?

Public Hospital Services > Te Whatu Ora – Health New Zealand Counties Manukau >

Library Database and Resource Directory | Te Whatu Ora

Public Service, Other

Description

The Health New Zealand - Te Whatu Ora Library Service provides online access to Health New Zealand staff and partners to a comprehensive collection of  databases, journals and ebooks to support evidence based care and evidence informed decision making.

We have libraries located at hospitals throughout New Zealand. Librarians located at the Districts below can advise on the resources available to staff and partners in each location.

Northern

Northland
Auckland
Waitematā
Counties Manukau

Te Manawa Taki

Waikato
Lakes
Bay of Plenty (Tauranga)
Bay of Plenty (Whakatāne)
Tairāwhiti Gisborne
Taranaki

Central

Whanganui
Capital, Coast
Hutt Valley
Hawkes Bay
Mid Central
Wairarapa

Te Waipounamu

Nelson Marlborough
Canterbury
Canterbury (Hillmorton)
South Canterbury
West Coast
Southern (Dunedin)
Southern (Invercargill)

Resources

What's New

Stay up-to-date with the latest news, developments and new resources. Reports, journal articles, newsletters, conferences, blogs and social media. Subscribe to 'Health in the news' a weekly round up of the latest news, research and reports of interest in NZ - http://eepurl.com/dcUdGH Browse the latest national and international reports curated by the Health New Zealand - Te Whatu Ora Library Follow the Health New Zealand - Te Whatu Ora Library on Twitter - Tweets by @CMHealthLibrary Topical Updates Medscape eMedicine Medscape offers specialists, primary care physicians, and other health professionals robust and integrated medical information and educational tools. After a simple, 1-time, free registration, Medscape from WebMD automatically delivers to you a personalized specialty site that best fits your registration profile. Some of the key features of Medscape from WebMD are: Original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, and more; Conference Coverage: Thought leaders summarize key data and presentations from major medical meetings; The Internet's first primary-source medical journal, The Medscape from WebMD Journal of Medicine; Selected daily professional medical news in your specialty from Reuters, Medscape Medical News, and medical news journal publishers; Physician Optimized MEDLINE; Free subscription to Medscape's MedPulse, a weekly email newsletter that highlights what's new in your specialty on Medscape from WebMD Evidence Alerts BMJ Group and McMaster University's Health Information Research Unit are collaborating to provide you with access to current best evidence from research, tailored to your own health care interests, to support evidence-based clinical decisions. New Zealand Research Review Research Review publications bring the best of 10,000 global medical journals to your inbox every issue with commentary from New Zealand experts. Over 40 areas including Cardiology, Diabetes, Oncology, General Practice and Psychiatry. Specialist opinions on guidelines, medicines and conferences. All Research Review publications are free to receive. Newsletters, bulletins and reviews to subscribe to: Grey Matter - Ministry of Health reports roundup Research Review [NZ] - latest literature, research, tools and case studies Child & Youth Health Newsletter (Kidz First) Mental Health Foundation Weekly E-Bulletin & Newsletter Ministry of Pacific Island Affairs Northern Region Weekly Update Health New Zealand Library on Scoop.it Public Health Association Bulletin The Edge - health innovation hub Health Literacy e-news [Workbase] Choices Health Apps Library (UK) Latest apps to help you manage your health. *All apps have been reviewed by the NHS (UK) to ensure they are clinically safe. Health Quality & Safety Commission e-update [NZ] On the Radar (Australian Commission on Safety and Quality in Health Care) A summary of recent publications in the areas of safety and quality in health care. National Health IT Board newsletter [NZ] Social media NZ Doctor https://twitter.com/NZDoctor_news Research Review New Zealand https://twitter.com/ResearchRev_NZ Nursing Review New Zealand https://twitter.com/NursingReviewNZ Health New Zealand - Te Whatu Ora Library https://twitter.com/CMHealthLibrary Ministry of Health (NZ) https://twitter.com/minhealthnz Last updated 26 February 2024

Stay up-to-date with the latest news, developments and new resources.  Reports, journal articles, newsletters, conferences, blogs and social media. 

 

Subscribe to 'Health in the news' a weekly round up of the latest news, research and reports of interest in NZ - http://eepurl.com/dcUdGH

  

Browse the latest national and international reports curated by the Health New Zealand - Te Whatu Ora Library

 Follow the Health New Zealand - Te Whatu Ora Library on Twitter -

 

Topical Updates

Medscape eMedicine
Medscape offers specialists, primary care physicians, and other health professionals  robust and integrated medical information and educational tools.  After a simple, 1-time, free registration, Medscape from WebMD automatically delivers to you a personalized specialty site that best fits your registration profile.

Some of the key features of Medscape from WebMD are:

  • Original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, and more;
  • Conference Coverage: Thought leaders summarize key data and presentations from major medical meetings;
  • The Internet's first primary-source medical journal, The Medscape from WebMD Journal of Medicine;
  • Selected daily professional medical news in your specialty from Reuters, Medscape Medical News, and medical news journal publishers;
  • Physician Optimized MEDLINE;
  • Free subscription to Medscape's MedPulse, a weekly email newsletter that highlights what's new in your specialty on Medscape from WebMD

Evidence Alerts
BMJ Group and McMaster University's Health Information Research Unit are collaborating to provide you with access to current best evidence from research, tailored to your own health care interests, to support evidence-based clinical decisions.

New Zealand Research Review
Research Review publications bring the best of 10,000 global medical journals to your inbox every issue with commentary from New Zealand experts. Over 40 areas including Cardiology, Diabetes, Oncology, General Practice and Psychiatry. Specialist opinions on guidelines, medicines and conferences. All Research Review publications are free to receive.

 

Newsletters, bulletins and reviews to subscribe to:

Grey Matter  - Ministry of Health reports roundup

Research Review [NZ]
- latest literature, research, tools and case studies

Child & Youth Health Newsletter (Kidz First)

Mental Health Foundation Weekly E-Bulletin &  Newsletter 

Ministry of Pacific Island Affairs Northern Region Weekly Update

Health New Zealand Library on Scoop.it 

Public Health Association Bulletin

The Edge - health innovation hub

Health Literacy e-news [Workbase] 

Choices Health Apps Library (UK)
Latest apps to help you manage your health.  *All apps have been reviewed by the NHS (UK) to ensure they are clinically safe.

Health Quality & Safety Commission e-update [NZ]

On the Radar (Australian Commission on Safety and Quality in Health Care)
A summary of recent publications in the areas of safety and quality in health care.

National Health IT Board newsletter [NZ]

 

Social media

NZ Doctor
https://twitter.com/NZDoctor_news

Research Review New Zealand
https://twitter.com/ResearchRev_NZ

Nursing Review New Zealand
https://twitter.com/NursingReviewNZ

Health New Zealand - Te Whatu Ora Library
https://twitter.com/CMHealthLibrary

Ministry of Health (NZ)
https://twitter.com/minhealthnz


Last updated 26 February 2024

Nursing Virtual Reference & Professional Development Library

The Library has completely revised and updated the ‘Nursing and Midwifery Library’ on the Library Discovery portal. Designed as a one stop shop to access all key nursing and midwifery databases, journals and ebooks, the Nursing Library also includes resources to support your professional development including clinical skills and competencies, core organisational capabilities, leadership and management. ‘Nursing and Midwifery Library’ Accessing the Library collections from home Our online library resources can be accessed via our new Library Discovery Portal When you click on any of the library resources you will be prompted for a username and password. Your username and password will be your staff ID and first name. Example: username = 12345 Password = PETER Once you have logged in once you will automatically be able to access all other resources. *Please note that your login to access library resources is NOT the same as the Health Point 'Sign in' and 'Register' on the top right of the Health Point webpage.

The Library has completely revised and updated the  ‘Nursing and Midwifery Library’ on the Library Discovery portal.  Designed as a one stop shop to access all key nursing and midwifery databases, journals and ebooks, the Nursing Library also includes resources to support your professional development including clinical skills and competencies, core organisational capabilities, leadership and management.

 ‘Nursing and Midwifery Library’

 

Accessing the Library collections from home

 

Our online library resources can be accessed via our new Library Discovery Portal

When you click on any of the library resources you will be prompted for a username and password. Your username and password will be your staff ID and first name. 

Example:

username = 12345

Password = PETER

Once you have logged in once you will automatically be able to access all other resources.

*Please note that your login to access library resources is NOT the same as the Health Point 'Sign in' and 'Register' on the top right of the Health Point webpage. 

Patient and Whaanau Learning Centre

Whare Rapu Matauranga Hauora Welcome to the Counties Manukau Patient Learning Centre. The Patient and Whaanau Learning Centre is an online collection of resources that provide access to easy to read consumer health information on medical conditions and treatments for patients and whaanau. Contents Web resources Communities and social media Apps Books Health 101: a collection of learning tools to learn more about how your body and how it works Web resources Introduction to the NZ Health & Disability System [video]: English ; Mandarin ; Hindi NZ Health System Fact Sheets: English, Arabic, Spanish , Burmese, Korean, Japanese . Introduction to Counties Manukau Health for Patients and Visitors This section includes information for visitors and patients at Middlemore Hospital and Manukau SuperClinic. It includes information about directions and parking, what to bring, your rights and visiting hours. Patient Information provided by Counties Manukau Health Services Click on the links to the Services at Counties Manukau Health for details of contact names, numbers and referral details . Also included is information prepared by the Service about common diseases / conditions and useful resources and websites to support you in your treatment and recovery. HealthEd [NZ] Health Ed is a catalogue of free health resources brought to you by the Health Promotion Agency (HPA) and the Ministry of Health. The public health resources on this website support healthier New Zealand communities. These resources will help you to make informed decisions for yourself and those you care about. HealthInfo [NZ] HealthInfo is a health information website, brought to you by the Canterbury District Health Board (Canterbury DHB). The information on HealthInfo has been written and approved by local doctors, practice nurses, hospital clinicians, and other healthcare professionals. The website has a mix of health information, ranging from factsheets on different topics and descriptions of local health services and supports, through to links to recommended websites for further reading and research. Health Navigator (NZ) Trusted health information and self-help resources for all New Zealanders. Information about long term conditions such as asthma, diabetes etc. Tips, recipes, advice and lot more to keep yourself and your family well. And a range of resources for healthcare providers. Includes information on a wide variety of topics translated into many languages see also the Health Navigator App Library. Mobile apps are made to support lifestyle, disease management, mental wellbeing and behaviour change, but how do you know if they work, or they are safe to use? Our library, currently funded by the Ministry of Health, comprises of apps that have been reviewed by a range of experts, so you can decide which ones are right for you. Healthpoint (NZ) Going to a medical specialist or hospital? Find up-to-date information about healthcare providers, referral expectations, services offered and common treatments Kids Health (NZ) Our mission is to provide New Zealand parents, caregivers, family and whaanau with accurate and reliable information about their children's health. This website is a joint initiative between the Paediatric Society of New Zealand and Starship Foundation. Patient Patient website is a trusted source of information for both patients and health professionals across the globe. The site contains over 4000 health information leaflets, a wellbeing centre, a free health check, and thousands of discussion forums. It is accredited by The Information Standard, NHS England’s quality mark and was listed as ‘The top health website you can’t live without’ by The Times newspaper (Jan 2013). HealthTalk (UK) Healthtalk.org provides free, reliable information about health issues, by sharing people's real-life experiences. You can watch people sharing their stories about cancer, autism, motor-neurone disease, pregnancy, drugs, depression and much more. Genetic and Rare Diseases Information Centre [GARD] (UK) GARD maintains a list of rare diseases and related terms to help people find reliable information. Communities and social media Patient Stories [curated by the Counties Manukau Health Library] Many patient and consumer groups maintain websites and also social media sites that share the stories and personal experiences of patients and their whaanau. Click on the following links to explore patient stories: Cancer - Breast / Leukemia / Melanoma / Prostate ; Dementia ; Depression; Diabetes; Epilepsy ; Gout; Heart attack ; Mental health; Parkinsons ; Patient stories (general) ; Spinal injury; Stroke Apps CM Health Library Health Apps Collection [curated by the Counties Manukau Health Library. All apps have undergone a review process by recognised clinical experts] * Tip: download a few apps and try them out to see which ones are right for you but beware of privacy issues and giving away too much personal information. ** Use of the tools / apps presented in this collection are not intended to be a substitute for a consultation with a healthcare professional. It is up to you to contact a healthcare professional if you are concerned about your health. Health Navigator App Library [NZ] Books on Prescription Health Apps Library [NZ] Healthy Living Apps [Aus.] NHS Apps Library [UK] Books Books on Prescription Books on Prescription is a programme run by WellSouth Primary Health Network and the libraries of Otago and Southland (Public Libraries, University libraries and prison libraries) to increase access to high quality health information. The resources in the collection have been recommended and reviewed by health professionals. Books are available at your local library and videos and smartphone applications can be accessed via this website. You can also read book reviews by both health professionals and consumers on this website. Although the programme is run from Southland you will find that most books reviewed will be available in your local Auckland Community Library - see below for details of how to access resoures from Auckland Libraries Reading Well Books on Prescription Reading Well Books on Prescription is a UK programme that helps you to understand and manage your health and wellbeing using self-help reading. The scheme is endorsed by health professionals and supported by public libraries. Health professionals involved in the book selection process never have any conflict of interest with the titles selected for each book list. There are currently four book lists available: Reading Well Books on Prescription for common mental health conditions, dementia , young people's mental health and living with long term conditions. Check out the titles and request them from your local public library here in Auckland. Auckland City Libraries [NZ] Excellent collection of magazines, books (ebooks, print books, large print),dvds, factsheets and articles. Resources for adults, teens and children in a range of languages including Chinese, Hindi and Korean. Aucklanders can request materials from 55 branches across Auckland to pick up from their nearest community library. Request online or pop into your local library and ask one of the friendly librarians for help. Browse the following collections: ADHD; Asthma; Blood pressure; Cancer; Dementia; Depression; Diabetes; Eating disorders; Gout, Heart conditions, Oral health (teeth and gums); Sexually transmitted diseases Diet and weightloss; Nutrition; Physical activity and exercise; Self management and living with chronic illness; Quitting smoking; Stress management and mindfulness; Resilience; Fertility and contraception; Pregnancy; Babies and breast feeding; Parenting; Babies health; Children's health; Women's health; Men's health; Senior's health Health 101: a collection of learning tools and free online courses to learn more about your body and how it works: Khan Academy. Health and Medicine The medical world can be a confusing place. Patients and their families might feel overwhelmed by the large vocabularies and complicated explanations they get from their health care providers. Students entering health care also struggle to grasp the complexity of health sciences, and are forced to memorize huge amounts of information. We hope to make understanding the medical world a bit easier; Innerbody Explore the human body like never before! With hundreds of interactive anatomy pictures and descriptions of thousands of objects in the body, InnerBody will help you discover what you want to know about human anatomy, right here at your fingertips. Includes 3d animations that you can rotate and zoom in on; Kids Health: how the body works Fun and interactive resource for learning about how our bodies work. Includes movies, activities and quizzes. Suitable for kids of all ages. last updated 13 February 2023

Whare Rapu Matauranga Hauora

Welcome to the Counties Manukau Patient Learning Centre.

The Patient and Whaanau Learning Centre is an online collection of resources that provide access to easy to read consumer health information on medical conditions and treatments for patients and whaanau.

Contents

Web resources
Communities and social media
Apps
Books
Health 101: a collection of learning tools to learn more about how your body and how it works

Web resources

Introduction to the NZ Health & Disability System [video]: English ; Mandarin ; Hindi
NZ Health System Fact Sheets: English, Arabic, Spanish , Burmese,  KoreanJapanese .

Introduction to Counties Manukau Health for Patients and Visitors
This section includes information for visitors and patients at Middlemore Hospital and Manukau SuperClinic.  It includes information about directions and parking, what to bring, your rights and visiting hours.

Patient Information provided by Counties Manukau Health Services
Click on the links to the Services at Counties Manukau Health for details of contact names, numbers and referral details .  Also included is information prepared by the Service about common diseases / conditions and useful resources and websites to support you in your treatment and recovery.

HealthEd [NZ]
Health Ed is a catalogue of free health resources brought to you by the Health Promotion Agency (HPA) and the Ministry of Health. The public health resources on this website support healthier New Zealand communities. These resources will help you to make informed decisions for yourself and those you care about.

HealthInfo [NZ]
HealthInfo is a health information website, brought to you by the Canterbury District Health Board (Canterbury DHB). The information on HealthInfo has been written and approved by local doctors, practice nurses, hospital clinicians, and other healthcare professionals. The website has a mix of health information, ranging from factsheets on different topics and descriptions of local health services and supports, through to links to recommended websites for further reading and research.

Health Navigator (NZ)
Trusted health information and self-help resources for all New Zealanders. Information about long term conditions such as asthma, diabetes etc.  Tips, recipes, advice and lot more to keep yourself and your family well. And a range of resources for healthcare providers. Includes information on a wide variety of topics translated into many languages

see also the Health Navigator App Library.
Mobile apps are made to support lifestyle, disease management, mental wellbeing and behaviour change, but how do you know if they work, or they are safe to use? Our library, currently funded by the Ministry of Health, comprises of apps that have been reviewed by a range of experts, so you can decide which ones are right for you.

Healthpoint (NZ)
Going to a medical specialist or hospital? Find up-to-date information about healthcare providers, referral expectations, services offered and common treatments

Kids Health (NZ)
Our mission is to provide New Zealand parents, caregivers, family and whaanau with accurate and reliable information about their children's health.  This website is a joint initiative between the Paediatric Society of New Zealand and Starship Foundation.

Patient
Patient website is a trusted source of information for both patients and health professionals across the globe. The site contains over 4000 health information leaflets, a wellbeing centre, a free health check, and thousands of discussion forums. It is accredited by The Information Standard, NHS England’s quality mark and was listed as ‘The top health website you can’t live without’ by The Times newspaper (Jan 2013).

HealthTalk (UK)
Healthtalk.org provides free, reliable information about health issues, by sharing people's real-life experiences. You can watch people sharing their stories about cancer, autism, motor-neurone disease, pregnancy, drugs, depression and much more.

Genetic and Rare Diseases Information Centre [GARD] (UK)
GARD maintains a list of rare diseases and related terms to help people find reliable information.

