Abstract



The long and winding road toward gender equity

The World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (Wonca) was organized in 1972. Gender equity in Wonca leadership was first brought up at the Wonca World Council in Hong Kong in 1995 by the Norwegian College of General Practitioners, when it recommended that both sexes be represented on the Executive. The dissenting view aired in that discussion was that affirmative action would result in less qualified representation, and that competence and capability were the important criteria in selection of members. The Norwegian motion was not approved by the Council. However, it was resolved that the proposed amendment “that both genders should normally be represented in the Executive” be referred to the Bylaws Committee, but no changes to this affect have occurred in the bylaws.² To date, there have been four women who have sat on the executive: a regional President for Europe, a Regional Vice President for Asia Pacific, a member-at-large and a Regional President for Africa.

At the 15th International Conference of Wonca in Dublin in 1998, a group of 50–100 women met regularly and proposed a Women in Family Medicine Special Interest Group (SIG). This SIG was accepted at the next Wonca Executive meeting in April 1999.³ The proposed aims and objectives of the SIG were seen to be worthy of a Wonca working party and the new Wonca Working Party for Women and Family Medicine (WWPWFM) was named at the 16th International Conference of Wonca in Durban, in 2001.

The Working Party continued to work through member interactions, subgroup meetings during regional conferences, rural health conferences and world conferences. Members of the SIG attended a Wonca workshop in Christchurch in June 2000 and developed Strategic Objectives from the 1995 4th World Conference on Women, Beijing Platform for Action for promoting and protecting the health of women.⁴

These objectives were supported by WWPWFM and were endorsed by the Wonca Executive in Durban, 2001, Singapore in 2001 and London in 2002, as the Strategic Action Plan.^5,6

Attendees at the 4th World Rural Health Conference in Calgary, Canada, in August 2000 recognized the special contributions of women physicians to rural practice in the Calgary Commitment to Women in Rural Family Medical Practice⁷ (http://www.globalfamilydoctor.com/aboutwonca/working_groups/rural_training/calgary_commitment.htm) This was endorsed at the Wonca World Council Meeting in 2001 in Alpine Heath, Durban.^8,9

An electronic mailing listserv called WoncaWomen became a venue for sharing experiences and thoughts and a Women’s Track was presented during the scientific sessions in Durban, 2001.⁸

Participants developed a series of recommendations for Wonca to promote leadership skills and opportunities for both junior and experienced women in family medicine at a Women-in-Leadership Symposium and several meetings were convened and the WWPWFM plan and budget was formulated for the next triennium, which was submitted to the Executive.¹⁰

Working Party members developed a Working Document, Monograph and Literature Review and Needs Assessment Questionnaire for the annual meeting in Orlando, Florida, in October 2004. Copies of the documents are available for review at the following website: www.womenandfamilymedicine.com A series of articles from this monograph on Women and Family Medicine have been written for Wonca News leading up to the Singapore conference in 2007. At the Wonca World Council in Orlando in 2004, the WWPWFM held a strategic planning workshop as a preconference event. The Vision of the Working Party was refined and is to promote women family doctors in Wonca, to highlight their special contributions and to reduce the barriers facing them, thereby enabling them to reach their full potential and enhance the contribution of all family physicians/GPs around the world to clinical care, women’s health, education, research and leadership in family medicine.

At the workshop the WWPWFM selected as its first Chair, Dr. Cheryl Levitt (Canada) with Dr. Amanda Howe (UK) as the Deputy Chair. Reflecting the group’s commitment to flexible work arrangements and to collaborative relationships, several representatives from each of the six Wonca regions were selected to support Dr. Levitt in her role as Chair. Thirty-eight women from 16 countries (US, Canada, UK, Netherlands, Austria, Thailand, Malaysia, Philippines, Australia, New Zealand, Ghana, Nigeria, South Africa, Ecuador, Lebanon, Venezuela) met at a 1½ day workshop. The main task was to review a detailed Working Document, drawing on work that had previously been developed at the Wonca meetings in Dublin in 1998 and in Durban in 2001.

The group committed to working on implementing the WWPWFM objectives. These are: to identify the key issues for women doctors; to review Wonca policies and procedures for equity and transparency; to provide opportunities to network at meetings and through the group’s listserve and website; and to promote women doctors’ participation in Wonca initiatives. The group committed to equitable representation of women in Wonca activities, and to ensuring and enhancing the presence of women and women’s issues at the next Wonca conference in Singapore.¹¹

The McMaster/Hamilton meeting August 2006

Following their commitments in Orlando, the Wonca Working Party on Women and Family Medicine (WWPWFM) convened from August 20–25, gathering 25 representative women family physicians, clinicians, teachers and health researchers – from 16 countries and all six Wonca regions – at McMaster University in Hamilton, Ontario, Canada. An innovative “travel equalization policy” was used to help finance the meeting and ensure that all parties could attend. During the meeting, the many participants carefully prepared and all signed the Hamilton Equity Recommendations – The HER Statement (Fig. 1) – which urges the general practice/family medicine organizations of the world that are constituted as Wonca to adopt four fundamental recommendations regarding gender equity:

1. Enshrine the principle of gender equity within Wonca governance by amending the Wonca Bylaws and Regulations, as proposed by the WWPWFM.
2. Implement gender equity in all activities of Wonca, in particular the scientific programs of its triennial, regional, and rural meetings.
3. Promulgate the pivotal role of gender as a key determinant of health.
4. Promote the equitable inclusion and advancement of women general practitioners/family physicians in Wonca

A key task at the meeting was to develop a programme (Women’s Track) for the Wonca Singapore ’07 meeting. Such an important international meeting provides concrete opportunities for the development of leaders and the advancement of women general practitioners/family physicians in Wonca. The proposed programme will ensure women’s participation in the Singapore conference and is in keeping with Wonca’s commitment to global consensus supporting the elimination of gender inequality as an important prerequisite for development both of organizations and of nations (see Fig. 2 for proposed Women’s Track for Singapore 2006).

In preparation for the Hamilton meeting, members of the WWPWFM reviewed Wonca policies and procedures with special emphasis on the bylaws and regulations and prepared a draft of suggested gender equity amendments. As well, Dr. Alfred Loh, the Wonca CEO, wrote in Wonca News in June 2006 that he hoped proposals from the Working Party would help the Wonca Executive in its deliberations on gender equity. Thus, a large part of the Hamilton Meeting was devoted to proposing gender equity amendments to the bylaws and regulations which have been submitted to the Wonca Council for their consideration.

Finally, participants drafted a guiding statement for Wonca on how to implement gender equity in health which will be presented to the Wonca Executive and Wonca Council for endorsement.

Singapore, 2007

The WWPWFM will convene a pre-conference meeting at the Wonca Singapore meeting on 24 July 2007 where all activities and developments will be discussed and the triennial elections will occur. In addition, as mentioned above, we hope to have a vibrant selection of workshops, symposia and meetings. We welcome all interested parties in Wonca to mark their calendars and attend the WWPWFM pre-conference and Wonca meeting.


References

1 Obaid TA (Executive Director). The Promise of Equality, Gender Equity, Reproductive Health and the Milleneum Development Goals: UNPFA State of the World Population. 2005. quoting Annan Kofi Chapter 3 on the Promise of Human Rights. UN Population Fund. 2005 p 27. Available at: www.unfpa.org/swp/2005/pdf/en_swp05.pdf
3 Shannon C. Report Wonca Women on meetings in Dublin, 14-18, June 1998. (Unpublished but sent to list group in 1998).
4 http://www.un.org/womenwatch/daw/beijing/platform/index.html
5 Minutes of Meeting, WONCA Executive in Singapore, 2001. (Unpublished paper)
6 Minutes of Meeting, WONCA Executive in London 2002. (Unpublished paper)
7 http://www.globalfamilydoctor.com/aboutwonca/working_groups/rural_training/calgary_commitment.htm.
8 McMurchie M. Report on the Women in Family Medicine Special Interest Group. World Organization of Family Doctors. Agenda Papers. Wonca World Council Meeting, May 10-12, 2001, Durban South Africa, p.179.
9 World Organization of Family Doctors. Minutes of Wonca Council Meeting, May 10–12, 2001, Alpine Heath South Africa. pp.51,55,56.
10 Candib L, Lent B, Levitt C. Wonca Working Party on Women and Family Medicine Working Document, November 2004. p.9.
11 Wonca Working Party on Women and Family Medicine. Action Plan 2005–2007. Manual for the Workshop of the WWPWFM on August 21–24, 2006 at McMaster University, Hamilton Canada. (Unpublished paper)




Figure 1 - HER Statement


WWPWFM

Wonca Working Party on
Women and Family Medicine



The Wonca Working Party on Women and Family Medicine (WWPWFM) was charged with the responsibility for developing recommendations on how to achieve and maintain gender equity within the World Organisation of Family Doctors (Wonca). Twenty–five leading women from 16 different countries and all six Wonca regions met in August 2006 at McMaster University, Hamilton, Canada.

The WWPWFM makes the following statement:

1. Cognizant of the fundamental aspiration of all individuals, families, communities and peoples to achieve and maintain the highest quality of life;

2. Recognizing the centrality of improved and optimal health to the achievement of the highest quality of life;

3. Recalling the important provisions of the charters, declarations and instruments of the United Nations, WHO, UNDP and other international organizations regarding human rights, equity, development, health and human dignity;

4. Convinced of the centrality of women’s and girls’ status as a determinant of the health of women and children, and of the families and communities of which they are part, throughout the world;

5. Recognizing that the elimination of gender inequality (as well as other violations of universal human rights) is an important prerequisite for development, including the improvement and achievement of optimal health;

6. Affirming that the improvement and achievement of optimal health is dependent on high standards and levels of health care provision, organization, teaching and research;

7. Convinced that general practice/family medicine is the cornerstone of the achievement of high standards and levels of health care provision, organization, teaching and research throughout the world;

8. Noting the global benefit of organization and knowledge exchange between general practice/family medicine organizations and practitioners, and between general practice/family medicine and other organizations concerned with health and medical care;

The WWPWFM urges the general practice/family medicine organizations of the world that are constituted as the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (Wonca) to adopt the following fundamental recommendations regarding gender equity:

1. Enshrine the principle of gender equity within Wonca governance by amending the Wonca Bylaws and Regulations, as proposed by the WWPWFM.

