Drs Amohia Boulton, Heather Gifford, Melissa Cragg and Lesley Batten
Research Site Leads Gill Potaka-Osborne, Rachel Brown and Kiri Parata
Chronic conditions such as asthma, heart disease and diabetes are major health issues that significantly impact Māori. Preventing Chronic Conditions (PCC) was a three-year project funded by the Health Research Council of New Zealand (HRC). The project took a Māori-centred approach to carrying out comparative case studies in partnership with three Māori health providers: Te Oranganui Iwi Health Authority in Whanganui, Tui Ora in Taranaki and Poutini Waiora on the West Coast of the South Island. The research looked at prevention related activities within these providers to gain an understanding of how programmes can work to avoid conditions such as these from occurring in the first place.
Findings revealed that all three cases had similar principles: cross-sector collaboration; integrated health services; improved health service access; emphasis on health outcomes; increased responsiveness to Māori; and whānau-centred services. Furthermore, all three Māori health and social service providers dealt with whānau who had complex and multiple issues, high needs and were most vulnerable. The issues for whānau are explicitly linked to the social determinants of health therefore, dealing with broader determinants such as housing or education needs plays an important role within health service delivery. Effective partnerships particularly related to District Health Boards (DHB) and service providers were found critical to effective prevention. With health promotion no longer evident as a government priority, it was found that prevention was primarily occurring in small pockets related to specific areas such as obesity, smoking and alcohol. Additional findings highlight:
Dissemination has occurred throughout the duration of the project, in varying ways and at different levels (local, national, provider and policy). Examples include, keeping Tumu Whakarae (the national reference group of Māori health strategy Managers within DHBs) informed and involved through presentations at meetings. Consistent contact with this group enabled both informal and formal discussions and debates as well as the provision of on-going guidance. Earlier this year, a hui was held that included bringing together all three providers and DHB representatives. The findings and discussions from all meetings were then presented to the Ministry of Health, policy and decision makers. Publications have also been submitted and findings will be presented at a range of conferences in this coming year. More recently as an end to the research journey, the team presented back to providers and participants using posters and booklets that captured the research processes, whānau stories as well as challenges and transformation.
