Womens Health Business Case Report

EXECUTIVE SUMMARY

The challenge facing NGO Women’s Health Centres in NSW The Women’s Health Program is a unique, integrated primary health care service model for women delivered by a network of 20 community-based NGOWomen’s Health Centres across NSW. The program provides evidence- based interventions to address both physical and mental health needs, as well as the health impacts of domestic and family violence and sexual violence on women and children, and a range of social determinants of health. Each year, the Women’s Health Program supports over 50,000 women of all ages, the majority from lower socio-economic backgrounds and other priority health populations. The Women’s Health Program grant provided by NSW Health - currently $10.56 million per annum - has not seen a real increase since 1986, despite major economic and social changes, and structural adjustments in the health sector over this period. As a result, the funding structure and resourcing for the Women’s Health Program currently reflects the expectations for a 1980’s era community- based health service. The Women’s Health sector as a whole is no longer sustainable under current arrangements and has now reached a crisis point. Women’s Health Centres are running unsustainable operating deficits, and are being forced to make skilled mental health, clinical and health education staff redundant and/or reduce services. Without additional investment, many Women’s Health Centres will be forced to close, or substantially reduce services in the next 2 years. This Business Case presents a detailed proposal for increased investment to ensure the sustainability of the Women’s Health Program and the well-established, community-based Women’s Health Centre infrastructure.

Rationale for Increased Investment In Women’s Health

Women in NSW continue to experience physical and mental health vulnerabilities at significantly higher rates than men across a wide range of indicators. Overall, women experience higher rates of psychological distress, poorer self-reported health status, higher rates of hospitalisation for self-harm, and are more likely to have multi-morbid chronic health conditions. Women face a range of gender-based vulnerabilities, many connected with social determinants of health, that impact on their access to health services and overall health outcomes. They are also more likely to experience socio- economic disadvantage as a result of income inequality and their disproportionate role as caregivers. Evidence shows that social determinants of health related to, and exacerbated by, socio-economic disadvantage are closely associated with poor mental and physical health in women. Domestic and family violence and sexual violence also have a profound impact on women’s health and well-being. In NSW, women are hospitalised following domestic and family violence at more than 7 times the rate of men. Recent analysis of Australian women also found that 51% of women in their late twenties, 34% of women in their early forties and 26% of women in their sixties to early seventies have experienced at least one type of sexual violence. The adverse physical and mental health impacts of trauma associated with domestic and family violence, and sexual violence are serious, long-lasting and complex, and continue even after the violence has ceased.

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Appendix B