ISSN ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 94– 2021

Maori Health Review
Maori Health Review

Empowering equity: Striving for socioeconomic equity in the Aotearoa New Zealand health workforce

Authors: Thomson R et al.

Summary: The Socioeconomic Equity (EQ) support programme at the University of Otago is helping to build a health workforce that fairly reflects people from all communities. The EQ programme includes group workshops on study skills, guidance from peer mentors, subject-specific academic support, one-onone course advice and pastoral support and activities. Students who attended secondary school in a low socioeconomic area are invited to take part in the EQ programme at the start of the university academic year. Comparing the first two years of the EQ programme with the previous year, a higher proportion of students from schools in low socioeconomic areas passed the Health Sciences First Year, and the proportion of students from low socioeconomic backgrounds entering health professional programmes doubled.

Comment: Love this programme and the results. As the authors say, the programme cannot directly influence the wider determinants for inequities. However, by improving the retention rates for students in health programmes and giving them the ‘skills for life’ there are clearly long-term impacts.

Reference: Clin Teach. 2021;18(5):565-569.


Perceptions of co-designing health promotion interventions with Indigenous communities in New Zealand

Authors: Harding T et al.

Summary: This Kaupapa Māori study identified facilitators and barriers of codesigning a health promotion intervention with Māori communities. The study considered a specific Māori co-design framework, He Pikinga Waiora (HPW), which is a participatory approach to creating interventions emphasising community engagement, systems thinking and Kaupapa Māori. Study participants (n = 19) were stakeholders in the New Zealand health sector, and were interviewed using an in-depth, semi-structured protocol. Collaboration and community voice were found to be facilitators for co-designing health promotion interventions with Māori communities. Mismanaged expectations and research constraints were barriers. In terms of the HPW framework, facilitators included providing clear guidelines and being grounded in Māori perspectives, while barriers included limited concrete case studies, jargon and questions about sustainability. The study authors concluded that collaboration and inclusion of community voice supports the development of more effective co-design health promotion interventions within Māori communities, and

Comment: Really useful for Health New Zealand and the Māori Health Authority as both commence work on co-design, whānau engagement and commissioning new programmes.

Reference: Health Promot Int. 2021;36(4):964-975.


Experiences of senior Māori public health practitioners working in public health units in Aotearoa New Zealand

Authors: Rawson E

Summary: This Kaupapa Māori qualitative study investigated success factors and barriers to Māori public health practitioners who have worked in mainstream public health units for at least 5 years. The study found that all participants were experiencing and/or had observed restrictions on Kaupapa Māori practice and cultural freedom in the workplace. Lack of value was placed on mātauranga Māori, Kaupapa Māori practice and te ao Māori worldview. Inconsistent practice was observed in relation to hiring for positions requiring te ao Māori knowledge. Resourcing for professional development or for Māori projects has generally not been prioritised, and institutional barriers or institutional racism has been present within these decisions. The study author concluded that solutions mitigating the perpetuation of environments less suitable to Māori success are needed, ideally solutions that prevent damaging situations or environments from existing in the first place.

Comment: Based on my experience, and particularly over the past 18 months, I really think our public health units would be strengthened with more Māori and Pacific consultants/leaders. Emma and her supervisors have really hit the nail on the head here with their description of barriers to working in New Zealand’s public health organisations – and very timely as we develop New Zealand’s Health Plan and Charter.

Reference: Auckland University of Technology 2021.


Prehospital barriers for rural New Zealand parents in paediatric appendicitis

Authors: Elliot BM et al.

Summary: Delayed presentation to hospital for paediatric appendicitis in rural families is most frequently due to extended decision-making around the costs and benefits of accessing hospital-level care, according to a qualitative study. The study involved semi-structured interviews with the parents of 11 rural children presenting to hospital with acute appendicitis between June 2019 and January 2020. The mean distance travelled to hospital was 50.4 km, and the median duration of prehospital symptoms was 42 hours. Families more likely to ‘watch and wait’ were those with reduced financial or social resources. Travel, organising childcare and parental income loss were key considerations. Prompt access and engagement with healthcare was further discouraged by structural barriers including poor cultural safety, maldistribution of rural health services, and contradictory public health messages. Earlier presentation to hospital was evident for families who sought informal community-based health advice.

Comment: Again, relevant to our current health predicament – managing COVID-19 in the community. The issues of rurality, in addition to costs and cultural safety of services when whānau attempt to engage, as identified here, must be taken into consideration – and quickly!

Reference: ANZ J Surg. 2021;91(10):2130-2138.


Maori Health Review