 

Communities and social media

Patient Stories [curated by the Counties Manukau Health Library]
Many patient and consumer groups maintain websites and also social media sites that share the stories and personal experiences of patients and their whaanau.  Click on the following links to explore patient stories:

Cancer -  Breast /  LeukemiaMelanoma / Prostate ;
DementiaDepression; Diabetes; Epilepsy ;  Gout; Heart attack Mental health; Parkinsons ; Patient stories (general) ;  Spinal injury;  Stroke

 

Apps

CM Health Library Health Apps Collection [curated by the Counties Manukau Health Library.  All apps have undergone a review process by recognised clinical experts]

* Tip: download a few apps and try them out to see which ones are right for you but beware of privacy issues and giving away too much personal information.
** Use of the tools / apps presented in this collection are not intended to be a substitute for a consultation with a healthcare professional. It is up to you to contact a healthcare professional if you are concerned about your health.

Health Navigator App Library [NZ]

Books on Prescription Health Apps Library [NZ]

Healthy Living Apps [Aus.]

NHS Apps Library [UK]


   

 Books

Books on Prescription

Books on Prescription is a programme run by WellSouth Primary Health Network and the libraries of Otago and Southland (Public Libraries, University libraries and prison libraries) to increase access to high quality health information. The resources in the collection have been recommended and reviewed by health professionals. Books are available at your local library and videos and smartphone applications can be accessed via this website. You can also read book reviews by both health professionals and consumers on this website. Although the programme is run from Southland you will find that most books reviewed will be available in your local Auckland Community Library - see below for details of how to access resoures from Auckland Libraries

Reading Well Books on Prescription

Reading Well Books on Prescription is a UK programme that helps you to understand and manage your health and wellbeing using self-help reading. The scheme is endorsed by health professionals and supported by public libraries. Health professionals involved in the book selection process never have any conflict of interest with the titles selected for each book list.

There are currently four book lists available: Reading Well Books on Prescription for common mental health conditions, dementia , young people's mental health and  living with long term conditions.  Check out the titles and request them from your local public library here in Auckland.

Auckland City Libraries [NZ]
Excellent collection of magazines, books (ebooks, print books, large print),dvds, factsheets and articles.  Resources for adults, teens and children in a range of languages including Chinese, Hindi and Korean.  Aucklanders can request materials from 55 branches across Auckland to pick up from their nearest community library.  Request online or pop into your local library and ask one of the friendly librarians for help.

Browse the following collections:

ADHD; Asthma; Blood pressure; CancerDementia; Depression; Diabetes; Eating disorders;  Gout, Heart conditions, Oral health (teeth and gums); Sexually transmitted diseases

Diet and weightlossNutrition; Physical activity and exercise; Self management and living with chronic illnessQuitting smoking; Stress management and mindfulness; Resilience;


Fertility and contraceptionPregnancy; Babies and breast feeding; Parenting; Babies health;  Children's health;  Women's health; Men's health; Senior's health



Health 101: a collection of learning tools and free online courses to learn more about your body and how it works:

Khan Academy. Health and Medicine
The medical world can be a confusing place. Patients and their families might feel overwhelmed by the large vocabularies and complicated explanations they get from their health care providers. Students entering health care also struggle to grasp the complexity of health sciences, and are forced to memorize huge amounts of information. We hope to make understanding the medical world a bit easier;

Innerbody
Explore the human body like never before! With hundreds of interactive anatomy pictures and descriptions of thousands of objects in the body, InnerBody will help you discover what you want to know about human anatomy, right here at your fingertips.  Includes 3d animations that you can rotate and zoom in on;

Kids Health: how the body works
Fun and interactive resource for learning about how our bodies work.  Includes movies, activities and quizzes. Suitable for kids of all ages.

 

last updated 13 February 2023

Patient and Whaanau Centred Care / Health Literacy Clearinghouse

Contents Patient experience Guidelines and Resources Patient Co-design Portals Additional Resources and Further Reading Selected Learning Opportunities Health literacy Guidelines and Resources Selected aids and communication tools developed by NZ DHBs Health Literacy Portals Additional Resources and Further Reading Selected Learning Opportunities Patient Experience Guidelines and Resources New Zealand Code of expectations for health entities’ engagement with consumers and whānau (HQSC, 2023) The code of expectations for health entities’ engagement with consumers and whānau | Te tikanga mō te mahi tahi a ngā hinonga hauora ki ngā kiritaki me ngā whānau (the code) sets the expectations for how health entities must work with consumers, whānau and communities in the planning, design, delivery and evaluation of health services. This code is required by the Pae Ora (Healthy Futures) Act 2022 and is underpinned by the health sector principles. All health entities must act in accordance with the code and are required to report annually on how the code has been applied. From knowledge to action: A framework for building quality and safety capability in the New Zealand health system (HQSC, 2016) A high-level framework to guide the development of quality and safety capability across all levels in the health and disability sector, including consumers/patients. Engaging with consumers: a guide for district health boards (HQSC, 2015) This resource is a practical guide to help New Zealand district health boards, and the health and disability services they fund, to engage better with consumers. It covers consumer engagement in the design and delivery of services, as well as the development of policy and governance procedures. A guide to developing a framework for collecting information from consumers to improve the quality of health and disability services (HQSC, 2012) This Guide and accompanying Toolkit are designed to assist health and disability service providers in developing and implementing a framework for capturing and using information about consumer experience to undertake service improvements. (…) In New Zealand consumer participation is also included in the Health and Disability Services Standards, which require that consumers and family/ whānau “are involved in the planning, implementation, and evaluation at all levels of the service to ensure services are responsive to the needs of individuals. see also Additional reading and useful links Health Service Co-Design [WDHB] A guide from Waitemata DHB providing a range of flexible tools for working effectively with patients in service improvement work. Patient Experience Explorer (HQSC) HQSC has launched the Experience Explorer, an improved tool for public reporting of results from the national patient experience programme. The explorer provides access to results from the Commission’s adult hospital inpatient experience and adult primary care patient experience surveys. Co-design in Aotearoa New Zealand: a snapshot of the literature (Knowledge Auickland; 2020) Co-design refers to a philosophical approach and evolving set of methodologies for involving people in the design of the services, strategies, environments, policies, processes, – that impact them. This review gathers together readily available local scholarship and literature about co-design in Aotearoa New Zealand up to September 2019. This document is aimed at the practitioners as much as academics and is more a snapshot than a formal academic literature review. Its aim is to: create a resource to support groups and individuals working in, or commissioning, co-design make visible for those practising or commissioning co-design in Aotearoa New Zealand the current landscape of formal scholarship and research in this space provide a benchmark of current research applying to, or about, co-design, highlighting areas for future scholarship and collaboration. As more literature is identified it can be added to this initial review. mprovement (HQSC, 2018)From PES to PDSA outlines how to use the patient experience reporting portal for quality improvement. Written collaboratively with the Commission's quality improvement team, this document breaks down Plan, Do, Study, Act cycles into well-defined steps so you can streamline quality improvement activities within your primary health organisation or general practice. International Partnering with Consumers: A guide for consumers (Australian Commision on Satefy and Quality in Healthcare, 2023) Developed by consumers for consumers, the Guide explains how to strengthen consumer partnerships at all levels of the health system to support person-centred care and drive positive change. The Guide has been developed by consumers for consumers, with Consumers Health Forum of Australia (CHF) engaged to undertake the co-design process. It explains how to build and strengthen consumer partnerships at all levels of the health system to support person-centred care and drive positive change. Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers ( La Trobe University, 2022) ‘Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers’ is a guide designed to help hospitals, providers and consumers include social media-based methods into their suite of consumer engagement activities. Researchers from the Centre for Health Communication and Participation at La Trobe University, along with an advisory committee of consumers and service providers, developed this guide. It draws from findings of a review of international literature, and new research exploring the use of social media as a consumer engagement tool in Australia. The Patient Experience Library "We have brought together the whole of the UK's qualitative literature on patient experience. We make as much stuff available free of charge as we can - through our weekly newsletter and through selected Insight reports and Knowledge maps. We also make reports available to download for free, grouped by the month they were added to the Library" - Search the library The Beryl Institute The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members. Copies of all reports and papers can be requested from the Counties Manukau Health Library. From PES to PDSA: A guide to using the patient experience survey portal for quality i Engaging Patients in Patient Safety – a Canadian Guide (CPSI, 2017) While the guide focuses primarily oThe Commission has developed a comprehensive training package for facilitators to use to help new health and disability consumer representatives to prepare for their role. It is designed to support consumers to participate confidently when sharing their views and experiences in decision-making forums across the sector. The training package was updated in 2017 and will continue to be revised to reflect changes to key government documents (such as updated national strategies) and to incorporate new information.n patient safety, many engagement practices apply to other areas, including quality, research, and education. The guide is designed to support patient engagement in any healthcare sector. Recommendations to OECD Ministers of Health from the High Level Reflection Group on the future of health statistics: Strengthening the international comparison of health system performance through patient-reported indicators (OECD, 2017) Groundbreaking ministerial statement endorsed plans for a major programme of work on patient reported indicators of health system performance. Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs) seem set to become the new currency for comparative performance assessment, but they may have an even more important role in clinical care. The Eight Principles of Patient Centred Care This webpage summarises findings from work by researchers from Harvard Medical School on behalf of Picker Institute and The Commonwealth Fund. It draws on a literature review and wide range of focus groups to identify 8 Principles of Patient Centred Care that are needed to meet the Institute of Medicine's definition of patient-centred care. NHS information and resources Experience Based Design: Questionnaire. Experience Based Design: Guide & Tools. Experienced Based Design: Concepts and Case Studies. Creating a revolution in patient and customer experience - Implementation Guidance The Friends and Family Test. Feeling better? Improving patient experience in hospital. NICE Quality standard for patient experience in adult NHS services Australian Commission on Safety and Quality in Health Care Person-centred healthcare organisations The Commission has developed a number of resources to help support healthcare organisations to achieve excellent person-centred care. Including reports, fact sheets and case studies. Australian Commission on Safety and Quality in Health Care Patient-centred care: improving quality and safety through partnerships with patients and the community Australian Commission on Safety and Quality in Health Care NSQHS Standard 2: Partnering with consumers: Tip Sheets and self assessment tool The Kings Fund Patient- and family-centred care toolkit The patient- and family-centred care toolkit from The King's Fund is a simple, step-by-step method for recording and understanding patient and family experiences. 1000 Lives Improvement [NHS Wales] Listening and Learning to Improve the Experience of Care The white paper collects case studies from around Wales of how NHS teams and departments have gathered ‘patient feedback’ to inform changes and improvements in services. Guide to patient and family engagement in hospital quality and safety (AHRQ) An evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety. Consumer Assessment of Healthcare Providers and Systems (CAHPS) AHPS surveys ask patients to report on their experiences with a range of health care services at multiple levels of the delivery system. Several surveys ask about experiences with ambulatory care providers such as health plans, physicians' offices, and mental health plans, while others ask about experiences with care delivered in facilities such as hospitals, dialysis centers, and nursing homes. The CAHPS Child Hospital Survey (Child CAHPS) Assesses the experiences of pediatric patients (17 and younger) and their parents or guardians with inpatient care. It complements the Adult Hospital Survey, which asks adult inpatients about their experiences. Child HCAHPS covers most of the topics addressed by the Adult version of the Hospital Survey as well as topics that are particularly relevant to pediatric care. Patient Engagement Resource Hub (Canadian Foundation for Healthcare Improvement) Hub resources include Canadian and international open source tools. Use them in patient and family engagement initiatives to improve health and healthcare. How to Successfully Engage Patients and Families: 10 Insights from Providers and Leaders (Canadian Foundation for Healthcare Improvement. ) Healthcare providers and leaders shared these 10 insights, distilled from their experience and learning when working together with patients and families. Patient and Public Engagement in Choosing Wisely. ( Choosing Wisely Canada. (2019). ) A new toolkit about engaging patients and the public in Choosing Wisely has been published. It includes brief case studies of patient and public engagement in Choosing Wisely campaigns, including in Australia. Twenty-eight cases from 12 countries describe ways campaigns have partnered, engaged, empowered and informed patients, consumers and the public. Helping measure person-centred care: a review of evidence about commonly used approaches and tools used to measure person-centred care (Health Foundation) This rapid review signposts to research about commonly used approaches and tools to help measure person-centred care. It aims to showcase the many tools available for those working in policy and practice. A spreadsheet listing 160 of the most commonly researched measurement tools accompanies this review. Person and patient-centred care An excellent collection of resources and articles curated by the team at Health Navigator. Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families A compilation of evidence-based best practices for improving patient safety through patient, family, and caregiver engagement. This comprehensive guide provides primary care practices with four strategies that they can adopt to improve patient safety. Patient/Family Advisory Councils in Ontario Hospitals – At Work, In Play (Change Foundation, 2014) This report investigates the evolving function and best practices of Ontario’s hospital-based Patient/Family Advisory Councils (PFACs): one mechanism some hospitals are using – among other approaches – to advance patient/family engagement and patient-centred care. This 3-part preliminary report aims to guide, connect and inspire by presenting thematic findings with examples of challenges and successes (part 1); quantitative data (part 2); and listings of PFAC initiatives, with contacts (part 3). The Foundation interviewed patients, family and staff from 29 hospitals about the functioning and impact of their councils. Strategies for Patient, Family and Caregiver Engagement. Technical Brief [AHRQ Publication No. 20-EHC017]. Agency for Healthcare Research and Quality (AHRQ). (2020). This brief applies a framework to create a map of the currently available evidence on patient and family engagement strategies that have been used to help people manage chronic conditions. Putting the consumer first: Creating a consumer-centred health system for a 21st century Australia: A health policy report. ( George Institute for Global Health & Consumers Health Forum of Australia. (2016). ) This report provides a series of recommendations for change and summarises key discussion points: • How do we empower consumers and communities to be informed and actively involved in their healthcare and the healthcare system? • How do we enable and support consumer-centred professional practice? • How do we enable services and providers to change? • How do we create the right policy, infrastructure and incentive platforms to drive change and support consumer-centred care? Helping measure person-centred care. (The Health Foundation, 2014). A review of evidence about commonly used approaches and tools used to help measure person-centred care. This rapid review signposts to research about commonly used approaches and tools to help measure person-centred care. It aims to showcase the many tools available for those working in policy and practice. Patient Co-design Portals, guides toolkits etcetera Australian Healthcare and Hospitals Association (AHHA) Experience Based Co-design Toolkit [ AHHA] Australian-developed toolkit developed by the Australian Healthcare and Hospitals Association (AHHA) and the Consumers Health Forum (CHF) will help individual hospitals and healthcare services to provide better experiences of healthcare for both workers and patients. Sets out a process for co-design and includes case studies. Flip the Clinic Flip the Clinic is an open experiment to transform the patient-clinician experience. It is where patients and health practitioners improve medical care, together. Find new ideas, join the collaboration, and follow the community’s progress Health Service Co-Design [WDHB] A guide from Waitemata DHB providing a range of flexible tools for working effectively with patients in service improvement work. Health Quality & Safety Commission Co-Design in Partners in Care [HQSC] Partners in Care is a six- to eight-month programme brought to you by the Health Quality & Safety Commission with a focus on consumer engagement, using the National Health Service Institute’s Experience-Based Design programme Co-design in health: free e-learning courses available | He hoahoa-tahi: He kaupapa ako-i utu kore | Health Quality & Safety Commission (hqsc.govt.nz) HQSC have developed a suite of free e-learning courses for co-design that are available to all health care professionals through Manatū Hauora | Ministry of Health’s Learn Online platform. Co-design is a tool that brings together consumers, whānau and communities to ensure that multiple perspectives are reflected in the design, delivery and evaluation of services. Courses: Co-design in health: an introduction Co-design in health: Supporting consumers, whānau and communities to contribute to co-design Engaging Māori consumers in co-design Engaging Pacific consumers in co-design Co-design in health: How you can be involved – a guide for consumers, whānau and communities These courses are open to anyone (first-time Learn Online users will need to create a login). Learners can work through these courses at their own pace. Patient Engagement Resource Hub (Canadian Foundation for Healthcare Improvement) Hub resources include Canadian and international open source tools. Use them in patient and family engagement initiatives to improve health and healthcare. Point of Care Foundation: EBCD: Experience-based co-design toolkit [UK] This toolkit gives a step-by-step guide to improving patient experience of health care using a technique called experience-based co-design (EBCD).The toolkit includes short videos from staff and patients involved in experience-based co-design (EBCD) projects to help bring to life the successes and intense rewards of running this type of improvement project. See also Patient- and family-centred care toolkit The patient- and family-centred care toolkit from The King's Fund is a simple, step-by-step method for recording and understanding patient and family experiences. The Beryl Institute The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members. Additional Resources and Further Reading Consumers’ and health providers’ views and perceptions of partnering to improve health services design, delivery and evaluation: a co‐produced qualitative evidence synthesis. Cochrane Database of Systematic Reviews (2023) Key messages • Power imbalances between health providers and consumers can limit consumer participation in health service planning, delivery and evaluation. • Power imbalances in the partnership may happen because of the ways consumers are recruited, how meetings are run, and how decisions are made. • To have successful partnerships with consumers, health providers need to address these power imbalances. • Some consumers and health providers believed that partnerships improved the culture and environment of the health service, as well as how health services were planned and developed. Consumers’ and health providers’ views and perceptions of partnering to improve health services design, delivery and evaluation: a co‐produced qualitative evidence synthesis / Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, et al. Cochrane Database of Systematic Reviews. 2023 (3). This qualitative evidence synthesis examined the partnering with consumers, particularly on ‘formal group partnerships where health providers and consumers share decision‐making about planning, delivering and/or evaluating health services’. The work sought to: 1. ‘To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences.’ Focussing on 33 studies, the analysis identified 19 findings that were then grouped into 5 categories: • Contextual factors influencing partnerships • Consumer recruitment • Partnership dynamics and processes • Perceived impacts on partnership participants • Perceived impacts on health service planning, delivery and evaluation. The authors emphasise the importance of power imbalances and the need to be aware of these and to address them. The key messages in the plain language summary stress these in noting: • ‘Power imbalances between health providers and consumers can limit consumer participation in health service planning, delivery and evaluation. • Power imbalances in the partnership may happen because of the ways consumers are recruited, how meetings are run, and how decisions are made. • To have successful partnerships with consumers, health providers need to address these power imbalances. • Some consumers and health providers believed that partnerships improved the culture and environment of the health service, as well as how health services were planned and developed.’ Consensus on how to optimise patient/family engagement in hospital planning and improvement: a Delphi survey. (BMJ open, 2022) Patient and family engagement (PE) in health service planning and improvement is widely advocated, yet little prior research offered guidance on how to optimise PE, particularly in hospitals. This study aimed to engage stakeholders in generating evidence-informed consensus on recommendations to optimise PE. Understanding integration: how to listen to and learn from people and communities | TheKingsFund (2021) The move towards integrated care has been the defining policy in health and care over the past decade and will continue to gather pace with the development of integrated care systems (ICSs). The aim of integrated care is to improve people’s outcomes and experiences of care by bringing services together around people and communities. This means addressing the fragmentation of services and lack of co-ordination that people often experience by providing person-centred, joined-up care. One key question for ICSs and the partners working in them is how they will know whether they are meeting the needs of the people they serve. Those best placed to understand what they need, what is working and what could be improved are the people and communities using services. Their lived experience is a powerful tool to improve existing services and identify new and better ways to meet people’s needs. Currently, people’s experiences of health and care services are usually collected and understood at the level of individual providers (Wellings 2019). This means we know about people’s experiences of individual services, such as general practice, hospitals or social care, but not about whether these services are working well together to meet people’s needs. Over the past year, Picker and The King’s Fund have been working with NHS England and NHS Improvement on how ICSs can listen to and learn from people and communities. We have produced a practical guide for partners working in these systems, with ideas on how they might go about this. There is no one-size-fits-all solution. It will require a range of different methods and approaches to understand, monitor and measure how well people’s needs are being met. Perhaps most importantly, it will require partners to listen and learn together. As important as the methods adopted, will be the importance placed on this area of work and we have put together a set of principles for systems to adopt to ensure that the voices of people and communities are at the heart of partnership working. The guide, created by The King’s Fund and Picker on behalf of NHS England and NHS Improvement, has been developed with input from ICSs, patient leaders, and engagement and experience experts. We hope it will prove useful to systems and will encourage and help them as they work to co-ordinate services around what matters to people and communities. NHS information and resources Experience Based Design: Questionnaire.Experience Based Design: Guide & Tools. Experienced Based Design: Concepts and Case Studies. Creating a revolution in patient and customer experience - Implementation Guidance The Friends and Family Test. Feeling better? Improving patient experience in hospital.NICE Quality standard for patient experience in adult NHS services Australian Commission on Safety and Quality in Health Care Patient-centred care: improving quality and safety through partnerships with patients and the community Australian Commission on Safety and Quality in Health Care NSQHS Standard 2: Partnering with consumers: Tip Sheets and self assessment tool The KingsFund Patients as partners: Building collaborative relationships among professionals, patients, carers and communities More collaborative relationships among health and care professionals, patients, service users, carers and communities are essential for the future of the NHS, but what helps to build effective relationships? This guide stems from an evolving body of the Fund's work focused on exploring and supporting shared leadership. This work is reinforced by a growing consensus that health services, agencies, patients and communities need to work together more – and differently. 1000 Lives Improvement [NHS Wales] Listening and Learning to Improve the Experience of Care The white paper collects case studies from around Wales of how NHS teams and departments have gathered ‘patient feedback’ to inform changes and improvements in services. Guide to patient and family engagement in hospital quality and safety (AHRQ) An evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety. Health Quality & Safety Commission Co-Design in Partners in Care [HQSC[ Partners in Care is a six- to eight-month programme brought to you by the Health Quality & Safety Commission with a focus on consumer engagement, using the National Health Service Institute’s Experience-Based Design programme Co-design programme evaluation and case studies 2015–16 [NZ HQSC] The 2015–16 co-design programme was delivered in two DHBs over an eight-month period from October 2015 to May 2016. The evaluation report, interviews and case studies from the programme are now available. The report has identified a number of learnings which offer potential future opportunities to increase the sustainability of co-design approaches. Putting the consumer first: Creating a consumer-centred health system for a 21st century Australia. A health policy report, April 2016 (The George Institute; 2016) Co-design: shared perspectives on authentic co-design: putting consumers and carers at the center of mental health reform (Co-design Initiative, 2016) Reexamining “Defining Patient Experience”: The human experience in healthcare (Patient Experience Journal; 2021) Journals Patient Experience Journal Patient Experience Journal (PXJ) is an international, multidisciplinary, and multi-method, open-access, peer-reviewed journal engaging research, proven practices and a range of perspectives, inclusive of patients and families, focused on understanding and improving patient experience. PXJ is designed to share ideas and reinforce key concepts that impact the delivery of service, safety and quality and their influence on the experience of patients, residents and families across healthcare settings. Journal of Participatory Medicine The Journal of Participatory Medicine is a peer-reviewed, open access journal with the mission to advance the understanding and practice of participatory medicine among health care professionals and patients. It is published by the Society for Participatory Medicine. Selected Learning Opportunities Health Literacy Guidelines and Resources Improving Health Literacy: New Zealand Medical Association Policy Briefing (2017) [NZMA] The New Zealand Medical Association has published a policy briefing on Improving Health Literacy, that seeks to promote a shared understanding of what health literacy means, why it is important, and what can be done to improve it. Health literacy review: a guide (2015) [NZ MoH] Developped to take organisations through the review process and show you how to develop a Health Literacy Action Plan see also 'A framework for health literacy: a health system response' Rauemi Atawhai – A guide to developing health education resources in New Zealand (2012) [NZ MoH] “A guide to developing health education resources in New Zealand has been developed to help the Ministry of Health and its contractors produce effective and appropriate health education resources that meet the needs of the intended audience, are easy to understand, and support improved health literacy.” Translation is not enough: cultural adaptation of health communication materials ([ECDC: 2016] This report describes the tools we need to effectively use print resources to communicate across cultures. This guide introduces an innovative five-step, stakeholder- based approach to adapting health communication materials. It describes how countries can take any health communication material, produced in English or other languages) and create adapted products which reflect national or local realities, needs and assets without losing the scientific correctness, core concepts and messages of the original version. More resources for developing information that is easy to understand and use: NSW Clinical Excellence Commission – Health Literacy Guide Agency for Healthcare Research and Quality – Health literacy universal precautions toolkit Agency for Healthcare Research and Quality – Patient Education Materials Assessment Tool Canadian Public Health Association – Easy does it! Plain language and clear verbal communication training manual US Centers for Disease Control and Prevention – Simply put: A guide for creating easy-to-understand materials Three steps to better health literacy: a guide for health professionals (2014) Engaging with consumers: a guide for district health boards (HQSC: 2015) This resource is a practical guide to help New Zealand district health boards, and the health and disability services they fund, to engage better with consumers. It covers consumer engagement in the design and delivery of services, as well as the development of policy and governance procedures. Health service co-design toolkit [Waitemata DHB] Toolkit for Staff working in Culturally & Linguistically Diverse Health Environments [Waitemata DHB] Cross Cultural Resource for Health Practitioners working with Culturally and Linguistically Diverse (CALD) clients [e-toolkit] Self management support toolkit [NZ Health Navigator] Health Literate Care Model: A Universal Precautions Approach A universal precautions approach means treating all patients as if they are at risk of not understanding health information. When health care providers use this approach, they acknowledge that: Professionals can’t accurately identify who understands and who doesn’t. Even individuals with proficient health literacy skills may not attribute the same meaning to health terms and instructions as professionals do. These inviduals can sometimes have trouble understanding health information – especially when they are sick, frightened, or in pain. Health literacy can be situational. For example, it may depend on the complexity of the information and the patient’s relevant experiences and stress level.Everyone benefits from clear, actionable information.By adopting a universal precautions approach, health care providers communicate with all patients in clear and actionable ways. Making it easier: a health literacy action plan for Scotland (2017) [NHS Scotland] Australian Commission on Safety and Quality in Health Care see HEALTH LITERACY: Taking action to improve safety and quality The aims of the paper are to raise awareness of the importance of health literacy, and to start discussions about how it can be addressed systematically and who can be involved in this process. The paper provides a broad overview of health literacy in Australia and identifies a number of areas and actions required to address health literacy in a coordinated way. Health literacy: a summary for clinicians (ACSQHC, 2017) see also Tip Sheet 8: Health literacy and the NSQHS Standards This fact sheet focusses on health literacy and how your organisation can strategically address health literacy and meet the requirements of the National Safety and Quality (NSQHS) Standards.| The Universal Patient Language The Universal Patient Language (UPL) is a set of resources that helps you communicate with patients about complex topics. We are constantly evolving the UPL as we learn new things. The UPL was designed to help you: Translate complex scientific data into digestible information; Make your communications relatable and meaningful to patients; Effectively use icons, visuals, and colors; Enable patient learning through digital media Health Literacy Toolkit (NHS, UK. 2017) Includes practical tools, techniques and case studies. Videos Why Capital and Coast DHB carried our a health literacy review (2015) Capital & Coast DHB reviewed a service issue – non-attendance at children’s outpatient clinics. This was an issue they were already investigating and the review contributed a health literacy perspective. Why Counties Manukau DHB carried our a health literacy review (2015) Counties Manukau Health reviewed oral health services and were concerned about life-long consumer engagement with services. Why Northland DHB and Te Tai Tokerau PHO did a health literacy review (2105) Northland DHB worked with Te Tai Tokerau Primary Healthcare Organisation to review diabetes services in primary care. The quality of diabetes care is of great importance in the North because of the growing numbers of consumers with diabetes. More videos from the Ministry of Health about conducting health literacy reviews Selected aids and communication tools developed by the New Zealand DHBs AI2DET (Acknowledge, Introduce, Identify, Duration, Enquire and Effective Communication, Thank you ) [Counties Manukau Health] A communication tool CM Health has adapted to improve face-to-face engagement experiences for patients and whānau, and promote values-based communication Communication cards [ADHB] Communication cards contain a set of icons that patients can use if they are having difficulty communicating their immediate needs, wants or concerns. The cards have been translated into 12 languages: Arabic ; Burmese ; Chinese (simplified) ; Chinese (traditional) ; English ; French ; Hindi ; Korean ; Maori ; Russian ; Samoan ; Tongan ; Vietnamese iTui [WDHB / IBMNZ] “iTui” – developed in partnership with IBM – is a free drawing based iPad app that enables doctors to have higher quality interactions and engagement with kids.The tool provides a common platform to describe and discuss thoughts, feelings and experiences, without being limited by drawing ability. Patient and Whaanau Learning Centre Virtual Library [Counties Manukau Health] The Patient and Whaanau Learning Centre provides access to valid health resources for patients and whaanau. The virtual library is curated by the Counties Manukau Health Library. Waikids Safety in Hospital video [Waikato DHB] No matter your age, gender or if you’re a dinosaur called Safetysaurus, coming to hospital can be quite scary, especially if you’re a kid. So the team at Waikids' Waikato Hospital rallied together to make a fun and informative video for unwell kids and their whanāu when they need to stay in hospital, highlighting the safety tips they need to know. Waitemata DHB Patient Safety Video [WDHB] Waitemata DHB has taken a leaf out of Air New Zealand's book, with the launch of a new safety video. Hospital safety is crucial to help reduce falls, infections and medicine mishaps, and the DHB has come up with an out-of-this-world way to get the message through. The in-hospital safety video stars an alien called Ghoumash, who crashes to Earth and winds up at North Shore Hospital, where a friendly nurse and doctor talk him through the standard safety procedures. Health Literacy portals Health Literacy NZ: Workbase Ministry of Health Health Navigator Health Quality and Safety Commission see also The Health Literacy Place [NHS Scotland] Health Literacy resources published by the Australian Commission on Safety and Quality in Health Care [Aus.] Additional Resources and Further Reading International Handbook of Health Literacy : Research, practice and policy across the lifespan (Policy Press, 2019) Available Open Access under CC-BY-NC licence. Health literacy addresses a range of social dimensions of health, including knowledge, navigation and communication, as well as individual and organizational skills for accessing, understanding, evaluating and using information. Particularly over the past decade, health literacy has globally become a major public health concern as an asset for promoting health, wellbeing and sustainable development. Building the Case for Health Literacy: Proceedings of a Workshop (National Academy of Medicine:2018) Health literacy reviews [MoH] Health literacy publications [MoH] Literature review of health literacy education, training tools, and resources for health providers. (Workbase: 2013) Community-based health literacy interventions: proceedings of a workshop. (Book. National Academy of Medicine. 2018) Health literacy: a necessary element for achieving health equity [Discussion paper. National Academy of Medicine] (2015) How can communities and organisations improve their health literacy? (Public Health Research & Practice, 2018) Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review (2017) Health promotion competencies for Aotearoa New Zealand (2012) Korero Marama: Health Literacy and Maaori: Results from the 2006 Adult Literacy and Life Skills Survey – Provides an overview of health literacy amongst Maaori. Ethnic Disparities in CPAP Adherence in New Zealand- Effects of Socioeconomic Status, Health Literacy and Self Efficacy Maaori Health Literacy Research: Gestational diabetes mellitus (2014) He Māramatanga Huangō: asthma health literacy for Maaori children in New Zealand (2015) Case Study 4: The Samoan Self-management Education Programme for People with Long-term Health Conditions (Word, 51 KB) Refugee healthcare: a handbook for health professionals (2012) Car J, Lang B, Colledge A, Ung C, Majeed A. Interventions for enhancing consumers' online health literacy. Cochrane Database Syst Rev 2011(6):CD007092. Nicola Diviani et al. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature. J Med Internet Res 2015;17(5):e112) Health literacy interventions and outcomes: an updated systematic review (2011) see also Health literacy resources curated by HQSC to support Engaging with consumers: a guide for district health boards. Maaori resources curated by by HQSC to support Engaging with consumers: a guide for district health boards. Health Information Resources for Patients and the Community: a clearinghouse curated by the Counties Manukau Health Library Selected Learning Opportunities Health Literacy eModules on Ko Awatea LEARN Go to My learning / ► Hawkes Bay DHB / ► Primary Care / ► HLPHO Health literacy is the capacity to find, interpret and use information and health services to make effective decisions for health and wellbeing (Ministry of Health). This course is made up of 6 eModules: What is Health Literacy? Organisational Health Literacy Communication Tools to Improve Health Literacy Strategies to Improve Communication and Engagement with Māori Effective engagement with Pacific patients and whānau Selected MOOCs of interest (international): Health literacy: hidden barriers and practical strategies [US] [Slide Presentation] *This PowerPoint presentation includes 30 slides, with speaker's notes, that can be delivered in 30-45 minutes to a group or as a self-study program. It can also be downloaded and edited. Health literacy for public health professionals [US] Effective Communication Tools for Healthcare Professionals: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency [US] last updated 12 February 2024 Patient experience: a selective bibliography. Compiled by the Counties Manukau Health Library.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf (PDF, 169 KB)

