Vliet, & Kolk, 1996). Wagner (1995)describes dramatic examples of the effects of either overmedicalizing orpsychologizing women’s health issues:

Women have reported that doctors do not listen to them and sometimes do notbelieve them when they relate their symptoms. Knowledge is withheld or non-existent. They encounter dishonesty and treatment without consent, are givenincomplete information regarding risks (breast implants, DES, tamoxifen), andare given tranquillizers instead of resources to improve their coping. Treat-ment is often unnecessary, mutilating and too severe for the problem (e.g.,hysterectomies). (p. 65)

A New York survey found that women were more than twice as likely asmen to change doctors because they were dissatis� ed and because they feltpatronized or “talked down” to (Broom, 1998). Australian studies suggestthat doctors often do not respond appropriately to women’s psychologicaldisturbances or physical assault by partners (Mazza, Dennerstein, & Ryan,1996; Taft, 1995, cited in Broom, 1998).

Health Research Excludes Women

Women have historically been excluded from pertinent health research.Rosser (1994) presented an overview of studies that are noteworthy for theirlack of inclusion of women. For example, although heart disease affects bothmen and women and is one of the leading causes of death in women, moststudies have only included men in their samples. In a study examining acholesterol-lowering drug, 3,086 men were included, but no women partici-pated. In another study examining the risk factors for heart disease, 12,866men participated, but no women were included. In an examination of therelationship between aspirin and heart disease, 22,071 men participated, butno women were involved. In fact, in all the studies on heart disease between1960 and 1991, only 20% included women (Rosser, 1994), and from 1992to 1996 only 16% of participants in heart disease research were women(Rochon, Clark, Binns, Patel, & Gurwitz, 1998). The exclusion of womenin research suggests that their health needs are not examined, explicated, orresolved.

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Women-Centred Care: Gender Inclusive Health Policy 87

What is Needed

An inextricable connection exists between the social construction ofwomen’s lives, their gendered role in society, and their health and the healthcare they receive (BC Women’s Hospital and Health Centre Society, 1994).Research indicates that women want health care professionals and the healthcare system to recognize this link (BC Women’s Hospital and Health CentreSociety, 1994; Charles & Walters, 1997).

Many service providers reported being aware of the need for servicesthat re� ect this connection between women and their lives, but expressedfrustration at their inability to meet this need. They reported barriers suchas in� exibility within the system, lack of integration of services, and lackof adequate resources (BC Women’s Hospital and Health Centre Society,1995). The development of gender inclusive policy for health professionalassociations is a fundamental step toward dealing with these barriers.

Gender Inclusive Policy

Some national governments have incorporated guidelines to assess the im-pact of policy development on women and, where appropriate, on speci� cgroups of women (New Zealand Ministry of Women’s Affairs, 1996; Stone,Carmen, & Yaremko, 1999; The Royal Ministry of Children and FamiliesAffairs, 1995). However, government guidelines alone will not guaranteethe development of positive practices or positive attitudes toward women.Ultimately, to have a systemic impact on the lives of women, gender inclu-sive policies and analyses need to be translated and operationalized at theorganizational and practice level by organizations other than government. Topromote this ideal, the authors aimed their research at creating policy withprofessionals from diverse organizations.

Policy developed by this approach is more relevant, has more credibilitywithin the organization, and is more likely to be implemented than policycreated in isolation using a top-down approach. Involving in� uential poli-cymakers from diverse organizations catalyzes a sharing of perspectives, fa-cilitates the transformation of consciousness regarding women’s health, andpositions professionals to incorporate the policy directives into the practicesand cultures of their organizations. According to Leninger (1995), “In ev-ery culture, power and politics tend to vary in organizational structures. . . .Power expressions and politics are closely related to persons in authorityor to those who hold in� uential positions, statuses or role responsibilities”(p. 50).

METHODOLOGY

A conceptually broad strategy is required to develop policy that is suf-� ciently general so as not to exclude professional associations, yet is ade-quately speci� c so that it has application for every professional group. Themethodology utilized for the research project focuses on the everyday prac-

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88 M. Hills and J. Mullett

tices of a particular group while addressing the broad macro-level societalprocesses.