2. Implement gender equity in all activities of Wonca, in particular the scientific programs of its triennial, regional, and rural meetings.

3. Promulgate the pivotal role of gender as a key determinant of health.

4. Promote the equitable inclusion and advancement of women general practitioners/family physicians in Wonca.

Signed in Hamilton, Ontario, Canada
24th August 2006

Dr. Cheryl Levitt Chair, WWPWFM Family Physician Professor, Department of Family Medicine McMaster University, Hamilton, Canada President, Ontario College of Family Physicians	Dr. Susana Alvear Family Physician Family Practice Residency Director Catholic University and Vozandes Hospital Quito , Ecuador
Dr. Marie Andrades Family Physician Family Medicine Department Aga Khan University Karachi , Pakistan	Dr. Kate Anteyi Family Physician Abuja , Nigeria West Africa
Dr. Liliana Arias-Castillo Family Physician Dean of Health Sciences Universidad del Valle Cali , Colombia	Dr. Anne. Deborah. Atai-Omoruto Head, Community Health Department Mulago Hospital Head, Department of Family Medicine Faculty of Medicine, Makerere University Kampala , Republic of Uganda East Africa
Dr. Lucy Candib Family Physician Professor of Family Medicine and Community Health University of Massachusetts Medical School Family Health Center of Worcester Worcester , MA , USA	Dr. May Cohen Family Physician Professor Emeritus Department of Family Medicine McMaster University Hamilton , Canada
Dr. Jan Coles Family Physician Monash University East Bentleigh, Australia	Dr. Nandani de Silva Family Physician Professor of Family Medicine Vice Chancellor Open University of Sri Lanka Vice President College of General Practitioners of Sri Lanka Colombo , Sri Lanka .
Dr. Sheila Dunn Family Physician Women’s College Hospital Toronto , Canada	Dr. Kymm Feldman Family Physician Pre-clerkship Director Department Family Medicine, University of Toronto , Women’s College Hospital Toronto , Canada
Dr. Linda French Family Physician Associate Professor Department of Family Practice College of Human Medicine Michigan State University , USA	Dr. Betsy Garrett Family Physician Professor of Clinical Family and Community Medicine University of Missouri-Columbia USA
Dr. Ilse Hellemann Family Physician Austrian Representative to the Council of the European Society of General Practice/Family Medicine Graz , Austria	Michelle Howard, MSc, Research Coordinator Department of Family Medicine, McMaster University Hamilton , Ontario Canada
Dr. Marlene Joseph Family Physician St. John’s , Antigua and Barbuda	Dr. Flor Ledesma Family Physician Associate Professor, Dpto. Integral Public Health University of Zulia Maracaibo-Edo.Zulia Venezuela
Dr. Barbara Lent Family Physician Associate Dean Schulich School of Medicine and Dentistry The University of Western Ontario London , Ontario, Canada	Dr. Zorayda Leopando Family Physician Professor of Family and Community Medicine Vice Chancellor for Planning and Development University of the Philippines Manila Philippines
Dr. Dorothy Pietersz-Janga, Family Physician, Director of CCFP for Curacao, Netherlands Antilles ( Dutch West Indies) Medenfys Curaçao, Neth. Antilles	Dr. Somjit Prueksaritanond Family Physician Associate Professor Family Medicine Department of Family Medicine Ramathibodi Medical School Mahidol University Bangkok , Thailand
Dr. Sue Smith Family Physician Assoc Prof, Dept of Family Medicine BPKIHS Dharan , Nepal	Dr. Sarah Strasser Family Physician Associate Professor Family Medicine Northern Ontario Medical School Sudbury , Ontario, Canada
Dr. Ruth Stewart Family Physician Director of Women in Rural Practice Australian College of Rural and Remote Medicine Camperdown , Victoria, Australia

 
 



Figure 2 - WWPWFM Singapore Program

The Working Party on Women and Family Medicine (WWPWEFM) proposes a variety of events (pre-conference activities, symposia and workshops) for the Wonca Triennial Conference in Singapore in 2007. These proposed events have developed from the discussions that took place in Orlando, in October 2004, and the follow up meeting of the WWPWFM held in McMaster University Hamilton in August 2006.
 
The proposed activities are outlined in the following table:
 



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