Contents

Patient experience

Guidelines and Resources
Patient Co-design Portals
Additional Resources and Further Reading
Selected Learning Opportunities

Health literacy

Guidelines and Resources
Selected aids and communication tools developed by NZ DHBs
Health Literacy Portals
Additional Resources and Further Reading
Selected Learning Opportunities


Patient Experience

 

Guidelines and Resources

New Zealand

Code of expectations for health entities’ engagement with consumers and whānau (HQSC, 2023)

The code of expectations for health entities’ engagement with consumers and whānau | Te tikanga mō te mahi tahi a ngā hinonga hauora ki ngā kiritaki me ngā whānau (the code) sets the expectations for how health entities must work with consumers, whānau and communities in the planning, design, delivery and evaluation of health services.  This code is required by the Pae Ora (Healthy Futures) Act 2022 and is underpinned by the health sector principles. All health entities must act in accordance with the code and are required to report annually on how the code has been applied.


From knowledge to action: A framework for building quality and safety capability in the New Zealand health system (HQSC, 2016)
A high-level framework to guide the development of quality and safety capability across all levels in the health and disability sector, including consumers/patients.

Engaging with consumers: a guide for district health boards (HQSC, 2015)
This resource is a practical guide to help New Zealand district health boards, and the health and disability services they fund, to engage better with consumers. It covers consumer engagement in the design and delivery of services, as well as the development of policy and governance procedures.


A guide to developing a framework for collecting information from consumers to improve the quality of health and disability services (HQSC, 2012)

 

This Guide and accompanying Toolkit are designed to assist health and disability service providers in developing and implementing a framework for capturing and using information about consumer experience to undertake service improvements. (…) In New Zealand consumer participation is also included in the Health and Disability Services Standards, which require that consumers and family/ whānau “are involved in the planning, implementation, and evaluation at all levels of the service to ensure services are responsive to the needs of individuals.

see also Additional reading and useful links



Health Service Co-Design [WDHB]
A guide from Waitemata DHB providing a range of flexible tools for working effectively with patients in service improvement work.

 

Patient Experience Explorer (HQSC)

HQSC has launched the Experience Explorer, an improved tool for public reporting of results from the national patient experience programme. The explorer provides access to results from the Commission’s adult hospital inpatient experience and adult primary care patient experience surveys.  

Co-design in Aotearoa New Zealand: a snapshot of the literature (Knowledge Auickland; 2020)

Co-design refers to a philosophical approach and evolving set of methodologies for involving people in the design of the services, strategies, environments, policies, processes, – that impact them.

This review gathers together readily available local scholarship and literature about co-design in Aotearoa New Zealand up to September 2019. This document is aimed at the practitioners as much as academics and is more a snapshot than a formal academic literature review. Its aim is to:

create a resource to support groups and individuals working in, or commissioning, co-design
make visible for those practising or commissioning co-design in Aotearoa New Zealand the current landscape of formal scholarship and research in this space
provide a benchmark of current research applying to, or about, co-design, highlighting areas for future scholarship and collaboration. As more literature is identified it can be added to this initial review.
mprovement (HQSC, 2018)From PES to PDSA outlines how to use the patient experience reporting portal for quality improvement.  Written collaboratively with the Commission's quality improvement team, this document breaks down Plan, Do, Study, Act cycles into well-defined steps so you can streamline quality improvement activities within your primary health organisation or general practice.



International



Partnering with Consumers: A guide for consumers (Australian Commision on Satefy and Quality in Healthcare, 2023)

Developed by consumers for consumers, the Guide explains how to strengthen consumer partnerships at all levels of the health system to support person-centred care and drive positive change.  The Guide has been developed by consumers for consumers, with Consumers Health Forum of Australia (CHF) engaged to undertake the co-design process. It explains how to build and strengthen consumer partnerships at all levels of the health system to support person-centred care and drive positive change.

 

 

 

Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers ( La Trobe University, 2022)

‘Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers’ is a guide designed to help hospitals, providers and consumers include social media-based methods into their suite of consumer engagement activities.

Researchers from the Centre for Health Communication and Participation at La Trobe University, along with an advisory committee of consumers and service providers, developed this guide. It draws from findings of a review of international literature, and new research exploring the use of social media as a consumer engagement tool in Australia.

The Patient Experience Library
"We have brought together the whole of the UK's qualitative literature on patient experience. We make as much stuff available free of charge as we can - through our weekly newsletter and through selected Insight reports and Knowledge maps.  We also make reports available to download for free, grouped by the month they were added to the Library" - Search the library

The Beryl Institute
The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members.  Copies of all reports and papers can be requested from the Counties Manukau Health Library.