A speci� c collaborative action research process, co-operative inquiry(Heron, 1996; Reason, 1988), was used to conduct the research. This typeof inquiry is particularly relevant to policy research because of its focus onbringing about change rather than on prediction or understanding alone. Wellsuited for studying women’s issues, it relies on a feminist process and onfeminist principles to conduct the inquiry. Co-operative inquiry does researchwith people, not on, to, or about them. The research procedures removethe boundaries between researcher and subject by engaging all participantsas coresearchers and cosubjects. The initiating researchers form an inquirygroup by inviting others interested in the research issue to join them. Thegroup engages in rigorous iterations of action and re� ection. Co-operativeinquiry consists of a series of logical steps:

1) identify the issues/questions to be researched,2) develop an explicit model/framework for practice,3) put the model into practice and record what happens, and4) re� ect on the experience and make sense out of the whole venture

(Reason, 1988).

This methodology has been used extensively and with great success bymany disciplines in Britain (Archer & Whitaker, 1994; De Venney-Tierman,Goldband, Rackham, & Reilly, 1994; Marshall & McLean, 1988; Reason,1988) and is gaining recognition in Australia and North America (Treleaven,1994) as a vital research methodology to bring about social and policychange.

In this project, the inquiry group engaged in four cycles of action andre� ection over six months. The time frame and number of cycles was de-signed to provide an appropriate blend of re� ection on action to producenew knowledge about the issue being studied. Through a collaborative pro-cess, representatives of the professional associations articulated the criticalelements of women-centred care and developed guiding principles that couldbe incorporated into their policy documents. The process included review-ing the relevant literature, appraising guidelines developed by other organi-zations, developing new guiding principles, and assessing the participants’associations’ documents in relation to the newly developed women-centredcare guidelines. These activities are described below.

RESEARCH PROCESS, RESULTS, AND DISCUSSION

Phase One: Establishing the Inquiry Group and De� ningWomen-Centred Care

Letters were sent to a variety of diverse professional associations invit-ing them to participate in the study. Representatives from the following 10

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Women-Centred Care: Gender Inclusive Health Policy 89

provincial professional associations agreed to form an inquiry group: theRegistered Nurses Association of BC, the BC Naturopathic Association, theBC Dieticians and Nutritionists Association, the College of Physicians andSurgeons of BC, the Health Association of BC, the Medical Services Com-mission, the BC Association of Clinical Counsellors, the West Coast Home-opathic Society, the College of Dental Surgeons of BC, and the College ofMidwives of BC.

In this initial phase, the inquiry group formalized as a working researchgroup, discussed the research methodology to be used, and conducted adocument review. At its inaugural meeting, the members of the inquiry groupexplored the concept of women-centred care and their understanding of andfamiliarity with this concept, which included

· an examination of the broader context of women-centred care withinhealth care delivery;

· a summary of the literature on women’s health and women-centred care,including policy documents and reports from provincial consultationswith women;

· a debate about the need to incorporate women-centred care within theparticipating organizations;

· a discussion of each organization’s existing policies on women-centredcare, person-centred care, and gender generally.

As a result of these discussions, the group examined each organization’sexisting documents, such as standards for practice, codes of ethics, or guidingprinciples, to determine the ideological context in which each professionalgroup conceptualized care.

Each organization submitted its existing policies to be copied and dis-tributed to all group members. In addition, every member of the inquirygroup received a copy of Gender Lens (a government policy document),journal articles on pertinent women’s health issues, and a set of guidelinesfor women-centred care developed by the BC Women’s Hospital and HealthCentre Society. Group members individually reviewed all of the documentswithin the frame of gender inclusive policy.

At a subsequent meeting, following this initial analysis, the group con-cluded that while some of the documents included person-centred policies,none had identi� able gender inclusive policies. Based on this analysis, thegroup agreed that gender inclusive guidelines should be developed collabo-ratively and, further, such guidelines should be incorporated into the existingdocuments of each association.

Phase Two: Developing Policy Guidelines

During the second phase, the inquiry group examined, de� ned, and devel-oped guidelines for women-centred care. During the re� ection component ofthis phase the group considered key elements of women-centred care, while

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90 M. Hills and J. Mullett

in the action component it examined the guidelines developed by the groupin the context of the individual organizations. It was in this phase that thevalue of the collaborative approach was most apparent.

