ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 107 – 2024

Maori Health Review
Maori Health Review

Closing the equity gap as we move to the elimination of seclusion: Early results from a national quality improvement project

Authors: Bensemann C et al.

Summary: A national programme to eliminate seclusion in mental health services in New Zealand, with a focus on reducing inequity for Māori, has been associated with a reduction in seclusion for Māori. A bicultural change package, combining Māori cultural and Western clinical interventions, was developed, and incorporated quality improvement methodologies. National seclusion rates for Māori decreased from a baseline of 7.5% per month in August 2019 to 6.8% per month after implementation of the programme (sustained from late 2020 to September 2022). In addition, the duration of seclusion for Māori decreased from 4.5 hours at baseline to 3.0 hours after programme implementation, a 33% reduction.

Comment: A fantastic paper demonstrating the positive impact of a Māori- and equity-focused approach to health. I suspect that the programme had wider benefits including a drop in rates for all ethnicities, in line with gold standards and human rights.

Reference: Australas Psychiatry. 2023;31(6):786-790.


Ethnic-specific prevalence rates of intimate partner violence against women in New Zealand

Authors: Fanslow JL et al.

Summary: A high lifetime prevalence of intimate partner violence is present across all ethnic groups in New Zealand, but is highest in Māori women, according to data from the 2019 New Zealand Family Violence Study. A total of 1431 ever partnered women were studied, of whom 55.8% reported intimate partner violence. Prevalence was 64.6% among Māori women, and was next highest in NZ European women, at 61.6%. Prevention and intervention services are needed at the population level, noted the study authors, and should be culturally responsive and attuned to the needs of communities that bear the greatest burden.

Comment: It’s always a challenge to report these statistics, given the potential to be highlighted by those who wish to perpetuate negative stereotypes. However, I felt some reassurance that Tracey MacIntosh was a lead researcher on the team. More than half of women reported intimate partner violence – it’s unacceptable. For those wanting to learn more I highly recommend a session with Dr Gabrielle Moss ( f iles/2019-09/Recognition%20%26%20Response%20to%20Intimate.pdf).

Reference: Aust N Z J Public Health. 2023;47(6):100105.


Socio-demographic profile of medical students in Aotearoa, New Zealand

Authors: Bagg W et al.

Summary: A national cross-sectional study has found that medical students do not reflect the diverse communities they will serve, with under-representation of Māori and Pacific students and those from low socioeconomic and rural backgrounds. A total of 2858 students enrolled to study medicine at the Universities of Auckland or Otago during 2016-2020 were included in the study. More women than men were enrolled in medicine (59.1% vs 40.9%), and almost all (96.5%) were in the 18-29 years age range. Rate ratios for enrolment of Māori and Pacific students were 0.92 (95% confidence interval [CI] 0.84-1.0) and 0.85 (95% CI 0.73-0.98), respectively. Enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation for all ethnic groups, irrespective of rural or urban origin. The rate ratio for enrolment of students from rural areas was 0.53 (95% CI 0.46-0.61) compared with those from urban areas. The study authors suggested several policy changes to address these issues.

Comment: Many will have seen this in the news at the end of 2023, and the excellent commentary from authors when interviewed. A couple of examples are provided here and-pasifika-medical-numbers-up-but-still-underrepresented-study/ and pathway-disappointing/.

Reference: BMJ Open. 2023;13(12):e073996.


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