From PES to PDSA: A guide to using the patient experience survey portal for quality i

Engaging Patients in Patient Safety – a Canadian Guide (CPSI, 2017)
While the guide focuses primarily oThe Commission has developed a comprehensive training package for facilitators to use to help new health and disability consumer representatives to prepare for their role. It is designed to support consumers to participate confidently when sharing their views and experiences in decision-making forums across the sector.  The training package was updated in 2017 and will continue to be revised to reflect changes to key government documents (such as updated national strategies) and to incorporate new information.n patient safety, many engagement practices apply to other areas, including quality, research, and education. The guide is designed to support patient engagement in any healthcare sector.


Recommendations to OECD Ministers of Health from the High Level Reflection Group on the future of health statistics: Strengthening the international comparison of health system performance through patient-reported indicators (OECD, 2017)

Groundbreaking ministerial statement endorsed plans for a major programme of work on patient reported indicators of health system performance. Patient Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs) seem set to become the new currency for comparative performance assessment, but they may have an even more important role in clinical care.

The Eight Principles of Patient Centred Care
This webpage summarises findings from work by researchers from Harvard Medical School on behalf of Picker Institute and The Commonwealth Fund.  It draws on a literature review and wide range of focus groups to identify 8 Principles of Patient Centred Care that are needed to meet the Institute of Medicine's definition of patient-centred care.

 

NHS information and resources
Experience Based Design: Questionnaire.
Experience Based Design: Guide & Tools.
Experienced Based Design: Concepts and Case Studies.
Creating a revolution in patient and customer experience - Implementation Guidance The Friends and Family Test.
Feeling better? Improving patient experience in hospital.
NICE Quality standard for patient experience in adult NHS services

Australian Commission on Safety and Quality in Health Care
Person-centred healthcare organisations
The Commission has developed a number of resources to help support healthcare organisations to achieve excellent person-centred care.  Including reports, fact sheets and case studies.

Australian Commission on Safety and Quality in Health Care
Patient-centred care: improving quality and safety through partnerships with patients and the community

Australian Commission on Safety and Quality in Health Care
NSQHS Standard 2: Partnering with consumers: Tip Sheets and self assessment tool

The Kings Fund
Patient- and family-centred care toolkit
The patient- and family-centred care toolkit from The King's Fund is a simple, step-by-step method for recording and understanding patient and family experiences.

1000 Lives Improvement [NHS Wales]
Listening and Learning to Improve the Experience of Care
The white paper collects case studies from around Wales of how NHS teams and departments have gathered ‘patient feedback’ to inform changes and improvements in services.

Guide to patient and family engagement in hospital quality and safety (AHRQ)
An evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety.

Consumer Assessment of Healthcare Providers and Systems (CAHPS)
AHPS surveys ask patients to report on their experiences with a range of health care services at multiple levels of the delivery system. Several surveys ask about experiences with ambulatory care providers such as health plans, physicians' offices, and mental health plans, while others ask about experiences with care delivered in facilities such as hospitals, dialysis centers, and nursing homes.

The CAHPS Child Hospital Survey (Child CAHPS)
Assesses the experiences of pediatric patients (17 and younger) and their parents or guardians with inpatient care. It complements the Adult Hospital Survey, which asks adult inpatients about their experiences. Child HCAHPS covers most of the topics addressed by the Adult version of the Hospital Survey as well as topics that are particularly relevant to pediatric care.

Patient Engagement Resource Hub (Canadian Foundation for Healthcare Improvement)
Hub resources include Canadian and international open source tools. Use them in patient and family engagement initiatives to improve health and healthcare.

How to Successfully Engage Patients and Families: 10 Insights from Providers and Leaders (Canadian Foundation for Healthcare Improvement. )

 

Healthcare providers and leaders shared these 10 insights, distilled from their experience and learning when working together with patients and families.


Patient and Public Engagement in Choosing Wisely. ( Choosing Wisely Canada. (2019). )

 

A new toolkit about engaging patients and the public in Choosing Wisely has been published. It includes brief case studies of patient and public engagement in Choosing Wisely campaigns, including in Australia. Twenty-eight cases from 12 countries describe ways campaigns have partnered, engaged, empowered and informed patients, consumers and the public.

 

Helping measure person-centred care: a review of evidence about commonly used approaches and tools used to measure person-centred care (Health Foundation)
This rapid review signposts to research about commonly used approaches and tools to help
measure person-centred care. It aims to showcase the many tools available for those working in
policy and practice.  A spreadsheet listing 160 of the most commonly researched measurement
tools accompanies this review.

Person and patient-centred care
An excellent collection of resources and articles curated by the team at Health Navigator.

Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families 
A compilation of evidence-based best practices for improving patient safety through patient, family, and caregiver engagement. This comprehensive guide provides primary care practices with four strategies that they can adopt to improve patient safety.

Patient/Family Advisory Councils in Ontario Hospitals – At Work, In Play (Change Foundation, 2014)
This report investigates the evolving function and best practices of Ontario’s hospital-based Patient/Family Advisory Councils (PFACs): one mechanism some hospitals are using – among other approaches – to advance patient/family engagement and patient-centred care.  This 3-part preliminary report aims to guide, connect and inspire by presenting thematic findings with examples of challenges and successes (part 1); quantitative data (part 2); and listings of PFAC initiatives, with contacts (part 3). The Foundation interviewed patients, family and staff from 29 hospitals about the functioning and impact of their councils.

Strategies for Patient, Family and Caregiver Engagement. Technical Brief [AHRQ Publication No. 20-EHC017]. Agency for Healthcare Research and Quality (AHRQ). (2020).

 

This brief applies a framework to create a map of the currently available evidence on patient and family engagement strategies that have been used to help people manage chronic conditions.

Putting the consumer first: Creating a consumer-centred health system for a 21st century Australia: A health policy report. ( George Institute for Global Health & Consumers Health Forum of Australia. (2016). )

 

This report provides a series of recommendations for change and summarises key discussion points:

•            How do we empower consumers and communities to be informed and actively involved in their healthcare and the healthcare system?

•            How do we enable and support consumer-centred professional practice?

•            How do we enable services and providers to change?

 

•            How do we create the right policy, infrastructure and incentive platforms to drive change and support consumer-centred care?

Helping measure person-centred care. (The Health Foundation, 2014).

 

A review of evidence about commonly used approaches and tools used to help measure person-centred care.  This rapid review signposts to research about commonly used approaches and tools to help measure person-centred care. It aims to showcase the many tools available for those working in policy and practice.

 

 

 

Patient Co-design Portals, guides toolkits etcetera

 

 

Australian Healthcare and Hospitals Association (AHHA)

Experience Based Co-design Toolkit [ AHHA] Australian-developed toolkit developed by the Australian Healthcare and Hospitals Association (AHHA) and the Consumers Health Forum (CHF) will help individual hospitals and healthcare services to provide better experiences of healthcare for both workers and patients. Sets out a process for co-design and includes case studies.

Flip the Clinic

Flip the Clinic is an open experiment to transform the patient-clinician experience. It is where patients and health practitioners improve medical care, together. Find new ideas, join the collaboration, and follow the community’s progress

 

Health Service Co-Design [WDHB] A guide from Waitemata DHB providing a range of flexible tools for working effectively with patients in service improvement work.

Health Quality & Safety Commission Co-Design in Partners in Care [HQSC] Partners in Care is a six- to eight-month programme brought to you by the Health Quality & Safety Commission with a focus on consumer engagement, using the National Health Service Institute’s Experience-Based Design programme

Co-design in health: free e-learning courses available | He hoahoa-tahi: He kaupapa ako-i utu kore | Health Quality & Safety Commission (hqsc.govt.nz)

HQSC have developed a suite of free e-learning courses for co-design that are available to all health care professionals through Manatū Hauora | Ministry of Health’s Learn Online platform. Co-design is a tool that brings together consumers, whānau and communities to ensure that multiple perspectives are reflected in the design, delivery and evaluation of services.

Courses:

These courses are open to anyone (first-time Learn Online users will need to create a login). Learners can work through these courses at their own pace.

Patient Engagement Resource Hub (Canadian Foundation for Healthcare Improvement) Hub resources include Canadian and international open source tools. Use them in patient and family engagement initiatives to improve health and healthcare.

Point of Care Foundation: EBCD: Experience-based co-design toolkit [UK] This toolkit gives a step-by-step guide to improving patient experience of health care using a technique called experience-based co-design (EBCD).The toolkit includes short videos from staff and patients involved in experience-based co-design (EBCD) projects to help bring to life the successes and intense rewards of running this type of improvement project.

See also Patient- and family-centred care toolkit The patient- and family-centred care toolkit from The King's Fund is a simple, step-by-step method for recording and understanding patient and family experiences.

The Beryl Institute

The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members.

 

 

Additional Resources and Further Reading


Consumers’ and health providers’ views and perceptions of partnering to improve health services design, delivery and evaluation: a co‐produced qualitative evidence synthesis. Cochrane Database of Systematic Reviews (2023)

 

Key messages

•            Power imbalances between health providers and consumers can limit consumer participation in health service planning, delivery and evaluation.

•            Power imbalances in the partnership may happen because of the ways consumers are recruited, how meetings are run, and how decisions are made.

•            To have successful partnerships with consumers, health providers need to address these power imbalances.

•            Some consumers and health providers believed that partnerships improved the culture and environment of the health service, as well as how health services were planned and developed.

Consumers’ and health providers’ views and perceptions of partnering to improve health services design, delivery and evaluation: a co‐produced qualitative evidence synthesis / Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, et al.  Cochrane Database of Systematic Reviews. 2023 (3).

This qualitative evidence synthesis examined the partnering with consumers, particularly on ‘formal group partnerships where health providers and consumers share decision‐making about planning, delivering and/or evaluating health services’. The work sought to:

1.           ‘To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services.

2.           To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences.’

Focussing on 33 studies, the analysis identified 19 findings that were then grouped into 5 categories:

•            Contextual factors influencing partnerships

•            Consumer recruitment

•            Partnership dynamics and processes

•            Perceived impacts on partnership participants

•            Perceived impacts on health service planning, delivery and evaluation.

The authors emphasise the importance of power imbalances and the need to be aware of these and to address them. The key messages in the plain language summary stress these in noting:

•            ‘Power imbalances between health providers and consumers can limit consumer participation in health service planning, delivery and evaluation.

•            Power imbalances in the partnership may happen because of the ways consumers are recruited, how meetings are run, and how decisions are made.

•            To have successful partnerships with consumers, health providers need to address these power imbalances.

 

•            Some consumers and health providers believed that partnerships improved the culture and environment of the health service, as well as how health services were planned and developed.’

Consensus on how to optimise patient/family engagement in hospital planning and improvement: a Delphi survey. (BMJ open, 2022)

 

Patient and family engagement (PE) in health service planning and improvement is widely advocated, yet little prior research offered guidance on how to optimise PE, particularly in hospitals. This study aimed to engage stakeholders in generating evidence-informed consensus on recommendations to optimise PE.

 

Understanding integration: how to listen to and learn from people and communities | TheKingsFund  (2021)
The move towards integrated care has been the defining policy in health and care over the past decade and will continue to gather pace with the development of integrated care systems (ICSs). The aim of integrated care is to improve people’s outcomes and experiences of care by bringing services together around people and communities.

This means addressing the fragmentation of services and lack of co-ordination that people often experience by providing person-centred, joined-up care. One key question for ICSs and the partners working in them is how they will know whether they are meeting the needs of the people they serve. Those best placed to understand what they need, what is working and what could be improved are the people and communities using services. Their lived experience is a powerful tool to improve existing services and identify new and better ways to meet people’s needs. Currently, people’s experiences of health and care services are usually collected and understood at the level of individual providers (Wellings 2019). This means we know about people’s experiences of individual services, such as general practice, hospitals or social care, but not about whether these services are working well together to meet people’s needs. 

Over the past year, Picker and The King’s Fund have been working with NHS England and NHS Improvement on how ICSs can listen to and learn from people and communities. We have produced a practical guide for partners working in these systems, with ideas on how they might go about this. There is no one-size-fits-all solution. It will require a range of different methods and approaches to understand, monitor and measure how well people’s needs are being met. Perhaps most importantly, it will require partners to listen and learn together. As important as the methods adopted, will be the importance placed on this area of work and we have put together a set of principles for systems to adopt to ensure that the voices of people and communities are at the heart of partnership working. 

The guide, created by The King’s Fund and Picker on behalf of NHS England and NHS Improvement, has been developed with input from ICSs, patient leaders, and engagement and experience experts. We hope it will prove useful to systems and will encourage and help them as they work to co-ordinate services around what matters to people and communities.

NHS information and resources Experience Based Design: Questionnaire.Experience Based Design: Guide & Tools. Experienced Based Design: Concepts and Case Studies. Creating a revolution in patient and customer experience - Implementation Guidance The Friends and Family Test. Feeling better? Improving patient experience in hospital.NICE Quality standard for patient experience in adult NHS services

Australian Commission on Safety and Quality in Health Care Patient-centred care: improving quality and safety through partnerships with patients and the community

Australian Commission on Safety and Quality in Health Care NSQHS Standard 2: Partnering with consumers: Tip Sheets and self assessment tool

 The KingsFund Patients as partners: Building collaborative relationships among professionals, patients, carers and communities

 More collaborative relationships among health and care professionals, patients, service users, carers and communities are essential for the future of the NHS, but what helps to build effective relationships? This guide stems from an evolving body of the Fund's work focused on exploring and supporting shared leadership. This work is reinforced by a growing consensus that health services, agencies, patients and communities need to work together more – and differently.

1000 Lives Improvement [NHS Wales]

Listening and Learning to Improve the Experience of Care

The white paper collects case studies from around Wales of how NHS teams and departments have gathered ‘patient feedback’ to inform changes and improvements in services.

Guide to patient and family engagement in hospital quality and safety (AHRQ) An evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety.

Health Quality & Safety Commission Co-Design in Partners in Care [HQSC[ Partners in Care is a six- to eight-month programme brought to you by the Health Quality & Safety Commission with a focus on consumer engagement, using the National Health Service Institute’s Experience-Based Design programme

Co-design programme evaluation and case studies 2015–16 [NZ HQSC] The 2015–16 co-design programme was delivered in two DHBs over an eight-month period from October 2015 to May 2016. The evaluation report, interviews and case studies from the programme are now available. The report has identified a number of learnings which offer potential future opportunities to increase the sustainability of co-design approaches.

Putting the consumer first: Creating a consumer-centred health system for a 21st century Australia. A health policy report, April 2016 (The George Institute; 2016)

Co-design: shared perspectives on authentic co-design: putting consumers and carers at the center of mental health reform (Co-design Initiative, 2016)

Reexamining “Defining Patient Experience”: The human experience in healthcare (Patient Experience Journal; 2021)


 

Journals

Patient Experience Journal
Patient Experience Journal (PXJ) is an international, multidisciplinary, and multi-method, open-access, peer-reviewed journal engaging research, proven practices and a range of perspectives, inclusive of patients and families, focused on understanding and improving patient experience. PXJ is designed to share ideas and reinforce key concepts that impact the delivery of service, safety and quality and their influence on the experience of patients, residents and families across healthcare settings.

Journal of Participatory Medicine
The Journal of Participatory Medicine is a peer-reviewed, open access journal with the mission to advance the understanding and practice of participatory medicine among health care professionals and patients. It is published by the Society for Participatory Medicine.

 

Selected Learning Opportunities

 

 

Health Literacy

 

Guidelines and Resources

 

Improving Health Literacy: New Zealand Medical Association Policy Briefing (2017) [NZMA]
The New Zealand Medical Association has published a policy briefing on Improving Health Literacy, that seeks to promote a shared understanding of what health literacy means, why it is important, and what can be done to improve it.

Health literacy review: a guide (2015) [NZ MoH]
Developped to take organisations through the review process and show you how to develop a Health Literacy Action Plan
see also 'A framework for health literacy: a health system response'

Rauemi Atawhai – A guide to developing health education resources in New Zealand (2012) [NZ MoH]
“A guide to developing health education resources in New Zealand has been developed to help the Ministry of Health and its contractors produce effective and appropriate health education resources that meet the needs of the intended audience, are easy to understand, and support improved health literacy.”

Translation is not enough: cultural adaptation of health communication materials ([ECDC: 2016]
This report describes the tools we need to effectively use print resources to communicate across cultures. This guide introduces an innovative five-step, stakeholder- based approach to adapting health communication materials. It describes how countries can take any health communication material, produced in English or other languages) and create adapted products which reflect national or local realities, needs and assets without losing the scientific correctness, core concepts and messages of the original version.

More resources for developing information that is easy to understand and use:
NSW Clinical Excellence Commission – Health Literacy Guide
Agency for Healthcare Research and Quality – Health literacy universal precautions toolkit
Agency for Healthcare Research and Quality – Patient Education Materials Assessment Tool
Canadian Public Health Association – Easy does it! Plain language and clear verbal communication training manual
US Centers for Disease Control and Prevention – Simply put: A guide for creating easy-to-understand materials

Three steps to better health literacy: a guide for health professionals (2014)

Engaging with consumers: a guide for district health boards (HQSC: 2015)
This resource is a practical guide to help New Zealand district health boards, and the health and disability services they fund, to engage better with consumers. It covers consumer engagement in the design and delivery of services, as well as the development of policy and governance procedures.

Health service co-design toolkit [Waitemata DHB]

Toolkit for Staff working in Culturally & Linguistically Diverse Health Environments [Waitemata DHB]

Cross Cultural Resource for Health Practitioners working with Culturally and Linguistically Diverse (CALD) clients [e-toolkit]

Self management support toolkit [NZ Health Navigator]

Health Literate Care Model: A Universal Precautions Approach
A universal precautions approach means treating all patients as if they are at risk of not understanding health information. When health care providers use this approach, they acknowledge that:
Professionals can’t accurately identify who understands and who doesn’t.
Even individuals with proficient health literacy skills may not attribute the same meaning to health terms and instructions as professionals do. These inviduals can sometimes have trouble understanding health information – especially when they are sick, frightened, or in pain.

Health literacy can be situational. For example, it may depend on the complexity of the information and the patient’s relevant experiences and stress level.Everyone benefits from clear, actionable information.By adopting a universal precautions approach, health care providers communicate with all patients in clear and actionable ways.

Making it easier: a health literacy action plan for Scotland (2017) [NHS Scotland]

Australian Commission on Safety and Quality in Health Care

see

HEALTH LITERACY: Taking action to improve safety and quality
The aims of the paper are to raise awareness of the importance of health literacy, and to start discussions about how it can be addressed systematically and who can be involved in this process.  The paper provides a broad overview of health literacy in Australia and identifies a number of areas and actions required to address health literacy in a coordinated way.