The group pursued its understanding of women-centred care by dis-cussing women’s health in general and by considering several de� nitionsof women’s health. The following de� nition of women’s health and descrip-tion of women-centred care were accepted and unanimously endorsed by therepresentatives of the participating associations:

Women’s health involves women’s emotional, social, cultural, spiritual andphysical well-being, and it is determined by the social, political and economiccontext of women’s lives as well as by biology. This broad de� nition rec-ognizes the validity of women’s life experiences and women’s own beliefsabout and experiences of health. Every woman should be provided with theopportunity to achieve, sustain and maintain health, as de� ned by that womanherself, to her full potential. (Phillips, 1995, pp. 507–508)

Women-centred care:

· recognizes the importance of gender differences in health experiences;· seeks to reduce inequalities;· values women’s experience in de� ning their problems and health goals;· recognizes women’s diversity—in race, ethnicity, culture, sexual pref-

erence, education, and access to health care;· supports empowerment of women in their own recovery and as valued

members of the community;· supports women’s values of caring and providing social support; and· works to change the context of women’s health problems.

The group felt that this de� nition of women’s health and conceptualiza-tion of women-centred care consolidated thinking and would guide furtherdeliberations of the guidelines for operationalizing women-centred care.

Wanting to build on previous work in this area, the group consideredguidelines that had previously been developed by the BC Women’s Hospitaland Health Centre Society (1995). The group critiqued and reviewed eachcharacteristic until a consensus was reached on the key elements.

In the action phase, the group members examined the key elements inrelation to the mandates of their own organizations. The group memberssubmitted their critiques and suggested revisions.

We then synthesized this information and presented it for discussion andvalidation at the next re� ection meeting. The diversity of professional per-spectives that had been presented and the respectful debate that followedcontributed to a depth of understanding and appreciation of the complexityof women’s health issues. Had guidelines been developed by any organiza-tion individually, even with the best of knowledge and intentions, they wouldhave lacked the insights and intricacies that were generated by the diversityand synergy of the group.

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Women-Centred Care: Gender Inclusive Health Policy 91

As an example, the guideline concerning working with other health prac-titioners originally read: “We will collaborate with other organizations andagencies in the community. We will respect holistic approaches to health andbe inclusive of other practitioners and other points of view.” Some membersthought that this was too broad and that there were agencies that they couldnot, in good conscience, include in the care of their clients. Others were morecomfortable with the broadness of diverse health and social agencies. Afterdiscussion, the guideline was modi� ed to re� ect these divergent positionsand read as follows: “When appropriate, seek cooperation with mutuallysupportive health professionals in order to promote synergistic collabora-tion, continuity of care and quality of care.”

In a similar example, many perspectives were considered on the issueof the role of allopathic and alternative approaches to health. Two originalguidelines were affected by this discussion: “We will respect holistic ap-proaches to health, and be inclusive of other practitioners and other pointsof view,” and “We will give women options and enough information to makeinformed choices. We will educate women about the health system and howit works.” Because the group consisted of both allopathic and alternativepractitioners, it learned about the nuances in the debate of these issues(for example, what constitutes the health system). As a result, the groupwas able to create two new guidelines that were more inclusive and ex-plicit: “Give women information to facilitate their making informed choices.Women will be encouraged to exercise their right to ask questions and will beprovided with the opportunity to consider appropriate alternative therapies,”and “Consider the possible contributions that other health care providersmay make including those whose approaches are other than mainstreammedicine.”

As a further example, a draft guideline seemed intuitively reasonable at� rst glance: “When dealing with the health care of individuals, we willcollaborate with the patient and, when appropriate, the patient’s self-de� nedfamily and other providers including those who may use non-traditionalapproaches.” In the ensuing discussion, the point was made that for somewomen, their health issues are enmeshed in their family structures (e.g.,violence, psychological distress, ethnic practices, stress from care-givingresponsibilities) and thus it is not always appropriate to include their family.Certain members of the group felt very strongly that the woman herself, notthe health provider, should decide who should be present at a consultation. Asa result, the above guideline was modi� ed to read: “Allow self determinationto manage the issue of whether or not family members or signi� cant otherswill be in attendance during consultations.”

Every guideline was subjected to similar scrutiny until consensus wasreached on each of them. Thus, the group created a set of general guidelinesto be circulated for a � nal validation. Once the inquiry group con� rmed theguidelines, they were sent to and approved by the Women’s Health Bureauand received � nal endorsement by the Minister of Health. See Table 1.

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92 M. Hills and J. Mullett

Table 1. Guidelines for women-centred care

The following guiding principles will be embodied by all professionals and their associ-ations in their approaches to women’s health and will be a consistent part of everydaypractice. All those engaged in health care practice will be sensitive to the needs of womenand will acknowledge, encourage, and include holistic approaches to health.

1. Treat women with respect. This includes preserving women’s dignity, acceptingwomen’s knowledge of their being, and acknowledging their experiences.

