Call for urgent reform of healthcare for marginalised women

Marginalised women voiced frustration at not being listened to and taken seriously in healthcare.

Reform is urgently needed to make healthcare more accessible to marginalised women, a new report by the National Women’s Council of Ireland (NWCI) has found.

Dismissive attitudes of healthcare providers, inaccessible services, and a lack of cohesive supports were repeated concerns raised by women from marginalised groups.

“The entire system is set up for coping, not thriving… to access supports you have to be barely coping,” said one woman with a disability.

“It’s very difficult for us to open up about our problems," said a woman of minority ethnicity. "Doctors are different, sometimes I had a good experience, but there were times I wouldn’t ask a question because the moment they see you they treat you differently and speak to you differently.” 

A woman from a disadvantaged community said: “As the mother, and as the woman, you are expected to advocate and push and put yourself under unbearable amounts of stress and pressure the whole time trying to advocate for what you know your child needs."

The report published today is part of the Radical Listening Exercise commissioned by the Department of Health to hear from marginalised women about their interactions with health services. Developed with Community Work Ireland, the report is based on focus groups with 50 women who identified as disabled, of minority ethnicity, as a survivor of domestic abuse, or from a disadvantaged area. 

Not taken seriously 

Although some women spoke positively about the care and support they received, across all groups, women voiced frustration at not being listened to and taken seriously in healthcare.

Lack of accessibility was a key issue in built environments but also in terms of supports available to enable women to be listened to in shared decision making, for example, translation services (e.g. sign language) and the availability of accessible, simple information. 

Women spoke enthusiastically about the accessibility of community support delivered by local organisations and this was often presented as an antidote to the complex network of broader services that women must navigate.

Based on the findings of the report, called Improving the Healthcare Outcomes and Experiences of the Healthcare System for Marginalised Women, NWCI is calling on the Government to address the problems raised.

This includes providing mandatory gender sensitivity and unconscious bias training for health and social care professionals so that women can be better listened to and have their concerns taken seriously.

"Our report highlights the importance of listening to women and their experiences of health services," said NWCI director Orla O’Connor.

In their own words, women have detailed how poor experiences of healthcare erode trust in the system and, in many cases, cause women to withdraw from vital care. 

"These experiences included a lack of join-up in services and failures to take health concerns of women seriously. 

"One simple example of this is how the physical design of facilities in hospitals resulted in some disabled women being unable to access mammograms and cervical smear tests — one woman did not have a cervical smear test in over 11 years due to the trauma of a previous experience.  

"Women have also highlighted the positive experiences of primary healthcare and the benefits of community-based supports.”