Health literacy: a summary for clinicians (ACSQHC, 2017)

see also

Tip Sheet 8: Health literacy and the NSQHS Standards
This fact sheet focusses on health literacy and how your organisation can strategically address health literacy and meet the requirements of the National Safety and Quality (NSQHS) Standards.|

The Universal Patient Language
The Universal Patient Language (UPL) is a set of resources that helps you communicate with patients about complex topics. We are constantly evolving the UPL as we learn new things.  The UPL was designed to help you:
Translate complex scientific data into digestible information;
Make your communications relatable and meaningful to patients;
Effectively use icons, visuals, and colors;
Enable patient learning through digital media

Health Literacy Toolkit (NHS, UK. 2017)
Includes practical tools, techniques and case studies.

 

Videos


Why Capital and Coast DHB carried our a health literacy review (2015)
Capital & Coast DHB reviewed a service issue – non-attendance at children’s outpatient clinics. This was an issue they were already investigating and the review contributed a health literacy perspective.


Why Counties Manukau DHB carried our a health literacy review (2015)
Counties Manukau Health reviewed oral health services and were concerned about life-long consumer engagement with services.


Why Northland DHB and Te Tai Tokerau PHO did a health literacy review (2105)
Northland DHB worked with Te Tai Tokerau Primary Healthcare Organisation to review diabetes services in primary care. The quality of diabetes care is of great importance in the North because of the growing numbers of consumers with diabetes.


More videos from the Ministry of Health about conducting health literacy reviews

 

Selected aids and communication tools developed by the New Zealand DHBs

 

AI2DET (Acknowledge, Introduce, Identify, Duration, Enquire and Effective Communication, Thank you ) [Counties Manukau Health]

A communication tool CM Health has adapted to improve face-to-face engagement experiences for patients and whānau, and promote values-based communication

 

Communication cards [ADHB]

Communication cards contain a set of icons that patients can use if they are having difficulty communicating their immediate needs, wants or concerns. 

The cards have been translated into 12 languages: Arabic ; Burmese ; Chinese (simplified) ; Chinese (traditional) ; English ; French ; Hindi ; Korean ; Maori ; Russian ; Samoan ; Tongan ; Vietnamese


iTui [WDHB / IBMNZ]

“iTui” – developed in partnership with IBM – is a free drawing based iPad app that enables doctors to have higher quality interactions and engagement with kids.The tool provides a common platform to describe and discuss thoughts, feelings and experiences, without being limited by drawing ability.
 

Patient and Whaanau Learning Centre Virtual Library [Counties Manukau Health]

The Patient and Whaanau Learning Centre provides access to valid health resources for patients and whaanau. The virtual library is curated by the Counties Manukau Health Library.

Waikids Safety in Hospital video [Waikato DHB]

No matter your age, gender or if you’re a dinosaur called Safetysaurus, coming to hospital can be quite scary, especially if you’re a kid.

So the team at Waikids' Waikato Hospital rallied together to make a fun and informative video for unwell kids and their whanāu when they need to stay in hospital, highlighting the safety tips they need to know.

Waitemata DHB Patient Safety Video [WDHB]

Waitemata DHB has taken a leaf out of Air New Zealand's book, with the launch of a new safety video. Hospital safety is crucial to help reduce falls, infections and medicine mishaps, and the DHB has come up with an out-of-this-world way to get the message through. The in-hospital safety video stars an alien called Ghoumash, who crashes to Earth and winds up at North Shore Hospital, where a friendly nurse and doctor talk him through the standard safety procedures.

 

Health Literacy portals

Health Literacy NZ: Workbase

Ministry of Health

Health Navigator

Health Quality and Safety Commission

see also

The Health Literacy Place [NHS Scotland]

Health Literacy resources published by the Australian Commission on Safety and Quality in Health Care [Aus.]

 

Additional Resources and Further Reading

 

International Handbook of Health Literacy : Research, practice and policy across the lifespan (Policy Press, 2019)
Available Open Access under CC-BY-NC licence. Health literacy addresses a range of social dimensions of health, including knowledge, navigation and communication, as well as individual and organizational skills for accessing, understanding, evaluating and using information. Particularly over the past decade, health literacy has globally become a major public health concern as an asset for promoting health, wellbeing and sustainable development.

Building the Case for Health Literacy: Proceedings of a Workshop (National Academy of Medicine:2018)

Health literacy reviews [MoH]

Health literacy publications [MoH]

Literature review of health literacy education, training tools, and resources for health providers. (Workbase: 2013)

Community-based health literacy interventions: proceedings of a workshop. (Book. National Academy of Medicine. 2018)

Health literacy: a necessary element for achieving health equity [Discussion paper. National Academy of Medicine] (2015)

How can communities and organisations improve their health literacy?  (Public Health Research & Practice, 2018)

Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review (2017)

Health promotion competencies for Aotearoa New Zealand (2012)

Korero Marama: Health Literacy and Maaori: Results from the 2006 Adult Literacy and Life Skills Survey – Provides an overview of health literacy amongst Maaori.

Ethnic Disparities in CPAP Adherence in New Zealand- Effects of Socioeconomic Status, Health Literacy and Self Efficacy

Maaori Health Literacy Research: Gestational diabetes mellitus (2014)

He Māramatanga Huangō: asthma health literacy for Maaori children in New Zealand (2015)

Case Study 4: The Samoan Self-management Education Programme for People with Long-term Health Conditions (Word, 51 KB)

Refugee healthcare: a handbook for health professionals (2012)

Car J, Lang B, Colledge A, Ung C, Majeed A. Interventions for enhancing consumers' online health literacy. Cochrane Database Syst Rev 2011(6):CD007092.

Nicola Diviani et al. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature. J Med Internet Res 2015;17(5):e112)

Health literacy interventions and outcomes: an updated systematic review (2011)

see also

Health literacy resources curated by HQSC to support Engaging with consumers: a guide for district health boards.
Maaori resources curated by by HQSC to support Engaging with consumers: a guide for district health boards.

Health Information Resources for Patients and the Community: a clearinghouse curated by the Counties Manukau Health Library

 

Selected Learning Opportunities

 

Health Literacy eModules on Ko Awatea LEARN

Go to

My learning
/ ► Hawkes Bay DHB
/ ► Primary Care
/ ► HLPHO

Health literacy is the capacity to find, interpret and use information and health services to make effective decisions for health and wellbeing (Ministry of Health).  This course is made up of 6 eModules:

What is Health Literacy?
Organisational Health Literacy
Communication
Tools to Improve Health Literacy
Strategies to Improve Communication and Engagement with Māori
Effective engagement with Pacific patients and whānau

 

Selected MOOCs of interest (international):

Health literacy: hidden barriers and practical strategies [US] [Slide Presentation]
*This PowerPoint presentation includes 30 slides, with speaker's notes, that can be delivered in 30-45 minutes to a group or as a self-study program. It can also be downloaded and edited.

Health literacy for public health professionals [US]

Effective Communication Tools for Healthcare Professionals: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency [US]

 