2. Acknowledge and accept the diversity of women. Diversity includes physiology, eth-nicity, economic circumstances, sexual orientation, ability, culture, religion, and levelof education.

3. Acknowledge women as the predominant caregivers who very often provide the safetynet for others in our society. In addition, recognize that women experience greaterdif� culty with access to health care because of their childrearing and caregiving re-sponsibilities.

4. Actively explore and consider the impacts of the social, economic, societal, and envi-ronmental factors on women’s lives. Recognize the gender imbalances in our societyand other cultures.

5. Give women information to facilitate their making informed choices. Women willbe encouraged to exercise their right to ask questions and will be provided with theopportunity to consider appropriate alternative therapies.

6. When appropriate, seek cooperation with mutually supportive health professionals inorder to promote synergistic collaboration, continuity, and quality of care.

7. Allow self determination to manage the issue of whether or not family members orsigni� cant others will be in attendance during consultations.

8. Consider the possible contributions that other health care providers may make, includ-ing those whose approaches are other than mainstream medicine.

Phase Three: Generating Examples of Gender Inclusive Policy forthe Associations

The guidelines were aimed at facilitating the incorporation of women-centred care into everyday practice. The group explored ways to implementthe guidelines. Members were concerned that if the guidelines were left as astand-alone document, they would not be operationalized. After considerablediscussion, the inquiry group formulated the following research question:“What would our guidelines for practice look like if they embodied genderinclusive policy and factored in the diversity of women”?

The group examined each of the association’s existing guidelines, stan-dards for practice, and/or codes of ethics in relation to the newly establishedguidelines in order to establish what alterations could be made to the exist-ing documents to make them more gender inclusive. Although it was beyondthe mandate of the group to change the individual organizations’ guidelines,it was realized that the group could make concrete suggestions to eachorganization about how their guidelines could be more gender inclusive.

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the

auto

nom

yof

clie

nts

and

help

them

toex

pres

sth

eir

heal

thne

eds

and

valu

es,

and

toob

tain

appr

opri

ate

info

rmat

ion

and

serv

ices

.

Ack

now

ledg

ean

dac

cept

the

dive

rsit

yof

wom

en.

Div

ersi

tyin

clud

esph

ysio

logy

,et

hnic

ity,

eco-

nom

icci

rcum

stan

ces,

sexu

alor

ient

atio

n,ab

ility

,cu

ltur

e,re

ligio

nan

dle

vel

ofed

ucat

ion.

Nur

ses

valu

ean

dad

voca

teth

edi

gnit

yan

dse

lf-

resp

ect

ofhu

man

bein

gs.

Tre

atw

omen

with

resp

ect.

Thi

sin

clud

espr

eser

ving

wom

en’s

dign

ity,

acce

ptin

gw

omen

’skn

owl-

edge

ofth

eir

bein

g,an

dac

know

ledg

ing

thei

rex

peri

ence

s.

(con

tinue

d)

93

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Tab

le2.

(Con

tinue

d)

Hea

lth

Ori

gina

lgu

idel

ines

,et

hica

lM

odi�

edco

rres

pond

ing

guid

elin

eas

soci

atio

nco

des,

orpr

inci

ples

for

wom

en-c

entr

edca

re

Nur

ses

reco

gniz

eth

athe

alth

stat

usis

in�

uenc

edby

ava

riet

yof

fact

ors.

Inw

ays

that

are

cons

iste

ntw

ithth

eir

prof

essi

onal

role

san

dre

spon

sibi

liti

es,

nurs

esar

eac

coun

tabl

efo

rad

dres

sing

inst

itu-

tiona

l,so

cial

,an

dpo

liti

cal

fact

ors

in�

uenc

ing

heal

than

dhe

alth

care

.

Ack

now

ledg

ew

omen

asth

epr

edom

inan

tca

regi

vers

who

very

ofte

npr

ovid

eth

esa

fety

net

for

othe

rsin

our

soci

ety.

Inad

diti

on,

reco

gniz

eth

atw

omen

expe

rien

cegr

eate

rdi

f�cu

ltyw

ith

acce

ssto

heal

thca

rebe

caus

eof

thei

rch

ildb

eari

ngan

dca

regi

ving

resp

onsi

bilit

ies.

