In 1997 and 1998, the WCHPC prepared a review of the current status of the health of women of reproductive age, and of health system goals, structure, components, and organization related to this population group. This initiative entailed a comprehensive examination and synthesis of the literature, deliberations of a national expert panel, and a series of publications and tool products. The major objective of this activity was to provide a basis for program development initiatives in the area of women's and perinatal health nationwide.
The conceptual framework developed for identifying and organizing health needs of women addressed systems concerns, including health status, health services, and quality of care.
The evolving women's health field has begun to be shaped by a philosophy that recognizes the impact of women's multiple roles in society on health, that rejects a false dichotomy between reproductive and non-reproductive health, and that focuses on women's health assets rather than just problems. Accordingly, the Charting a Course initiative was guided by four main perspectives:
- A holistic perspective that considers the multiple influences of biological, psychological, and social factors on women’s health and that embraces a wellness approach, rather than being problem-focused. Such a perspective focuses on women’s assets, stressing their resiliency and positive factors that affect their health.
- A lifespan perspective that recognizes that women have different health and psychosocial needs as they encounter transitions across their lives and that the positive and negative effects of health and health behaviors are cumulative across a woman’s life. A lifespan perspective also means conceptualizing perinatal health within the context of women’s overall health. Pregnancy is recognized as an important event in the life of a woman, although not the only important event.
- A social role perspective that recognizes that women routinely perform multiple, overlapping social roles.
- A women-centered perspective that considers women’s gender-specific experiences as normative and recognizes the diversity among women in their health care needs and access to adequate health resources.
A manuscript published in the Maternal and Child Health Journal (September 1997) discusses the extension of women's health beyond the mere absence of disease or disability. In "Changing Definitions of Women's Health: Implications for Health Care and Policy," Dr. Carol Weisman argues in support of a holistic approach to women's health, as opposed to a disease- or reproductive-focused model.
An invitational meeting on the State of the Field was convened in April 1998. Individuals representing professional organizations, MCH advocacy groups, academics, and federal agencies met to formulate recommendations and strategies to address pressing health concerns of women. The principal product of the initiative is a two-volume compendium entitled Charting a Course for the Future of Women's and Perinatal Health: Volume I: Concepts, Findings and Recommendations, and the companion document, Volume II: Reviews of Key Issues. Thirteen Perinatal and Women's Health Issue Summaries also were produced, each concisely presenting the extensive materials covered in the background papers in a format more useable for sharing with policymakers, among others.
Multiple publications and tools resulted from this initiative, including several manuscripts, as well as a tool for states.
- Misra DP, Grason H, Weisman C, 2000. "An intersection of women's and perinatal health: The role of chronic conditions." Women's Health Issues 10(5): 256-267.
- Strobino DM, Grason H, Minkovitz C, 2002. "Charting a course for the future of women's health in the United States: Concepts, findings and recommendations." Social Science and Medicine 54: 839-848.
- Minkovitz CS, O'Campo PJ, Chen YH, Grason HA, 2002. Associations between maternal and child health status and patterns of medical care use. Ambul Pediatr. Mar-Apr;2(2):85-92.
Faculty participating in preparing this review include Donna Strobino, Carol Weisman, Dawn Misra, Yvonne Bronner, Patricia O'Campo, Cynthia Minkovitz, Wanda Nicholson, Charlyn Cassady, Bernard Guyer, and Holly Grason.
In recognition of the Maternal and Child Health Bureau's evolving commitment in the arena of women's health, and the expansion of the MCH population of focus to include women's health, state and local public health data needs continue to grow. To assist in this regard, the WCHPC designed a publication entitled "State Strategies for Improving Data on Women's Health" to assist states in gathering, organizing, and analyzing information about women and their health, centering around the Women's Health Care Experiences survey instrument.
Another initiative that resulted from the Charting a Course work is the development of a modified conceptual framework for the study of perinatal health. More information about this project can be found on the associated web page.