 last updated 12 February 2024

Innovation and Improvement Clearinghouse

Contents Research Selected documents and resources Selected learning opportunities Staying current Innovation and improvement at Counties Manukau Health & Ko Awatea Innovation hubs (NZ) Innovation hubs (International) Whats's New Health Improvement and Innovation Digest The goal of the Health Improvement and Innovation Digest is to improve the health and wellbeing of New Zealanders by sharing the latest research that can help drive innovation and quality improvement. Research Research Review [NZ] Research Review is an independent publishing company that harnesses the expertise of New Zealand's leading specialists to select and advise on the most important medical research and the local implications. We condense what's important and bring it to subscribers on a regular basis as a four page summary with a specialist opinion and a web link to the full study. The Reviews keep medical professionals up to date in over 40 interest areas. Health Systems Evidence database Maintained by McMaster University this database is a comprehensive, free access point for evidence to support policy makers, stakeholders and researchers interested in how to strengthen or reform health systems or in how to get cost-effective programs, services and drugs to those who need them. Implementation Science Implementation Science is an open access, peer-reviewed online journal that aims to publish research relevant to the scientific study of methods to promote the uptake of research findings into routine healthcare in clinical, organisational or policy contexts. Healthcare Transformation Peer-reviewed, open access journalzine, delivers foremost research in re-imagining healthcare delivery, education, technology, innovation, and discovery. Health system quality dashboard Health & Quality Safety Commission (NZ) Research HINTS When searching databases such as PubMed / Medline / CINAHL add "quality improvement" as a subject heading ( MeSH) to your search. When looking for Randomised Controlled Trials and/or Systematic Reviews in an area identified for improvement do your subject search on PubMed and then use the 'Article type' filter to only include RCTs and systematic reviews in your results list. Example : SEARCH: AND "quality improvement"[MeSH Major Topic] AND (Randomized Controlled Trial[ptyp] OR systematic[sb]) Search Strategy Used to Create the Systematic Reviews Subset on PubMed This strategy is intended to retrieve citations identified as systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, guidelines, and citations to articles from journals specializing in review studies of value to clinicians. This filter can be used in a search as systematic [sb]. Example: exercise hypertension AND systematic [sb] This filter is also available on the Filters sidebar under "Article types." It is also available on the Clinical Queries screen. Use the 'Clinical Queries' search template in PubMed to identify Systematic Reviews on your topic of interest. When reviewing abstracts identified in your search results on PubMed use the 'Similar articles' and 'Cited by' features to read more widely on the topic. see also An evidence rating scale for New Zealand: Understanding the effectiveness of interventions in the social sector Selected documents and resources Approached to spread, scale-up, and sustainability (THIS Institute, 2024) This is the latest release in the Elements of Improving Quality and Safety in Healthcare series from The Healthcare Improvement Studies Institute (the THIS Institute) in Cambridge. This volume examines the challenges of spreading and scaling up improvements in health care. The authors provide: Definitions of spread, scale-up, and sustainability in the context of healthcare improvement. An overview of different approaches, noting their strengths and limitations. Case studies highlighting how different ways of viewing spread and scale-up can make a difference in practice. A summary of key practical lessons for improvement practitioners and researchers. Improving health and care at scale: learning from the experience of systems | NHS Confederation (2023) NHS England has outlined plans to develop an improvement approach - NHS IMPACT - to support continuous improvement. There are also ambitions for integrated care systems (ICSs) to become ‘self-improving systems’. This report, written and researched by Sir Chris Ham and jointly commissioned by the NHS Confederation, the Health Foundation and the Q community, reviews the experience of a number of ICSs identified as being at the forefront of this work, focusing on the approaches they have taken and the results achieved.” What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System (2023) Paper examining the views on quality improvement managers in New Zealand on the competencies and qualities required ‘to achieve day-to-day and long-term quality improvement objectives.’ Based on interviews with 56 quality improvement managers from across New Zealand, the study identified two groups ‘traditional and clinical quality improvement managers’ with the traditional group being ‘those with formal quality improvement education’ while the clinical group ‘was represented by clinical staff—physicians and nurses—who received on-the-job training.’ The authors report three major themes emerged from the interviews: quality improvement expertise, leadership competencies and interpersonal competencies. The ‘traditional quality improvement managers emphasising leadership competencies and interpersonal skills more than clinical quality improvement managers’. Cambridge Elements: Improving Quality and Safety in Healthcare. THIS Institute, Cambridge The THIS Institute (The Healthcare Improvement Studies Institute) at the University of Cambridge has developed this series of open access publications. The series seeks to offer ‘a comprehensive and authoritative set of overviews of the different improvement approaches available, exploring the thinking behind them, examining evidence for each approach, and identifying areas of debate’. Elements that have been published include: Workplace Conditions Simulation as an Improvement Technique Reducing Overuse Implementation Science Making Culture Change Happen Co-Producing and Co-Designing Collaboration-Based Approaches The Positive Deviance Approach. Building an organisational culture of continuous improvement: Learning from the evaluation of the NHS partnership with Virginia Mason Institute | The Health Foundation (2022) The evaluation of the NHS partnership with Virginia Mason Institute, which examined how five NHS trusts in England attempted to build a culture of continuous improvement, provides important lessons about how to plan and implement an organisation-wide approach to improvement. This long read outlines some of the key learning from the evaluation and offers recommendations for national policymakers and local systems leaders. Measures Library (HQSC) Health sectors rely on data to improve quality. Our Measures Library provides technical documents and summaries, management and case documents, plus links to other resources like the Atlas of Healthcare Variation. Beyond improvement skills: what do clinicians, managers, patients and others need to do to make improvement happen? (BMJ Quality and Safety; 2022) In this issue of the journal, Wright et al offer an in-depth examination of the implementation of six improvement projects in three English hospitals to elucidate the work that matters most to those directly involved Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies (BMJ Quality and safetyl 2022) Our case studies provide a nuanced understanding of the skills used by healthcare staff. While technical skills are important, the ability to judge when and how to use wider skills was paramount. The provision of QI training and fidelity to the improvement programme may be less of a priority than the deployment of SOFFT skills used to overcome barriers. QI projects will fail if such skills and resources are not accessed. Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers ( La Trobe University, 2022) ‘Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers’ is a guide designed to help hospitals, providers and consumers include social media-based methods into their suite of consumer engagement activities. Researchers from the Centre for Health Communication and Participation at La Trobe University, along with an advisory committee of consumers and service providers, developed this guide. It draws from findings of a review of international literature, and new research exploring the use of social media as a consumer engagement tool in Australia. What enabled health service innovation during the pandemic? Crisis, staff, system or management? Deeble Institute This Perspectives brief from the Australian Healthcare and Hospitals Association‘s Deeble Institute examines some of the changes that happened in Queensland during the VOVID-19 pandemic. The authors argue that the pandemic saw rapid shifts in the way health care is being delivered, but their focus on the factors that enabled innovation to occur. They examine the key enablers of innovative allied health models of care and practice changes within Queensland’s publicly funded health services during the pandemic preparedness phase. Based on interviews with 28 health professionals conducted by the Allied Health Professions’ Office of Queensland (AHPOQ) the brief identifies three key innovation enablers: adaptive management style, devolved authority structures and trust in staff capability. Quality improvement made simple. What everyone should know about health care quality improvement The Health Foundation (2021) The Health Foundation in the UK has produced an updated third edition of their Quality improvement made simple guide. According to the Health Foundation, improving quality is about making health care safe, effective, patient-centred, timely, efficient and equitable. It’s about giving the people closest to problems affecting care quality the time, permission, skills and resources they need to solve them. Quality improvement involves the use of a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement within a health care setting. This guide offers an explanation of some popular approaches used to improve quality, including where they have come from, their underlying principles and their efficacy and applicability within the healthcare arena. It also describes the factors that can help to ensure the successful use of these approaches and methods to improve the quality of care processes, pathways and services. New Zealand Māori quality improvement in health care: lessons from an ideal type International Journal for Quality in Health Care, Volume 16, Issue 5, October 2004, Pages 417–422 There is no single best approach to quality improvement. Quality improvement has been adapted from its predominantly Japanese origins to form distinct, hybrid systems embedded in national cultures. These systems have seldom been studied despite their potential internationally to inform the local management of health care organizations. This article suggests six lessons from an ‘ideal type’ of one such system, New Zealand Māori quality improvement in health care. Mapped against ‘mainstream’ concepts of quality improvement, the lessons are to: emulate the character of leaders in health care; encourage ‘cultural governance’; operate the health care organization as a ‘family’; move forward with eyes on the past; foster spiritual health; and respect everything for itself. These lessons support a global struggle by indigenous peoples to have their national cultures reflected in programmes to improve their health care, and have potential relevance to mainstream services. By increasing cultural competence, responsiveness to indigenous health needs, and awareness of insights from another culture, the lessons reveal opportunities to improve quality by incorporating aspects of a Māori ideal type. A Guide to Patient Safety Improvement: Integrating Knowledge Translation & Quality Improvement Approaches Canadian Patient Safety Institute (2020) When it comes to patient safety, a substantial body of evidence exists to demonstrate interventions (leading practices and processes) that lead to improved patient outcomes for numerous healthcare conditions. Despite available evidence, practice changes are not implemented consistently and effectively to support organizations and teams to address patient safety challenges. This resource has been designed to support teams across all healthcare sectors in using a Knowledge Translation and Quality Improvement integrated approach to change that will impact patient safety outcomes. This Guide for Patient Safety Improvement is intended to accompany current best available evidence change ideas, and tools and resources for your specific project. It includes ideal practice changes “the what” and strategies “the how” that creates the evidence-based intervention. Adaptations are expected and important considerations for implementation will be provided in this guide. What influences improvement processes in healthcare? :A rapid evidence review RAND Corporation (2020) The Healthcare Improvement Studies (THIS) Institute commissioned RAND Europe to conduct a rapid evidence review of the academic and grey literature, to draw out initial learning about what influences quality improvement processes in healthcare, and to inform potential themes to explore in future research. Key Findings We identified and reviewed 38 academic and 16 grey literature publications covering diverse improvement approaches. Some examples include Six Sigma, Lean, Business Process Reengineering, Plan-Do-Study-Act, clinical audits and feedback, quality improvement collaboratives and peer-learning communities, training and education interventions, and patient engagement and feedback-related interventions. Key influences on improvement processes in healthcare Based on the reviewed literature, six key factors influence the implementation of improvement efforts: Leadership Relationships and interactions that support an improvement culture Skills and competencies Use of data Patient and public involvement, engagement and participation Working as an interconnected system of individuals and organisations, influenced by internal and external contexts This review also attempted to go beyond identifying these high-level influences by explaining what specific aspects of the influencing factors are important for quality improvement. The report provides a detailed analysis of influencing factors across the six categories outlined above, as well as summary tables for each. Implementation Science Resource Directory Melbourne Academic Centre for Health (MACH) With an increasing focus by health services, government and funding bodies on implementing evidence into practice and policy, Melbourne Academic Centre for Health (MACH) has developed a free online directory of implementation science tools and resources for students, clinicians and researchers to make it easier to find resources that support efforts to improve routine practice and care. The new MACH Implementation Science Resource Directory conveniently brings together diverse digital tools and resources into a central location to support health implementation efforts by beginners and experts. Creating a culture of excellence: how healthcare leaders can build and sustain continuous improvement (KPMG: 2019) At a time when healthcare faces growing challenges globally, KPMG International set out to learn how leading healthcare organizations around the world are successfully building and sustaining a culture of continuous improvement. As part of this report we have produced a short series of video interviews with a number of international contributors, who share their perspectives and learning. Quality improvement (BMJ; Health Foundation, 2018 -) The BMJ and the Health Foundation have launched a joint series of papers exploring how to improve the delivery of healthcare. The series aims to discuss the evidence for systematic quality improvement, provide knowledge and support to clinicians, and ultimately to help improve care for patients. How do we ensure that innovation in health service delivery and organization is implemented, sustained and spread? (WHO: 2018) This policy brief (i) reviews the main frameworks and factors that have been identified as supportive for the successful introduction of innovation in service organization and delivery and (ii) illustrates these factors using selected examples of service innovations in European countries. Improving the quality of health services: tools and resources. Turning recommendations into practice (WHO, 2018)The World Health Organization (WHO) has released this document that compiles together a range of WHO resources with the aim of supporting the implementation of quality improvement approaches to make health services more effective, safe and people-centred. The compilation lists the main quality improvement tools and resources currently used within WHO’s Department of Service Delivery and Safety. However, as is noted, this compendium is not an exhaustive list of quality improvement interventions. From PES to PDSA: A guide to using the patient experience survey portal for quality improvement (HQSC, 2018)From PES to PDSA outlines how to use the patient experience reporting portal for quality improvement. Written collaboratively with the Commission's quality improvement team, this document breaks down Plan, Do, Study, Act cycles into well-defined steps so you can streamline quality improvement activities within your primary health organisation or general practice. Building Capacity and Capability for Improvement [NHS] This is a guide for NHS organisations seeking to begin or do more to build improvement capacity and capability in their organisations. It should be used in conjunction with Developing People – Improving Care an evidence-based, adaptive national framework published in December 2016 to guide action on improvement skill and capability building, leadership development and talent management for people in NHS-funded roles in England. 10 IHI Innovations to Improve Health and Health Care (IHI, 2017) About 10 years ago, IHI established a Research and Development team and a systematic process of 90-day innovation cycles to tackle some of the vexing issues in health care. A new publication, 10 IHI Innovations to Improve Health and Health Care, curates some key ideas that have emerged from this systematic approach, and reshaped how and what IHI has committed itself to over the years — including the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, among others. Making the case for quality improvement: lessons for NHS boards and leaders ( Kings Fund / Health Foundation, 2017) This briefing makes the case for quality improvement to be at the heart of local plans for redesigning services. The briefing does this by drawing on existing literature and examples from within the NHS of where quality has been improved and describing how this was done. It describes the potential benefits from investing in quality improvement – including for patients, staff and the financial sustainability of the system. Embedding quality improvement skills: guides to build improvement capacity and capability (NHS Improvement, 2017) These guides are for organisations seeking to begin or build on their improvement capacity and capability. Leading large scale change: A practical guide to leading large scale change through complex health and social care environments (NHS, 2017) Quality Improvement Essentials Toolkit (IHI, 2017) IHI’s QI Essentials Toolkit includes the tools and templates you need to launch and manage a successful improvement project. Each of the ten tools in the toolkit includes a short description, instructions, an example, and a blank template. BMJ Quality Improvement Series (BMJ, 2018) The BMJ has, in conjunction with The Health Foundation, launched a joint series of paper on how to improve the quality of healthcare delivery. What we know about designing an effective improvement intervention (but too often fail to put into practice) [BMJ Quality & Safety, 2017) Open innovation in health: A guide to transforming healthcare through collaboration [Nesta, 2017] Caring for Quality in Health: Lessons Learnt from 15 Reviews of Health Care Quality [OECD, 2017] Building the foundations for improvement: how five UK trusts built quality improvement capability at scale within their organisations [Health Foundation] Exploring the links between quality improvement strategies and organisational outcomes in four New Zealand district health boards [NZ MoH, 2016] Performance Improvement Framework: Core Guide 3: Getting to great: Lead reviewer insights from the Performance Improvement Framework [NZ State Services Commission] Evaluation: what to consider. Commonly asked questions about how to approach quality improvement in health care [Health Foundation] Communications in health care improvement - a tool kit [Health Foundation] Using communications approaches to spread improvement [Health Foundation] Overcoming challenges to improving quality [Health Foundation, 2012] Findings from a survey of healthcare delivery innovation centers [Commonwealth Fund] Improving quality and achieving equity: a guide for hospital leaders [Disparities Solutions Centre] Roadmap to Reduce Disparities: a six-step framework for healthcare organisations to improve minority health and foster equity [Finding Answers: Disparities Research for Change] The Art of Making Change - theories, approaches, tools and techniques for creating meaningful change [Leadership Centre, 2015] A guide to quality improvement tools [HQIP, 2015] Quality improvement made simple: what everyone should know about healthcare quality improvement [Health Foundation, 2016] RCEM Quality Improvement Guide: a practical guide for clinicians undertaking quality improvement in Emergency Departments [RCEM, 2020] Evidence scan: Quality improvement training for healthcare professionals [Health Foundation, 2016] Crossing the quality chasm:a new health system for the 21st century [NAP. 2001] see also 10 New Rules to accelerate healthcare redesign Improving care delivery through Lean: implementation case studies [AHRQ, 2014] The CAHPS Improvement Guide [AHRQ] Improving Patient Safety in Hospitals: A Resource List for Users of the AHRQ Hospital Survey on Patient Safety Culture [AHRQ] This document contains references to Web sites that provide practical resources hospitals can use to implement changes to improve patient safety culture and patient safety. Standards for Quality Improvement Reporting Excellence [SQUIRE] Designing and growing innovation: a case study [State Services Commission study of Canterbury District Health Board] Experience Based Co-Design Toolkit [Kings Fund] Health Service Co-Design Toolkit [Waitemata DHB, NZ] Creative Approaches to Problem Solving: Methods Toolkit - [Q Improvement] A fabulous free toolkit of 25 methods for creative problem solving. There are many of Helen Bevan's favourite tools here, all well explained & organised by objectives Co-design: shared perspectives on authentic co-design: putting consumers and carers at the center of mental health reform (Co-design Initiative, 2016) The quest for integrated health and social care: a case study in Canterbury, New Zealand [The Kings Fund] Stewarding regional health transformation: a guide for changemakers [ReThink Health, 2015] Performance Improvement Framework [NZ State Services Commission] Who's who in healthcare sustainability? [Counties Manukau Health] see also Case Studies, Posters and Examples of Innovative Practice: NHS Improving Quality; NHS Scotland see also Value-Based Health Care Value-based health care Harvard Business Review Based on the research of Professor Michael Porter, Value-Based Health Care is a framework for restructuring health care systems around the globe with the overarching goal of value for patients. Value-based health care is one of the most important topics in health care transformation today. Value-based approaches to organizing care are widely touted as critical to improving the health outcomes of patients worldwide and controlling runaway health care costs. Value-based health care's central tenant is that the overarching principle in redesigning health care delivery systems must be value for patients. We define value as the outcomes that matter to patients and the costs to achieve those outcomes. There are six major elements that are necessary in a truly value-based system: Organize Care Around Medical Conditions → Care delivery is organized around patients' medical conditions or segments of the population. Measure Outcomes & Cost for Every Patient → Outcomes and cost are measured for every patient. Aligning Reimbursement with Value → Reimbursement models that reward both better outcomes and efficiency of care, such as bundled payments. Systems Integration → Regional delivery of care organized around matching the correct provider, treatment, and setting. Geography of Care → National centers of excellence providing care for exceedingly complex patients. Information Technology → An information technology system designed to support the major elements of the agenda. Defining Value-based Healthcare in the NHS Centre for Evidence-base Medicine (2019) "Value-based healthcare is the equitable, sustainable and transparent use of the available resources to achieve better outcomes and experiences for every person." ‘Value’ is gaining prominence in healthcare systems facing increased demand for services with limited resources. However, value-based healthcare has not yet been embraced as part of the everyday language and business of the NHS in the way that evidence-based healthcare has. The absence of an agreed definition of ‘value-based healthcare’ in the NHS, the lack of skills required to deliver value-based healthcare and a clear understanding of the barriers to effective development and implementation inhibits the health system in addressing problems such as overdiagnosis, too much medicine, poor allocation of resources and the introduction of inadequately evidenced technologies This report sets out a route to defining value-based healthcare in the NHS, an assessment of the barriers to its development, and an understanding of what skills and training would support implementation. A stakeholder workshop informs the report with patients and leaders across the NHS and value sector. Approaches to better value: improving quality and cost The KingsFund, 2018 The NHS is increasingly focusing on how it can improve the value of its Services, to deliver the highest quality health outcomes for patients at the lowest possible cost. This report shares learning and insight from three NHS hospital trusts that have developed organisation-wide strategies for value improvement. It draws on interviews, roundtables and site visits with senior leaders in the NHS who are committed to developing better value services. Our report suggests a wide variety of approaches are being taken to improve value in the NHS. These include top-down programmes that focus on a wide range of clinical services from their inception, to value improvement strategies that are more organically grown from a few individual services until they cover a wider breath of hospital-based care. While there are differences in how organisations are approaching value improvement, there are also several common conditions for success. These include fidelity to a clearly defined strategy that brings the various strands of value improvement work together; recognition that value improvement is a long-term commitment that will require considerable staff time and resources; and a new leadership approach that requires continuous engagement with frontline clinicians and managers. Value-Based Healthcare Toolkit Canadian Foundation for Healthcare Improvement: 2020 Value-Based Healthcare (VBHC) is becoming a leading approach to improving patient and health system outcomes around the world. It is one-way of organizing healthcare to transform health outcomes. VBHC is about linking the dollars spent to outcomes that matter to patients, rather than to the volumes of services, processes or products that may or may not achieve those outcomes. VBHC aims to deliver services that are high value, scale back or drop those that do not, and/or re-balance the mix of services to improve the ratio of outcomes to overall costs. The goal is better outcomes at the same or lower total cost. The purpose of this toolkit is to provide information and guidance to those who are interested in learning about value-based healthcare (VBHC); those who are thinking about implementing it; and those who are ready to assess and improve their current VBHC initiatives. Implementing Value-Based Health Care in Europe: Handbook for Pioneers EIT Health, 2020 VBHC provides a methodology for measurable health and care outcomes that make the biggest difference to patients, while driving cost efficiencies within health services. The EIT Health handbook and framework explores insights from pioneers in the field and defines the key steps critical to implementing VBHC in health services. Directed by Professor Gregory Katz, Chair of Innovation & Value in Health at the University of Paris School of Medicine, it aims to help health care providers fully realise the opportunity presented by VBHC and drive forward a medical culture shift in Europe. Value-based healthcare - what is it and can it work in New Zealand? HiNZ, 2018 Value-based healthcare drives accountability for outcomes and creates incentives for improving patient outcomes at lower costs. What would it take to move to this focus on quality, outcome and performance in our healthcare funding? What is the future for value-based healthcare? Deloitte, 2020 Across Europe there have there are distinct patterns of VBHC adoption with key therapy areas like oncology and rare diseases leading the way. In early adopter countries. VBHC is underpinned by system and policy leadership, supported by access to relevant datasets. However, there are a number of common reasons why VBHC has not yet been adopted at scale. We consider each of these reasons and identify potential catalysts to help organisations realise the true potential of VBHC. Value-Based Healthcare in Practice: A Systematic Review Journal of Healthcare Management , 2021 Value-based initiatives are growing in importance as strategic models of healthcare management, prompting the need for an in-depth exploration of their outcome measures. This systematic review aimed to identify measures that are being used in the application of the value agenda. Multiple electronic databases (PubMed/MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials) were searched. Eligible studies reported various implementations of value-based healthcare initiatives. A qualitative approach was used to analyze their outcome measurements. Outcomes were classified according to a tier-level hierarchy. In a radar chart, we compared literature to cases from Harvard Business Publishing. The value agenda effect reported was described in terms of its impact on each domain of the value equation. A total of 7,195 records were retrieved; 47 studies were included. Forty studies used electronic health record systems for data origin. Only 16 used patient-reported outcome surveys to cover outcome tiers that are important to patients, and 3 reported outcomes to all 6 levels of our outcome measures hierarchy. A considerable proportion of the studies (36%) reported results that contributed to value-based financial outcomes focused on cost savings. However, a gap remains in measuring outcomes that matter to patients. A more complete application of the value agenda by health organizations requires advances in technology and culture change management. The Strategy That Will Fix Health Care Michael Porter and Thomas Lee, Harvard Business Review 2013 Based on the 2006 book by Teisberg and Porter ‘Redefining Health Care’ this HBR paper describes how the health system needs to make value the overarching goal of the health system, shifting the focus from volume to value or improving the outcomes that matter to patients relative to the cost of achieving those outcomes. The strategic agenda is based on six interdependent components: organizing around patients’ medical condition, measuring costs and outcomes for every patient, developing bundled prices for the full care cycle, integrating care across separate facilities, expanding geographic reach and building an enabling IT platform. Value in Healthcare Laying the Foundation for Health System Transformation 2017 World Economic Forum in collaboration with The Boston Consulting Group Value in Healthcare has been an ongoing project led by the World Economic Forum and more recently the Global coalition for Value in Healthcare has been established. This paper from 2017 described the foundation for health system transformation including the foundational principles (health outcomes that matter to patients and the costs across the full cycle of care, the identification of clearly defined population segments, the development of segment-specific interventions) and key enablers (informatics; benchmarking, research and tools; payments that help to improve patient value; new roles and organizational models) and public policy that shape the healthcare sector’s legal and regulatory environment. There are a range of other papers in the series available on the Global Coalition’s website here. Value-based healthcare: A global assessment, 2016 The Economist Intelligence Unit The Economist Intelligence Unit has published a number of case studies and policy papers and also conducted this study on value-based healthcare alignment across 25 countries - a qualitative study across four domains of enabling context, policies and institution in healthcare; measuring outcomes and costs; integrated and patient-focused care and outcome-based payment approach. Value Based Health Care: Setting the scene for Australia Deeble Institute issues brief, no 31, 2019 Established by the Australian Healthcare and Hospitals Association in 2019, the Australian Centre for Value-Based Health Care is pursing the creation of a system where health care is funded and delivered with a prime focus on outcomes achieved at an affordable cost for patients and the health system. Victorian Dental Health Services *video presentation Dental Health Services Victorian won the 2019 European Value Based Health Care Europe primary care award. This is a link to a short presentation in the Australian Health Journal and provides insight into the challenges of implementing VBHC and also some of their early successes with decreases in failure to attend rates, dentists practicing at the top of their scope, increased preventative interventions. The Diabeter Established in 2006, the Dutch clinic network Diabeter has been a pioneer in value-based diabetes care, focusing on e-health solutions, delivering individualized, comprehensive care and supporting self care management. This website contains information about Diabeter and a white paper by BCG that describes how they have implemented the six components of the Porter value agenda. How Dutch Hospitals Make Value-Based Health Care Work A Boston Consulting Group case study This describes how Santeon, a Dutch network of hospitals, began implementing VVBHC in 2015 among five patient groups with breast cancer, prostate cancer, lung cancer, stroke and hip arthritis. It describes the infrastructure, governance and approach to measurement and suggests key lessons for other hospitals (eg develop common understanding of value, start small and be pragmatic, build a safe learning environment, have medical professionals take the lead, implement with the patient). Breast Cancer is the most advanced group and they reduced reoperations due to positive surgical margins by 17%, postop complications after lumpectomy by 27%. A case study by All. Can, an international multi-stakeholder initiative working to improve the efficiency of cancer care The Martini-Klink in Germany is the biggest specialist prostate cancer centre worldwide (website here). This case study describes how they systematically measure the quality of care using outcomes that are most relevant to patients. Examples include rates of incontinence and erectile dysfunction following treatment. These data are shared