BC

Ass

ocia

tion

ofC

lini

cal

Cou

nsel

lors

:S

tand

ards

,G

uide

line

san

dE

thic

alP

ract

ice

Stan

dard

s

The

coun

sell

or’s

prim

ary

resp

onsi

bili

tyis

toth

ein

divi

dual

(s)

dire

ctly

rece

ivin

gor

invo

lved

wit

hth

eco

unse

llor

’spr

ofes

sion

alac

tivit

ies,

that

is,

the

clie

nt.

Thi

sre

spon

sibi

lity

isno

rmal

lygr

eate

rth

anth

ere

spon

sibi

lity

toth

ose

indi

rect

lyin

volv

ed.

Allo

wse

lfde

term

inat

ion

tom

anag

eth

eis

sue

ofw

heth

eror

not

fam

ily

mem

bers

orsi

gni�

cant

othe

rsw

ill

bein

atte

ndan

cedu

ring

cons

ulta

tion

s.

Cou

nsel

lors

upho

ldcl

ient

righ

tsto

info

rmed

con-

sent

,th

atis

the

clie

nt’s

full

and

activ

epa

rtic

ipa-

tion

inde

cisi

ons

whi

chaf

fect

them

,an

dfr

eedo

mof

choi

ceba

sed

onth

ein

form

atio

nsh

ared

.

Giv

ew

omen

info

rmat

ion

tofa

cili

tate

thei

rm

akin

gin

form

edch

oice

s.W

omen

wil

lbe

enco

urag

edto

exer

cise

thei

rri

ght

toas

kqu

esti

ons

and

wil

lbe

prov

ided

wit

hth

eop

port

unit

yto

cons

ider

appr

opri

ate

alte

rnat

ive

ther

apie

s.T

heco

unse

llor

trea

tsco

llea

gues

and

all

othe

rpe

rson

sw

ith

who

mhe

/she

inte

ract

sin

apr

o-fe

ssio

nal

capa

city

with

resp

ect,

hone

sty

and

fair

ness

.

Whe

nap

prop

riat

e,se

ekco

oper

atio

nw

ith

mut

uall

ysu

ppor

tive

heal

thpr

ofes

sion

als

inor

der

topr

o-m

ote

syne

rgis

tic

coll

abor

atio

n,co

ntin

uity

,an

dqu

alit

yof

care

.C

ouns

ello

rs,

asm

embe

rsof

the

com

mun

ity

inw

hich

they

live

and

wor

k,co

nsid

erth

eri

ghts

and

safe

tyof

othe

rsan

dac

tso

asto

supp

ort

thos

eco

nsid

erat

ions

.

Act

ivel

yex

plor

ean

dco

nsid

erth

eim

pact

sof

the

soci

al,

econ

omic

,so

ciet

al,

and

envi

ronm

enta

lfa

ctor

son

wom

en’s

lives

.R

ecog

nize

the

gend

erim

bala

nces

inou

rso

ciet

yan

dot

her

cult

ures

.

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Women-Centred Care: Gender Inclusive Health Policy 95

The group worked together to identify person-centred guidelines for eachassociation and made recommendations about how they could be changedto be gender inclusive. Examples of some of the professional associations’“person-centred” standards, codes, or principles that were modi� ed to specif-ically address the needs of women are included in Table 2.

Phase Four: Developing Strategies

The inquiry group members discussed possible strategies to have thenewly created guidelines endorsed and incorporated into policy documentswithin their respective associations. It was agreed that the individual mem-bers would present the guidelines and examples of gender inclusive policy tothe boards of directors of their associations. Many of the boards of directorshave, subsequently, endorsed these women-centred care guidelines for useby their organizations.

CONCLUSION

“Successful strategies are visions, not plans . . . which take on value onlyas committed people infuse them with energy” (Mintzberg, 1994, cited inValentine, Styles, & Mangan, 1995, p. 114). Involving key stakeholdersproved to be an important ingredient in the success of the project. Thediversity of the group, tempered by the collaborative process that was usedto develop and carry out the research, generated broad ranging yet relevantand appropriate women-centred care guidelines. Most importantly, not onlyare the guidelines useful for the organizations involved, but the organizationsare actually using them.

Organizational commitment to implement women-centred care is essentialto the advancement of women’s health. The guidelines developed in thisproject have built a bridge between existing macro government policy and theguidelines, standards, and ethical codes of professional health associations.The process used in this project to develop the policy guidelines for women-centred care could be easily adapted by others wishing to support a women’shealth agenda. Implementing similar guidelines elsewhere could serve toimprove the health status of women, remove barriers to health care, andhonour women’s role in society.

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