May 11, 2017 / 3:48 PM / 2 months ago

UK military health workers feel ill-equipped to manage women’s care

Although women make up a tenth of the UK military, many medical workers feel they don’t have the training or guidance to handle women’s health issues among troops on deployment, a small study found.

In the survey of Afghanistan-based UK medical staff, more than half said they felt “underprepared to handle gynecological conditions confidently,” researchers report in the Journal of the Royal Army Medical Corps. One third of respondents thought gynecology should be added to predeployment medical training, and two thirds wanted guidelines on the subject.

Currently 10 percent of the UK military and 15 percent of the U.S. military is made up of women and these numbers are on the rise, said Elspeth Ritchie, author of the book “Women at War,” who wasn't involved in the study.

Though women make up a significant part of the military, they are more likely to leave than men, and one of the reasons for this may be issues with gynecological treatment, said Ritchie, a retired army psychiatrist who currently works for the U.S. Department of Veterans Affairs in Washington D.C.

“If patients think that clinicians are not competent, they won’t go and seek treatment, so they may ignore early signs and that may lead to problems,” Ritchie told Reuters Health by email.

To assess how confident military medical staff feel in managing women’s health on deployment, Major Magdalena Thiel of Queen Alexandra Hospital in Portsmouth, UK, and her colleagues gave questionnaires to 44 randomly selected military doctors, nurses and medical technicians working in Afghanistan.

More than half of the participants said they treated one or more gynecological conditions per month, and four doctors said they treated five or more gynecological problems per month.

More than half, 53 percent, of the medical staff, said they felt underprepared to confidently manage women’s health problems. And only 55 percent of participants said they had enough equipment to properly manage gynecological conditions.

Two thirds of the staff said they would be willing to attend a short course on the subject of women’s healthcare. About one third of medical personnel thought that gynecology should be included in medical predeployment training.

A large majority, 65 percent, of military medical workers wanted management guidelines for gynecology to be included among the Clinical Guidelines for Operations, a guidebook for best medical practices.

The study team declined to comment on the results.

“The number of women in the military is growing, and more are serving in deployed environments and leadership positions,” said Kevin Dwyer, chief of media operations at the Defense Health Agency, which provides combat support for the health of U.S. Army, Navy and Air Force members.

The healthcare needs of service women are regularly evaluated and addressed, Dwyer, who wasn’t involved in the UK study, told Reuters Health by email.

He cited a 2015 report from the Office of the Assistant Secretary of Defense for Health Affairs which, in response to a request from Congress, details programs and policies the U.S. military has in place to meet "the specific gender health needs of women in various deployed environments.”

According to the report, there is no military-wide policy or protocol to address women’s health, but there are efforts being made to standardize education and training on women’s health.

Among these, experts from the Army Women’s Health Task Force (WHTF) and the U.S. Army Public Health Command have created the online Women’s Health Portal, which provides female service members with updated and evidence-based recommendations for women’s health screening and links to women’s health support resources.

The WHTF also created a women’s health-specific decision making tool for medics out in the field and other healthcare providers to help determine what they can treat and what conditions require women to be evacuated, the report notes.

Military medical attention is often focused on more serious injuries, Ritchie noted. “Our providers also need to think about prevention and basic health issues.”

SOURCE: bit.ly/2q2MTm1 Journal of the Royal Army Medical Corps, online April 11, 2017.

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