with the healthcare professionals at the clinic to continually revise and improve care. The European Commission report on defining value. The European Commission produced a report on effective ways of investing in health and adopted an opinion on defining value in “value-based health care”. They proposed to define VBHC as a comprehensive concept built on four value-pillars: appropriate care to achieve patients’ personal goals (personal value), achievement of best possible outcomes with available resources (technical value), equitable resource distribution across all patient groups (allocative value) and contribution of healthcare to social participation and connectedness (societal value). A Queensland Health video describing the importance of VBHC This is a Metro North HHS video that reinforces the importance of optimal care pathways and guidelines and collecting data on the outcomes that matter to patients through the story of Peter. He is a hypothetical character with prostate cancer who received prostate surgery (at a cost of $21,000 and with a reduction in the quality of his life due to unwanted outcomes of incontinence and erectile dysfunction) rather than the recommended approach of regular monitoring for men with low risk prostate cancer. Selected learning opportunities Improving Together Improving Together is a national learning programme that focusses on quality improvement for people delivering education, social services and health services. You can find out how improvement methodologies accelerate learning and innovation, and how it can be applied to improve the quality of social service delivery in New Zealand. Improvement Knowledge and Skills Guide [ HSE, Ireland] This guide will help to support the ongoing learning and professional development of all staff both clinical and non-clinical by providing a list of improvement knowledge and skills which can help to educate, train and guide staff on how to deliver improvement in the health service. LEAN Thinking LEAN Thinking is a methodology that will help you improve quality of care, increase efficiency of processes, and identify and eliminate waste. LEAN Thinking evolved in the manufacturing industry but is now routinely applied in the health sector. This course introduces the LEAN methodology and a number of associated tools to implement the methodology in your work environment. Lifehack Resource Library Guidelines and workshops to support design thinking to support better health outcomes. Lifehack is a space where people can come together to develop new approaches, projects and ventures, with young people at the centre of the process. We bridge backgrounds, skill sets and place, and empower young people and communities to redefine their own version of success. In short, Lifehack is the R&D ground for Youth Wellbeing interventions. The School for Change Agents Develop the skills to make a difference and create change in your organisation on this course targeted at health and care staff. IHI Open School Video Library (videos) The growing library of freely available IHI Open School videos is one way to learn from health care leaders and experts from around the world as they share bite-sized pearls of knowledge and advice. In the newly reorganized IHI Open School Video Library, browse by topics such as improvement capability; patient safety; person- and family-centered care; Triple Aim for populations; quality, cost, and value; and leadership. Health Improvement Scotland QI Global Webex series Hour long webinars from global leaders in health care transformation and innovation. Risky Business Exceptional talks sharing ideas on risk, culture, human performance, teams and leaders. TedMed talks (videos) TEDMED is the independently owned and operated health and medicine edition of the TED conference, dedicated to “ideas worth spreading.” TED Talks have been viewed online over two billion times around the world. "TEDMED convenes and curates extraordinary people and ideas from all disciplines both inside and outside of medicine in pursuit of unexpected connections that accelerate innovation in health and medicine". Stanford Centre for Professional Development: Innovation and Entrepreneurship Series View online, without charge, webinars, seminars, and lectures presented by Stanford faculty, industry experts, and senior researchers. see also Institute of Design at Stanford A range of free resources, and learning experiences to develop design thinking. Includes a virtual "90 minute crash course in design thinking". Staying current Subscribe Grey Matter Research Review [NZ] Health Improvement and Innovation Digest - NZ Ministry of Health Library roundup of literature, research, tools and case studies Health Roundtable Roundup On the Radar [ACSQHC) Health Quality & Safety Commission e-update Follow (via twitter) Health Affairs Health Foundation Health Quality and Safety Commission [NZ] Health Research Council New Zealand [NZ] Health Roundtable Healthcare Improvement Scotland Institute for Healthcare Improvement (IHI) Ministry of Health (NZ) National Institute for Health Innovation [NZ] Nuffield Trust Nursing Review New Zealand [NZ] NZ Doctor [NZ] Quality Watch [UK] Research Review NZ [NZ] TeamHQi [NZ] The King's Fund Innovation and improvement at Counties Manukau Health & Ko Awatea Quality Improvement at Counties Manukau Health: A case study evaluation Ko Awatea Publications Health Transformation series Creating Systems (Healthcare Transformation Book 1) by David Galler , Jonathon Gray , Muir Gray [Kindle edition] September 2015 LINK Population Medicine (Healthcare Transformation Book 2) by Jonathon Gray, Karina McHardy, Muir Gray [Kindle edition] June 2015 LINK Creating Culture (Healthcare Transformation Book 3) by Geraint Martin, Jonathon Gray, Mataroria Lyndon, Lynne Maher, Muir Gray [Kindle edition] September 2015 LINK Knowledge Management (Healthcare Transformation Book 4) by Muir Gray , Jonathon Gray, Eli Rotenberg, Clare Nelson, Peter Murgatroyd & Lynne Armstrong [Kindle edition] April 2017 LINK Ko Awatea White Papers A case for change (PDF, 1018 KB) Establishing an independent commentator panel (PDF, 705 KB) Ko Awatea leadership academy (PDF, 1001 KB) Five key initiatives for healthcare improvement – APAC Thought Leaders white paper (PDF, 151 KB) Final Reports of Major Campaigns and Reports Target CLAB Zero CLAB final report [HWSC] *CLAB article: 'From ICU to hospital-wide: extending central line associated bacteraemia (CLAB) prevention' [NZMA] 20,000 days VHIU* Link Collaborative SMOOTH collaborative (PDF, 933 KB) Early Delirium Identification and Management (PDF, 2.4 MB) *Transitions of care [*presentation on slideshare] Skin infection (PDF, 1.3 MB) 20,000 Days Campaign – From small revolutions to Big Change (PDF, 1.4 MB) An evaluation of CMDHB 20,000 days campaign (PDF, 1.2 MB) Beyond 20,000 days Beyond 20,000 days booklet 2014 (PDF, 6.2 MB) Beyond 20,000 days brochure (PDF, 2.3 MB) Beyond 20,000 days pocket guide (PDF, 2.4 MB) Supporting life after stroke (PDF, 9.3 MB) Feet for life (PDF, 6.2 MB) Acute care for the elderly (PDF, 13 MB) Well managed pain (PDF, 4.3 MB) Kia Kaha: Manage better, feel stronger (PDF, 2.9 MB) Kia Kaha case study (DOCX, 2.3 MB) 20,000 Days and Beyond Evaluation of CMDHB’s Quality Improvement Campaign A report for Counties Manukau District Health Board Handle the Jandal *Handle the Jandal: a report assessing social mobilisation and community organising in the Counties Manukau District Health Board, with Ko Awatea, Health System Innovation and Improvement [Harvard] Article: An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand [ https://doi.org/10.1177/1039856215597539 ] Manaaki Hauora – Supporting Wellness Enabling Self-Management Support (PDF, 4.4 MB) Folau I Lagi-Ma – Journey to Wellness (PDF, 7.2 MB) Smokefree Buffet (PDF, 2 MB) Evaluations and Joint Publications with HQSC *Co-design programme evaluation and case studies 2015–16. Prepared for the Health and Safety Quality Commission. 2016. *Co-design Programme 2015-2016: Report of the evaluation survey and interviews *Case Study: Safe, effective and efficient discharge (SEED) team (Central PHO) *Case Study: ED patient experience from the front door to seeing the first treating clinician (MidCentral DHB) *Case Study: Severe nausea and vomiting in pregnancy (SNVP) - 'suffering in silence' (MidCentral DHB) *Case Study: Spiritual care at end of life for refugee communities (MidCentral DHB) *Case Study: A review of the patient experience when accessing head and neck cancer services (Nelson Marlborough DHB) *Case Study: Radiology service improvement initiative (Nelson Marlborough DHB) *Case Study: 'Through the eyes of children' (Nelson Marlborough DHB) 20,000 Days: An evaluation of CMDHB 20,000 days campaign Beyond 20,000 Days: 20,000 Days and Beyond Evaluation of CMDHB's Quality Improvement Campaign - A report for Counties Manukau District Health Board Ko Awatea Publications (articles, presentations etcetera) Health system and service level improvement 2022 Measuring health consumers’ engagement at the governance level: development and validation of the Middlemore Consumer Engagement Questionnaire (PDF, 300 KB) 2021 *An NP-led pilot telehealth programme to facilitate guideline-directed medical therapy for heart failure with reduced ejection fraction during the COVID-19 pandemic Reducing the MRI outpatient waiting list through a capacity and demand time series improvement programme (PDF, 620 KB) *Patient safety leadership walk rounds: Lessons from a mixed-methods evaluation. 2020 *At the coalface of the COVID-19 pandemic: the role of the Counties Manukau Health Library *Creating Health Literate Consumer Resources: Insights from a Professional Development Programme *Ethnic Disparities in Access to Publicly Funded Bariatric Surgery in South Auckland, New Zealand *Kōrero mai site case studies (2017–2020) *Making change last? Exploring the value of sustainability approaches in healthcare: a scoping review Patient safety leadership walk rounds: lessons learned from a mixed-method evaluation *Reflections from New Zealand: Counties Manukau's COVID-19 Journey. *Saving 20,000 Days and Beyond using breakthrough improvements: lessons from an adaption of the Breakthrough Series Collaborative *Perspectives: Reflections on leadership and innovation in unprecedented times 2019 *Anyone can co-design?”: A case study synthesis of six experience-based co-design (EBCD) projects for healthcare systems improvement in New South Wales, Australia *Establishing gold standards for system-level measures: a modified Delphi consensus process *He Awatea Hou: Improving health literacy and health outcomes for bariatric patients *Saving 20 000 Days and Beyond: a realist evaluation of two quality improvement campaigns to manage hospital demand in a New Zealand District Health Board *The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement 2018 *An 8-step framework for framework for identifying opportunities for improvement [HQSC not available] *Experience-Based Co-Design: Tackling common challenges *From place to space: a Heideggerian analysis *Increasing early childhood education enrolment and attendance rates in south Auckland, New Zealand *Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare *Owning My Gout- A Pharmacist-led collaborative gout management model at Counties Manukau DHB *Top tips for a successful co-design project *What initiatives do healthcare leaders agree are needed for healthcare system improvement? 2017 *A literature review for large-scale health information system project planning, implementation and evaluation *Accomplishing reform: successful case studies drawn from the health systems of 60 countries *An evaluation of a leadership development coaching and mentoring programme *Building quality improvement capability in the New Zealand IPC workforce *Creating self-management team-lets in a primary care clinic; the successes of a clinical-peer team *Estimated reduction in expenditure on hospital-acquired pressure injuries after an intervention for early identification and treatment *Ethical Guideline for Quality Improvement (Ko Awatea) [HQSC unavailable] Handle the jandal: a story of Polynesian youth leadership in South Auckland *Healthcare leaders’ views on successful quality improvement initiatives and context *Increasing patient engagement in healthcare service design: A qualitative evaluation of a co-design programme in New Zealand *Increasing sustainability in co-design projects: A qualitative evaluation of a co-design programmme in New Zealand *Integrated care in action -The Counties Manukau experience Ko Awatea: Health System Innovation and Improvement *My home is my marae: Kaupapa Maori evaluation of an approach to injury prevention *Patients’ and families’ perception of a need for a patient and/or family initiated rapid response service: a case study design *Real Raw And Relatable : A collection of stories from the people of South Auckland *Time to embrace the digital age in health care *Transforming patient engagement to take charge of their health and wellbeing 2016 *Developing and implementing a framework for system level measures: lessons from New Zealand *Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay *Evaluation of general practice house officers attachments in Counties Manukau: insights and benefits *Nurse educators: What really matters to patients *Optimisation of hospital resource use: A rapid review of the literature *Quality Improvement at Counties Manukau Health: A case study evaluation *Things that matter: Stories of life and death 2015 *An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand *Coordination of care in hospitals: a rapid review of the literature *How well does your healthcare system perform? Tracking progress toward the triple aim using system level measures *Partnership and rigor in improving patient care *Target CLAB Zero: A national improvement collaborative to reduce central line-associated bacteraemia in New Zealand intensive care units *The Health Quality and Safety Commission: making good health care better *The power of patient ownership: The path from engagement to equity 2014 *Building a culture for innovation: A leadership challenge *Cultivating inter-professional practice in New Zealand: an inter-sectorial approach to developing inter-professional education An Evaluation of the 20,000 Days Campaign *Experience and Co-Design Methods Northland District Health Board *Triple aim program: Assessing its effectiveness as a hospital management tool 2013 *Handle the Jandal: a report assessing social mobilisation and community organising in the Counties Manukau District Health Board, with Ko Awatea, Health System Innovation and Improvement [Harvard] *The Adverse Drug Event Collaborative: a joint venture to measure medication-related patient harm [NZMA] 2012 *A world of difference through collaborative governance and disruptive innovation *Ko Awatea: the first one hundred days [Management Exchange, unavailable] *Reporting hospital performance--a balancing act between accountability and quality improvement *Target CLAB Zero National Collaborative to Prevent Central Line Associated Bacteraemia The Medicine Stories Project The Medicine Stories Project collection (PDF, 5.6 MB) Expert Views · Sustainable conferences: how to minimise the environmental impact · Turning safety on its head: team resilience for the everyday · Boundary spanning in healthcare: bridging the silos · Primary care – ensuring safety systems through integration · Working with personalities and their communication styles · The seven dimensions of an innovation culture · Logic models: an essential tool to integrate evaluation into project design · Six tips on co-design · Re-imagining the role and value of library services in the health sector · Making better business decisions with a data warehouse · Mapping patient journeys to improve patient experience · Hardwiring an innovation culture in your organisation · Where medicine and poetry meet · Game on! Using gamification to maximise motivation and engagement for health improvement · Social network innovations for health and wellbeing · Using social media to disseminate research · Holding the gains: sustaining change in quality improvement · Setting the seeds of a community organising movement in healthcare · Painting pictures with numbers: how clinical analysts make sense of data · Simulation: Bridging the gap between textbook and patient · Designing projects that promote equity · Organisational development: looking beyond the boundaries · Evidence-informed decision-making in project management · Building understanding: Health literacy, cultural competence and language access · Clearing the confusion: Are you really doing co-design? · Nine things to check before you publish · Success factors for improvement projects in primary care · The myth of resistance to change · Did the butterfly really cause the hurricane? · CALM communication and de-escalation in healthcare · Working with at-risk collaborative project teams · Enabling healthcare staff in training to be quality improvers · Working together better: leadership compacts in improvement projects · Ten tips for running a national improvement collaborative · An introduction to practical improvement science · Cultivating interprofessional practice in healthcare with interprofessional student education · Flexible learning in healthcare. Part 1: E-portfolios: an essential component in change · Reducing venous congestion: the magic of medical leeches · Creating a good digital experience for your target audience · Community organising: activating people power to create health *external website New Zealand Ko Awatea [NZ] Counties Manukau Health's centre for innovation and improvement i3 [NZ] Waitemata 's Instite for Innovation and Improvement Publications, Resources, and Projects The National Institute of Health Innovation [NZ] At NIHI we measure our success by our contribution to improving people’s health in New Zealand and around the globe. We discover, develop, test and deliver innovative approaches to today’s most pressing health problems. Our work is focused on preventing disease, improving people’s health, reducing health inequities and enabling the delivery of more effective and equitable healthcare. We provide independent scientific evidence that supports individuals, communities, clinicians and policymakers. Supported by The University of Auckland and Auckland UniServices Limited infrastructures, we are experts in providing researchers with complex project management, IT, data management and analytics support, delivery of commercial health projects and commercialisation/deployment of health initiatives. Health Improvement and Innovation Resource Centre (HIIRC) [NZ] * ceased operation 1 July 2015. Archive only. Improvement and innovation is occurring throughout New Zealand’s health care system. The HIIRC supported this by providing: an extensive knowledge library of literature directories of individuals and organisations access to improvement projects, tools and initiatives the latest news, events and innovations. Whilst the site is no longer being updated the Ministry of Health library continues to curate and disseminate the Health Improvement and Innovation Resource Centre Digest . ** Archives of resources from the HIIRC site including project initaitves and case studies can be viewed as follows: Hospital productivity Maori health innovation Primary care Quality improvement Improved access to elective surgery More health and diabetes checks Better help for smokers to quit Increased immunisation Shorter stays in ED Faster cancer treatment Health Innovation Hub [NZ] Confidentially and alongside the clinicians, we provide industry with access to clinicians and their new ideas. We also provide innovative clinicians with advice on product design and health innovation funding options. Health Quality and Safety Commission [NZ] The Health Quality & Safety Commission works with health professionals, patients and consumers across health and disability services to improve the quality and safety of care. A range of resources including: Open Book - reports to alert providers to the key findings of adverse event reviews. The reports emphasise the changes implemented to stop the event happening again. See also Resources for providers starting quality improvement projects [primary care] Health Research Council of New Zealand [NZ] The HRC supports research that has the potential to improve health outcomes and delivery of healthcare, and to produce economic gain for New Zealand. Health Roundtable [NZ / Aus.] We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to: Provide opportunities for health executives to learn how to achieve Best Practice in their organisations Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices Promote interstate and international collaboration and networking amongst health organisation executives Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address. 89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis. Telehealth Resource Centre [NZ] Brings together information about the various regulations and guidelines that apply to telehealth as well as explaining services the centre provides like free on-site visits and education workshops. Includes case studies and resources to support implementation. Innovation hubs (international) International Society for Quality in Health Care (ISQua) ISQua's mission is to inspire, promote and support continuous improvement in the safety and quality of health care worldwide. WHO Patient Safety portal "Adverse events may result from problems in practice, products, procedures or systems. Patient safety improvements demand a complex system-wide effort, involving a wide range of actions in performance improvement, environmental safety and risk management, including infection control, safe use of medicines, equipment safety, safe clinical practice and safe environment of care" World Innovation Summit for Health (WISH) A global healthcare community dedicated to capturing and disseminating the best evidence-based ideas in healthcare, providing global solutions that will save both lives and much needed resources. Australia Australian Centre for Health Innovation [Aus.] The Australian Centre for Health Innovation (CHI) connects diverse health, policy and industry communities to more effectively address the changing needs of healthcare and improve patient experience. Australian Commission on Quality and Safety in HealthCare [Aus.] The Australian Commission on Safety and Quality in Health Care (the Commission) was created by Health Ministers in 2006, and funded by all governments on a cost sharing basis, to lead and coordinate health care safety and quality improvements in Australia. Australian Institute of Health Innovation [Aus.] We are leading researchers investigating many aspects of health care. We are a major national resource for many people whose work is intrinsic to strengthening health systems, organisations and services. ACI: NSW Agency for Clinical Innovation - see also the ACI Innovation Exchange [Aus.] The Agency for Clinical Innovation (ACI) works with clinicians, consumers and managers to design and promote better healthcare for NSW. Clinical Excellence Commission [Aus.] The Clinical Excellence Commission (CEC) is responsible for leading safety and quality improvement in the NSW public health system. It was established in 2004 to promote and support improved clinical care, safety and quality across NSW. Australasian Association for Quality in Health Care [Aus.] It is a member-driven, not-for-profit organisation served by a volunteer Council comprised of representatives from all Australian States and Territories and New Zealand. Health Issues Centre [Aus.] We support and inform consumers and the health sector to partner for health care improvements. United Kingdom Advancing Quality Alliance (AQuA) Is a NHS health and care quality improvement organisation who are at the forefront of transforming the safety and quality of healthcare. AHSN Atlas of Solutions in Healthcare he AHSN Atlas is an online resource that shares some of the very best examples from across the Academic Health Science Networks of how to spread high impact innovation across the health and care system. Cochrane [UK] We are a global independent network of researchers, professionals, patients, carers, and people interested in health. Healthcare Improvement Scotland [UK] We produce a range of resources from evidence based reports to best practice and improvement guides. All our resources are designed to support healthcare improvement. Healthcare Quality improvement Partnership [UK] The Healthcare Quality Improvement Partnership (HQIP) was established in April 2008 to promote quality in healthcare, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. The Health Foundation [UK] The Health Foundation is an independent charity working to improve the quality of health care in the UK. We are here to support people working in health care practice and policy to make lasting improvements to health services. We carry out research and in-depth policy analysis, run improvement programmes to put ideas into practice in the NHS, support and develop leaders and share evidence to encourage wider change. see also Improvement Research Institute [UK] The Health Innovation Assessment Portal (HIAP-Scotland) The Health Innovation Assessment Portal (HIAP-Scotland) to encourage prospective providers of new and/or innovative products and solutions to put them forward. This will allow NHSScotland to assess how the solution might support NHSScotland's strategic aims, and what the associated costs and benefits would be Health Quality Improvement Partnership [UK] The Healthcare Quality Improvement Partnership (HQIP) is an independent organisation led by the Academy of Medical Royal Colleges, The Royal College of Nursing and National Voices. We were established in April 2008 to promote quality in healthcare, and in particular to increase the impact that clinical audit has on healthcare quality improvement. Institute of Global Health innovation [UK - Imperial College London] The Institute of Global Health Innovation (IGHI) works to design & diffuse high impact global healthcare innovations and to reduce health inequalities worldwide. NHS Scotland, Quality Improvement Hub [UK] Includes a section on quality and efficieny supporting the business case for safety. The Nuffield Trust [UK] The Nuffield Trust is an authoritative and independent source of evidence-based research and policy analysis for improving health care in the UK. Quality Watch A joint research programme of the Nuffield Trust and the Health Foundation monitoring how the quality of health and social care is changing over time. Highlights areas where improvement is possible. Royal College of Emergency Medicine QI Resources [UK] This page collates some of the most useful quality improvement resources for EDs. Scottish Health Innovations Ltd. [UK] Scottish Health Innovations Ltd works in partnership with NHSScotland to protect and develop new innovations that come from healthcare professionals. Scottish Patient Safety Programme [UK] National initiative that aims to improve the safety and reliability of healthcare and reduce harm, whenever care is delivered. NHS Scotland Quality Improvement Hub [UK] Contains resources, case studies, and networks for knowledge sharing. The King's Fund [UK] The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. THIS.Institute - The Healthcare Improvement Studies Institute [UK] At THIS Institute we have an important goal: To strengthen the evidence-base for improving healthcare. Creating an evidence-base that supports replicable and scalable improvements to healthcare delivery and patient experiences. Working in partnership with patients and NHS staff throughout the UK, we’re boosting research activity to provide more clarity on what works in improving healthcare, what doesn’t, and why. NHS Impact NHS Impact is the new, single, shared NHS improvement approach. By creating the right conditions for continuous improvement and high performance, systems and organisations can respond to today's challenges, deliver better care for patients and give better outcomes for communities. Includes a library of useful improvement resources. United States 100 Million Healthier Lives [US] 100 Million Healthier Lives is an unprecedented collaboration of change agents who are fundamentally transforming the way we think and act to improve health, wellbeing and equity. Initiatives: SCALE 1.0: Becoming Communities of Solutions SCALE 1.0: The first phase of Spreading Community Accelerators through Learning and Evaluation (SCALE 1.0, January 2015 – January 2017) supported 24 communities across 21 states in the U.S. to accelerate their community transformation journey toward a Culture of Health. These 24 communities, who worked on a variety of health, wellbeing, and equity topics, went on to support 43 additional communities in a program called Pathway to Pacesetters. Key lessons learned in SCALE 1.0 can be found in the following 5 synthesis reports: 1.Overview of SCALE & a Community of Solutions 2.Foundations of a Community of Solutions 3.Engaging Community Residents with Lived Experience 4.Leading for Abundance: Approach to Generative Sustainability 5.Using Improvement Methods & Design Thinking to Guide Action Agency for Healthcare Research & Quality (AHRQ) [US] The Agency for Healthcare Research and Quality's (AHRQ) mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used. see also AHRQ Innovations Exchange The Innovations Exchange is expanding efforts to scale up and spread innovations by sponsoring three Learning Communities (LCs) focused on the following high-priority topic areas: “Advancing the Practice of Patient- and Family-Centered Care in Hospitals,” “Reducing Non-Urgent Emergency Services,” and “Promoting Medication Therapy Management for At-Risk Populations.” Centre for Health Care Innovation [US: Penn Medicine] The Penn Medicine Center for Health Care Innovation facilitates the rapid, disciplined development, testing and implementation of new strategies to reimagine health care delivery for dramatically better value and patient outcomes. The Center for Health Organization Transformation The Center for Health Organization Transformation, or CHOT, is an industry-university cooperative research center (I/UCRC) funded by the National Science Foundation and health organizations to conduct research supporting major management, clinical, and information technology innovations in healthcare. Health Care Improvement Foundation [US] The Health Care Improvement Foundation (HCIF), was founded to support a responsive, coordinated health care delivery system that fulfills the needs of patients and consumers, and achieves better health. Through large-scale collaboration, HCIF works with health systems, community based organizations, payors and a variety of other stakeholders to find solutions to complex healthcare challenges, which any one stakeholder could not achieve alone. Healthy Mendocino Promising Practices Database The Promising Practices database informs professionals and community members about documented approaches to improving community health and quality of life. The ultimate goal is to support the systematic adoption, implementation, and evaluation of successful programs, practices, and policy changes. The database provides carefully reviewed, documented, and ranked practices that range from good ideas to evidence-based practices. Improvement Science Learning Centre [US] Developed by Brandon Bennett this curated collection of resources includes eLearning Modules, Videos, and a range of tools, guides and frameworks. Institute for Health Care Improvement [IHI] [US] The Institute for Healthcare Improvement (IHI), an independent not-for-profit organization based in Cambridge, Massachusetts, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide. Institute for Healthcare Optimization [US] An independent not-for-profit 501(c)(3) research, education and service organization focused on bringing the science and practice of operations management to healthcare delivery. The Commonwealth Fund [US] The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. Mayo Clinic's Centre for Innovation [US] Mayo Clinic's Center for Innovation fuses design principles with the scientific method to uncover human needs in the health care environment, which include empathy, creativity, systems thinking and a human-centered focus. National Academies of Sciences, Engineering and Medicine: Health and Medicine Division [US] HMD’s aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely. National Patient Safety Foundation [US] The National Patient Safety Foundation’s vision is to create a world where patients and those who care for them are free from harm. A central voice for patient safety since 1997, NPSF partners with patients and families, the health care community, and key stakeholders to advance patient safety and health care workforce safety and disseminate strategies to prevent harm. Network for Regional Healthcare Improvement [US] The Network for Regional Healthcare Improvement (NRHI) is a national organization representing over thirty member Regional Health Improvement Collaboratives (RHICs). These multi-stakeholder organizations are working in their regions and collaborating across regions to transform the healthcare delivery system and achieve the Triple Aim: improving the patient experience of care, including quality and satisfaction; improving the health of populations; and reducing the per-capita cost of healthcare. ReThink Health [US] We work with visionary leaders to transform health at the regional level – their neighborhoods, cities, counties, or states. Our hope is that by demonstrating regional success, we inspire transformation across the country. The Beryl Institute The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members. Choosing Wisely [US] Choosing Wisely aims to promote conversations between clinicians and patients by helping patients choose care that is: Supported by evidenceNot duplicative of other tests or procedures already receivedFree from harmTruly necessary. Planetree [US] Planetree, Inc. is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to transform how care is delivered Canada Accreditation Canada: Leading Practices Database Leading Practices Database is proud to serve as the new location for innovative practices from the former Health Council of Canada Health Innovation Portal. The Leading Practices Database fosters inter-organizational learning and harvesting of new ideas. It includes nearly 1,000 practices recognized as being particularly innovative and effective in improving quality. Canadian Foundation for Healthcare Improvement A not-for-profit organization funded by the Government of Canada, dedicated to accelerating healthcare improvement. CFHI plays a unique, pan-Canadian role in supporting healthcare delivery innovation. We help teams from different jurisdictions work together on common improvement priorities, providing opportunities to share and implement evidence-informed solutions across regions, provinces and territories. Canadian Health Human Resources Network Innovations Portal CHHRN partnered with the Health Council of Canada to initiate and populate a health human resources (HHR) innovations portal to showcase innovative approaches to health human resource issues. Canadian Patient Safety Institute The Canadian Patient Safety Institute (CPSI) is a not-for-profit organization that exists to raise awareness and facilitate implementation of ideas and best practices to achieve a transformation in patient safety. The Change Foundation An independent health policy think tank, The Change Foundation is changing the debate, practice and experience in Ontario health care, prompting system-wide, patient-centred improvements. Africa The Ubora Institute Africa’s first institute dedicated to the use of improvement science to achieve the best in health and health care for the people of Africa. Launched in February 2016, Ubora, which means “excellence” in Swahili, has already lined up work in partnership with IHI to support health systems in Ghana and Liberia. Last updated 12 February 2024 Who's who in healthcare sustainability?.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf.pdf (PDF, 77.5 KB) A summary of sustainability organizations/networks compiled by Debbie Wilson, Sustainability Officer, Counties Manukau Health

