Taking inventory requires identification of existing data, needs
assessments, health services inventories, and other appropriate resources on
which to build. This is an important step to help ensure you do not
duplicate efforts. Creating a comprehensive starting point is a crucial step
for documenting progress and building momentum.
We assessed the status of women's health using both qualitative and
quantitative approaches, successfully engaging many partners as a direct
result of these efforts. Both quantitative and qualitative data are
important in building momentum. Qualitative analyses can poignantly
emphasize points illustrated by the numbers (quantitative data). Moreover,
the process of gathering qualitative data can help to build momentum.
Gathering broad public input provided a platform to promote awareness
messages and to identify potential partners. In this section, we describe
the processes used to take inventory and highlight how each contributed to
Strengths, Weaknesses, Opportunities, and Threats (also known as
Analysis") [pdf; 53.12kb]
Shortly after naming Florida's First Officer of Women's Health Strategy, we
held three open forums to collect opinions about state and community-level
priorities related to women's health. Having the support of a highly visible
Officer of Women's Health Strategy added legitimacy to these meetings and
mobilized groups interested in women's health. Having legislative authority
also increased interest and participation. We generated an extensive list of
interested persons from these forums and all of these individuals became
partners or participants in ongoing women's health activities.
Gap Analysis of Women's Health Services
One of the first places to start building momentum is within one's agency.
The decision to begin with an emphasis on mobilizing internal partners is
consistent with the
Association of Maternal and Child Health Programs (AMCHP)
framework for developing effective partnerships. This framework promotes
integration within women's health entities (e.g., Healthy Start, Family
Planning Program, HIV/AIDS and STD Programs) before planning and
implementing programs and policies across non-health entities. The
Intra-Agency Women's Health Committee had the potential to reach all of the
key women's health programs within the department, so we decided to engage
this group in our mobilization efforts.
The Intra-Agency Women's Health Committee includes leaders who are
responsible for advocating and overseeing nearly 30 statewide programs. It
can be challenging to mobilize individuals who are typically concerned with
different, single-program interests and unite them around an issue that they
view as peripheral to their primary focus. Thus, mobilization centered on
the need for integration of services. For details about the process, please
see Mobilizing Support.
The focus on integration required a gap analysis assessment of which
services are adequately available to women and which are not. Gap analyses
are important tools for building momentum, and we found the action-oriented
meetings focused on the gap analysis were more effective for engaging
individuals and mobilizing support than education- and awareness-oriented
meetings. The gap analysis
[pdf; 128kb] proceeded in three distinct stages:
defining core women's health
linking services with programs,
The Intra-Agency Women's Health
Committee's first task in conducting a gap analyses was to identify a core
set of services that are critical to women's health. While this step may
sound simple enough, it was not. We found it necessary to establish an age
focus for identifying services for women. We focused on women between the
ages of 15 to 44, since the grant focuses on women of reproductive health
age. We then decided on a definition of Women's Health:
"Health is a state of complete
physical, mental, and social well-being and not merely the absence of
disease or infirmity. Women's health involves their emotional, social,
spiritual, and physical well-being and is determined by the social,
political, and economic context of their lives, as well as biology."
(Adapted from Platform for Action of the Fourth World Conference on Women in
Beijing, September 1995)
The Intra-Agency Women's Health Committee then finalized a core set of
women's health services. For details about the process, please see
Defining Core Women's Health Programs and Services.
Once we finalized this list of core services, the next step was to link
those services with programs to identify the gaps. The Intra-Agency Women's
Health Committee reviewed the list of departmental programs that correspond
to this core set of services. For the purpose of linking core women's health
services to programs, the committee defined state programs as those that
support core services through funding, policy development, monitoring, or
technical assistance to service providers. The committee identified a list
of programs that included bureaus, programs, or activities within programs
that directly provide one or more core women's health services. For
consistency with other departmental documents, the group edited the list of
programs so they align with the titles used in the Florida Department of
Health Resource Manual, an document the department updates annually. .
