Curriculum for General Practice - The Royal New Zealand College ...

W Curriculum Women’s Health for General Practice
Women’s Health
Women’s health has often been
synonymous with reproductive health, but
it is important to address women’s health
more broadly and within a social framework.
Women have special needs associated with
their roles, responsibilities and position in
society as well as their reproductive roles.
Women tend to be the major agents for improving health
care in the community as they manage the health needs of
the family. In New Zealand, many women are still the primary
care givers in a family/whānau. Family/whānau is central to
Māori culture and the role of women is paramount.
While many of the problems with which women present are
not unique to women, the way in which they present and
need to be managed is often different from that of men. A
number of health problems of women are preventable: key
factors influencing the health status of women in New Zealand
include smoking, alcohol consumption, physical activity,
socioeconomic status and family violence.
Cervical cancer is one of the most curable of cancers and
yet 200 women develop it in New Zealand each year and 70
die from it. Māori and Pacific women have a higher risk of
cervical cancer and poorer survival rates, and yet this group
is less likely to obtain screening. 1 Breast cancer is the most
common cancer in New Zealand women. The incidence of
breast cancer is higher for Māori than non-Māori, and despite
an improvement in survival rates during the period 1991–2004,
Māori women are more likely to die from it. This is attributed to
a lower participation in screening programmes by Māori. 2
New Zealand has a strong rural environment. Many women
work in the agricultural industry and are exposed to illness
related to a rural way of life. Additionally, many older people
in rural communities are cared for by their extended families/
whānau with much of the caregiver’s role placed on the
woman, which brings an added dimension to an already-busy
rural life.
The fertility rate for 2011 in New Zealand was 2.1 births per
woman. Fertility rates are highest in women aged 30-34 years
and marks a significant shift from the 1960s when women
aged 20-24 had the highest fertility rates. 2011 recorded the
lowest number of live births since 2006, and is reflected in
women of all age groups having fewer babies. 3 Fertility rates
are still highest among Māori women aged 20-24 and Pacific
people show similar patterns with fertility being high in the
early 20s but peaking in the years 25-29. 4
Although few general practitioners now deliver babies, they
continue to have an important role in maternity care. A 2001
consumer survey revealed that, on finding out or suspecting
that they were pregnant, 60 percent of women approached
a general practitioner, rather than a midwife or obstetrician.
First-time mothers, Pacific women and women under 25 were
even more likely to approach a general practitioner. 5
1
National Screening Unit, Cervical Cancer in New Zealand, http://www.nsu.govt.nz/current-nsu-programmes/1228.aspx
2
Ministry of Health, Cancer: New Registrations and Deaths 2007, p.76. Wellington: Ministry of Health. 2010.
3
Statistics New Zealand. 2012. Births and Deaths: Year ended December 2011 [online]
4
Statistics New Zealand. 2006. Age Specific fertility rates for the major ethnic groups [online]
5
http://www.health.govt.nz/publication/maternity-consumer-survey-2011
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Curriculum for General Practice