Background
More and more women are living with HIV in Canada. This increasing proportion has evoked calls for women-centred services that are tailored to women’s needs. In response, a team of researchers, clinicians, community-based service providers, policy-makers, and women living with HIV from across Canada initiated a new study – the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) – to determine if women-centred practices could lead to better sexual, reproductive, and women’s health outcomes. However, first, we needed to ask (and, more importantly, answer!): What is “women-centred care”?
Methods
CHIWOS is wrapping up its second year and has completed a formative research phase dedicated to understanding women-centred care. Our quest for learning about the topic began with a literature review, entitled “Women-specific HIV/AIDS services: Identifying and defining the components of holistic service delivery for women living with HIV/AIDS.”
To strengthen our understanding, however, we needed to hear from women living with HIV. To this end, we conducted 11 focus groups with 77 women living with HIV in Quebec, Ontario and British Columbia. Focus groups were led by Peer Research Associates (or PRAs), HIV-positive women who were trained in community-based research and focus group facilitation. Focus groups were audio-recorded, transcribed, and analyzed using thematic analysis.
Findings
In BC, five major themes regarding women-centred care emerged through our conversations with women. These included care environments that:
- Consider and address how women’s whole lives affect their health;
- Implement policies that recognize women as valued volunteers, employees, partners and leaders within the services they access;
- Prioritize a safe (physically and emotionally) atmosphere;
- Are cognisant of and compassionate towards women’s intersecting forms of oppression; and
- Encapsulate care for women’s unique health needs.
Importantly, while themes emerged, the discussion highlighted that women aren’t all the same and that the key features of women-centred care may vary depending on the context, purpose and patients involved.
Based on these findings and our other formative research activities, we developed a definition that recognizes the range of meaning of women-centred care: “Women-centred care supports women living with HIV to achieve the best health and well-being as defined by women. This type of care recognizes and addresses women’s unique health and social concerns, and recognizes that they are connected. Because this care is driven by women’s diverse experiences, women-centred care is flexible, and takes the different needs of women into consideration“.
Next steps
Using this definition, we developed a scale to measure and evaluate use of women-centred care. This work will be undertaken in the second phase of CHIWOS, which is set to begin in May 2013 and will enroll 1,250 women living with HIV from BC, ON and QC. Participants will complete a PRA-administered survey at baseline and 18 months later. At both visits, they’ll share their voices on a range of topics including their use of women-centred care and their sexual, reproductive, emotional, and women’s health. It is though listening to their voices that we hope to evaluate the potential of women-centre care to achieve optimal health outcomes. We hope we are doing their stories justice.
For further information
Please contact our CHIWOS BC team (below), follow us on twitter at: @CHIWOSresearch, or visit the CHIWOS website.
- Angela Kaida, Co-Principal Investigator
- Allison Carter, Provincial Coordinator
- Valerie Nicholson, Community Representative and PRA