The task of linking services with programs created an
Women's Health Programs [pdf; 20.4kb] using program descriptions from the resource
manual. We categorized program descriptions into two groups: core women's
health programs (with official documentation of core women's health
services' provision), and other public health programs that are essential to
the department's ability to provide the core women's health services.
The final step in conducting the gap analysis, validating the data, was the
most labor-intensive and included:
a word search of the Florida
Department of Health Resource Manual cross-referencing programs to core
program review and update of
which core services their programs provided , and
validation of the matched list
of core women's health services and programs by cross referencing with the
department's service coding manual and data collection forms (state adult
and adolescent health history form, adult and adolescent physical
examination form, and health promotion form).
We learned some lessons in
conducting the gap analysis, which we would like to share. The first lesson
was the importance of specifying and reaching agreement on inclusion
criteria for services very early in the process. It is essential that
everyone understands definitions and inclusion criteria BEFORE beginning the
process. This will avoid rehashing and second-guessing at later stages. This
step may require more time than expected. You may think everyone is in
agreement, but then find that changes are necessary to the written product.
Below are a few of the questions we encountered.
How are we defining "women"
(what ages are we including)?
When you say "services," do you
mean clinical services?
What about health promotion?
What about assessments?
How are you defining programs?
Are we talking about programs
just at the state or county level?
The Intra-Agency Women's Health Committee (with 350 combined years of public
health experience) reviewed the cross referenced list and identified
additional gaps in core women's health services and barriers through an
in-depth discussion about accessibility. For details, about the process,
please see Identifying Gaps in Women's Health Services - Part 1
[pdf; 23.7kb] and
Identifying Gaps in Women's Health Services - Part 2.
[pdf; 25.6kb] An ad hoc
sub-committee finalized the
summary of gaps and barriers
[pdf; 19.7kb] and the full
committee approved it.
We developed a vision and several strategies related to this focus at two,
meetings. For details about the process, please see
Strategic Planning --
Prioritizing Needs [pdf; 17.6kb] and
Strategic Planning - Brainstorming Strategies.
[pdf; 17.8kb] At the
first meeting, we crafted the vision and developed strategies for focus
heightened awareness of
departmental women's health programs,
active sharing of information,
coordination of program
increased joint efforts.
The committee then broke into
four groups to brainstorm strategies related to these focus areas. We
circulated results from this meeting to the full committee and solicited
additional suggestions . At the next meeting, we reviewed all strategies and
made a few adjustments to focus areas by combining those that were similar.
For a summary of the final strategies, please see
After the committee reached consensus regarding the final list of
strategies, we prioritized the strategies and developed action plans. For
details about that process, please see
Strategic Planning - Prioritizing
and Refining Strategies. [pdf; 18.2kb] We carried out two exercises to prioritize the
strategies by impact and by feasibility.
The committee focused on the top three strategies and developed activities,
benchmarks and strategic champions. These activities included:
disseminate information via new
employee orientations, bulletins, and newsletters,
develop and promote the use of
a women's health data profile in the DOH web-based Community Health
Assessment Resource Tool Set, and
link websites of health
programs that serve women with the women's health website.
Tools for success with workgroups:
When using an ongoing workgroup
to develop a product over multiple meetings, strive to maintain continuity
of members to avoid renegotiating previous decisions.
Set a standing day and time for
recurring meetings to reduce schedule conflicts for workgroup members and
If possible, spread the work
over fewer but longer meetings.
The Women's Health Data Report 2006 was the department's first comprehensive
assessment of women's health status in Florida. This inaugural report
provides analyses of morbidity and mortality data, behavioral factors,
indicators of access, and reproductive health. It also summarizes the unique
health issues of special populations and documents racial and ethnic
disparities in women's health. A copy of the
Women's Health Data Report
2006 [pdf; 1.90mb] is available on the
Department of Health's Women's Health
website, with hyperlinks to a number of data sources.