"Quality Women's Healthcare Should Be A Top Priority": Service Women's Experiences With the Health Care Provided by the Netherlands Armed Forces.

Introduction: Fit and healthy military personnel are the basis for a strong organization and good health care is essential to ensure service people's deployability. This applies equally to female-specific health care (FSH). Quality health care can help not only to recruit but also retain more women in the military. However, as there is a lack of empirical studies focusing on service women's experiences with FSH, this study explores female military personnel's experiences with FSH in the Netherlands Armed Forces (NAF), including conditions such as menstruation, pregnancy, and menopause in order to find ways of improving these women's health care and self-care.

Methods: We carried out a qualitative study involving 4 focus groups of service women (n = 17) from all military branches of the NAF (Navy, Air Force, Army, and Military Police).

Results: Using inductive thematic analysis, we ascertained 4 key themes: inadequate knowledge and experience among military primary care providers; a perceived lack of gynecologists in the military health care system; difficulties around FSH-related self-care; and inadequate (and inadequately provided) information on menstruation, pregnancy, and menopause. Our findings imply several recommendations to foster good FSH. Changes are needed on four fronts: agenda setting, information, normalization, and implementation. Leaders and role models can bring the topic FSH to the chain of command's attention.

Conclusion: The NAF are currently not focusing sufficiently on FSH. In order to provide their female personnel with a high quality of care, this will require changes in policy, implementation, and supervision as well as fostering the development of an open culture that enables discussions on FSH.