PRACTITIONERS IN WOMEN’S HEALTH: MEETING WOMEN WHERE THEY ARE
A range of health care practitioners from many disciplines are involved in the health of women and girls and their activities occur across the lifespan and in a diverse range of settings. A life course approach to women's health conceptualizes health as a developmental trajectory, incorporating the interactions among biological, behavioral, and social contexts. The social, political, and economic contexts of women's lives have undergone major transformations throughout the world and not always for the better. These issues influence women's mental, social, and spiritual well-being, expression of chronic and mental health disorders, and access to health care.
To be an effective health practitioner we need to provide comprehensive and culturally appropriate care to women and girls. This requires meeting women where they are, not judging, labeling, or blaming. This is not always easy as many cultural practices, values, and beliefs can challenge our belief systems. Dealing with issues such as child marriage and female genital mutilation can be confronting for many of us. But reacting with outrage and disapproval can sometimes alienate individual women, men, and communities. We need to be thoughtful, respectful, and considerate to effectively advocate and intervene to improve women's health. As health care practitioners we need to meet women where they are, be aware of both our conscious and unconscious biases, and be mindful of the complex factors moderating health care outcomes.
To be an effective women's health practitioner we require not just technical proficiency in women's health but also a suite of strategies to engage those who are marginalized and vulnerable. Core skills to be an effective women's health practitioner include positioning ourselves within the health care encounter, appraising the social determinants of health, and doing more listening and less talking to enable targeted and tailored health care interventions. Being able to talk with women on highly sensitive issues, such as sexuality and intimate partner violence, is dependent on creating a therapeutic alliance of trust and mutual understanding and respect.
Appraising the circumstances of women and girls is integral for performing effective health interventions. Through assessing the social, political, economic, and cultural context we can identify the levers for behavior change and also look for opportunities for empowerment. In this issue a number of articles challenge us to look at sentinel events in women's lives with a gendered lens, considering the range of socio-cultural factors influencing health.
Preparing practitioners for women's health requires not only facilitating clinical, technical skills, and competencies, but also the capacity to engage with individuals and communities to advocate for women and girls. Improving the status of women and girls has been integral to the gains of the Millennium Development Goals and will be equally as important in the upcoming Sustainable Development Goal agenda. Advancing women's health is dependent on practitioners working in policy, practice, education, and research. Rising to this challenge will require preparation of a generation of practitioners trained to work in complex milieus and also the humility and respect to meet women where they are.
Patricia Davidson, PhD, Med, RN, FAAN
School of Nursing, Johns Hopkins University
©Patricia Davidson