Contents


Research
Selected documents and resources
Selected learning opportunities
Staying current
Innovation and improvement at Counties Manukau Health & Ko Awatea
Innovation hubs (NZ)
Innovation hubs (International)


Whats's New

Health Improvement and Innovation Digest

The goal of the Health Improvement and Innovation Digest is to improve the health and wellbeing of New Zealanders by sharing the latest research that can help drive innovation and quality improvement. 

 

Research

Research Review [NZ]
Research Review is an independent publishing company that harnesses the expertise of New Zealand's leading specialists to select and advise on the most important medical research and the local implications. We condense what's important and bring it to subscribers on a regular basis as a four page summary with a specialist opinion and a web link to the full study. The Reviews keep medical professionals up to date in over 40 interest areas.

Health Systems Evidence database
Maintained by McMaster University this database is a comprehensive, free access point for evidence to support policy makers, stakeholders and researchers interested in how to strengthen or reform health systems or in how to get cost-effective programs, services and drugs to those who need them.

 
Implementation Science
Implementation Science is an open access, peer-reviewed online journal that aims to publish research relevant to the scientific study of methods to promote the uptake of research findings into routine healthcare in clinical, organisational or policy contexts.
 
Healthcare Transformation
Peer-reviewed, open access journalzine, delivers foremost research in re-imagining healthcare delivery, education, technology, innovation, and discovery.
 
Health system quality dashboard
Health & Quality Safety Commission (NZ)
 
Research HINTS
 
When searching databases such as PubMed / Medline / CINAHL add "quality improvement" as a subject heading ( MeSH) to your search.
 
When looking for Randomised Controlled Trials and/or Systematic Reviews in an area identified for improvement do your subject search on PubMed and then use the 'Article type' filter to only include RCTs and systematic reviews in your results list.
 
Example :
SEARCH: AND "quality improvement"[MeSH Major Topic] AND (Randomized Controlled Trial[ptyp] OR systematic[sb])

Search Strategy Used to Create the Systematic Reviews Subset on PubMed

This strategy is intended to retrieve citations identified as systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, guidelines, and citations to articles from journals specializing in review studies of value to clinicians. This filter can be used in a search as systematic [sb].

     Example: exercise hypertension AND systematic [sb]

This filter is also available on the Filters sidebar under "Article types." It is also available on the Clinical Queries screen.  Use the  'Clinical Queries'  search template in PubMed to identify Systematic Reviews on your topic of interest.
 
When reviewing abstracts identified in your search results on PubMed use the 'Similar articles' and 'Cited by' features to read more widely on the topic.
 


Selected documents and resources


Approached to spread, scale-up, and sustainability (THIS Institute, 2024)  

This is the latest release in the Elements of Improving Quality and Safety in Healthcare series from The Healthcare Improvement Studies Institute (the THIS Institute) in Cambridge. This volume examines the challenges of spreading and scaling up improvements in health care. The authors provide:

 

  • Definitions of spread, scale-up, and sustainability in the context of healthcare improvement.
  • An overview of different approaches, noting their strengths and limitations.
  • Case studies highlighting how different ways of viewing spread and scale-up can make a difference in practice.
  • A summary of key practical lessons for improvement practitioners and researchers.

Improving health and care at scale: learning from the experience of systems | NHS Confederation (2023)

NHS England has outlined plans to develop an improvement approach - NHS IMPACT - to support continuous improvement. There are also ambitions for integrated care systems (ICSs) to become ‘self-improving systems’. This report, written and researched by Sir Chris Ham and jointly commissioned by the NHS Confederation, the Health Foundation and the Q community, reviews the experience of a number of ICSs identified as being at the forefront of this work, focusing on the approaches they have taken and the results achieved.” 


What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System (2023)

Paper examining the views on quality improvement managers in New Zealand on the competencies and qualities required ‘to achieve day-to-day and long-term quality improvement objectives.’ Based on interviews with 56 quality improvement managers from across New Zealand, the study identified two groups ‘traditional and clinical quality improvement managers’ with the traditional group being ‘those with formal quality improvement education’ while the clinical group ‘was represented by clinical staff—physicians and nurses—who received on-the-job training.’ The authors report three major themes emerged from the interviews: quality improvement expertise, leadership competencies and interpersonal competencies. The ‘traditional quality improvement managers emphasising leadership competencies and interpersonal skills more than clinical quality improvement managers’.

 

Cambridge Elements: Improving Quality and Safety in Healthcare.  THIS Institute, Cambridge

The THIS Institute (The Healthcare Improvement Studies Institute) at the University of Cambridge has developed this series of open access publications. The series seeks to offer ‘a comprehensive and authoritative set of overviews of the different improvement approaches available, exploring the thinking behind them, examining evidence for each approach, and identifying areas of debate’.

Elements that have been published include:

  • Workplace Conditions
  • Simulation as an Improvement Technique
  • Reducing Overuse
  • Implementation Science
  • Making Culture Change Happen
  • Co-Producing and Co-Designing
  • Collaboration-Based Approaches
  • The Positive Deviance Approach.

 

Building an organisational culture of continuous improvement: Learning from the evaluation of the NHS partnership with Virginia Mason Institute | The Health Foundation (2022)

The evaluation of the NHS partnership with Virginia Mason Institute, which examined how five NHS trusts in England attempted to build a culture of continuous improvement, provides important lessons about how to plan and implement an organisation-wide approach to improvement. This long read outlines some of the key learning from the evaluation and offers recommendations for national policymakers and local systems leaders. 

Measures Library (HQSC)

Health sectors rely on data to improve quality. Our Measures Library provides technical documents and summaries, management and case documents, plus links to other resources like the Atlas of Healthcare Variation.

Beyond improvement skills: what do clinicians, managers, patients and others need to do to make improvement happen? (BMJ Quality and Safety; 2022)

In this issue of the journal, Wright et al offer an in-depth examination of the implementation of six improvement projects in three English hospitals to elucidate the work that matters most to those directly involved

 

Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies (BMJ Quality and safetyl 2022)

Our case studies provide a nuanced understanding of the skills used by healthcare staff. While technical skills are important, the ability to judge when and how to use wider skills was paramount. The provision of QI training and fidelity to the improvement programme may be less of a priority than the deployment of SOFFT skills used to overcome barriers. QI projects will fail if such skills and resources are not accessed.

Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers ( La Trobe University, 2022)

‘Using social media as a tool to facilitate consumer engagement in service design and quality improvement: A guide for hospitals, service providers and consumers’ is a guide designed to help hospitals, providers and consumers include social media-based methods into their suite of consumer engagement activities.

Researchers from the Centre for Health Communication and Participation at La Trobe University, along with an advisory committee of consumers and service providers, developed this guide. It draws from findings of a review of international literature, and new research exploring the use of social media as a consumer engagement tool in Australia.

What enabled health service innovation during the pandemic? Crisis, staff, system or management?

Deeble Institute

This Perspectives brief from the Australian Healthcare and Hospitals Association‘s Deeble Institute examines some of the changes that happened in Queensland during the VOVID-19 pandemic. The authors argue that the pandemic saw rapid shifts in the way health care is being delivered, but their focus on the factors that enabled innovation to occur. They examine the key enablers of innovative allied health models of care and practice changes within Queensland’s publicly funded health services during the pandemic preparedness phase. Based on interviews with 28 health professionals conducted by the Allied Health Professions’ Office of Queensland (AHPOQ) the brief identifies three key innovation enablers: adaptive management style, devolved authority structures and trust in staff capability.

 

Quality improvement made simple. What everyone should know about health care quality improvement
The Health Foundation (2021)

The Health Foundation in the UK has produced an updated third edition of their Quality improvement made simple guide. According to the Health Foundation, improving quality is about making health care safe, effective, patient-centred, timely, efficient and equitable. It’s about giving the people closest to problems affecting care quality the time, permission, skills and resources they need to solve them. Quality improvement involves the use of a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement within a health care setting. This guide offers an explanation of some popular approaches used to improve quality, including where they have come from, their underlying principles and their efficacy and applicability within the healthcare arena. It also describes the factors that can help to ensure the successful use of these approaches and methods to improve the quality of care processes, pathways and services.

 

New Zealand Māori quality improvement in health care: lessons from an ideal type
International Journal for Quality in Health Care, Volume 16, Issue 5, October 2004, Pages 417–422
There is no single best approach to quality improvement. Quality improvement has been adapted from its predominantly Japanese origins to form distinct, hybrid systems embedded in national cultures. These systems have seldom been studied despite their potential internationally to inform the local management of health care organizations. This article suggests six lessons from an ‘ideal type’ of one such system, New Zealand Māori quality improvement in health care. Mapped against ‘mainstream’ concepts of quality improvement, the lessons are to: emulate the character of leaders in health care; encourage ‘cultural governance’; operate the health care organization as a ‘family’; move forward with eyes on the past; foster spiritual health; and respect everything for itself. These lessons support a global struggle by indigenous peoples to have their national cultures reflected in programmes to improve their health care, and have potential relevance to mainstream services. By increasing cultural competence, responsiveness to indigenous health needs, and awareness of insights from another culture, the lessons reveal opportunities to improve quality by incorporating aspects of a Māori ideal type.

 

A Guide to Patient Safety Improvement: Integrating Knowledge Translation & Quality Improvement Approaches
Canadian Patient Safety Institute (2020)
When it comes to patient safety, a substantial body of evidence exists to demonstrate interventions (leading practices and processes) that lead to improved patient outcomes for numerous healthcare conditions. Despite available evidence, practice changes are not implemented consistently and effectively to support organizations and teams to address patient safety challenges.

This resource has been designed to support teams across all healthcare sectors in using a Knowledge Translation and Quality Improvement integrated approach to change that will impact patient safety outcomes. This Guide for Patient Safety Improvement is intended to accompany current best available evidence change ideas, and tools and resources for your specific project. It includes ideal practice changes “the what” and strategies “the how” that creates the evidence-based intervention. Adaptations are expected and important considerations for implementation will be provided in this guide.

What influences improvement processes in healthcare? :A rapid evidence review
RAND Corporation (2020)
The Healthcare Improvement Studies (THIS) Institute commissioned RAND Europe to conduct a rapid evidence review of the academic and grey literature, to draw out initial learning about what influences quality improvement processes in healthcare, and to inform potential themes to explore in future research.

Key Findings

We identified and reviewed 38 academic and 16 grey literature publications covering diverse improvement approaches. Some examples include Six Sigma, Lean, Business Process Reengineering, Plan-Do-Study-Act, clinical audits and feedback, quality improvement collaboratives and peer-learning communities, training and education interventions, and patient engagement and feedback-related interventions.

Key influences on improvement processes in healthcare
Based on the reviewed literature, six key factors influence the implementation of improvement efforts:

Leadership
Relationships and interactions that support an improvement culture
Skills and competencies
Use of data
Patient and public involvement, engagement and participation
Working as an interconnected system of individuals and organisations, influenced by internal and external contexts


This review also attempted to go beyond identifying these high-level influences by explaining what specific aspects of the influencing factors are important for quality improvement. The report provides a detailed analysis of influencing factors across the six categories outlined above, as well as summary tables for each.

 

Implementation Science Resource Directory
Melbourne Academic Centre for Health (MACH)
With an increasing focus by health services, government and funding bodies on implementing evidence into practice and policy, Melbourne Academic Centre for Health (MACH) has developed a free online directory of implementation science tools and resources for students, clinicians and researchers to make it easier to find resources that support efforts to improve routine practice and care.  


The new MACH Implementation Science Resource Directory conveniently brings together diverse digital tools and resources into a central location to support health implementation efforts by beginners and experts.

Creating a culture of excellence: how healthcare leaders can build and sustain continuous improvement (KPMG: 2019)
At a time when healthcare faces growing challenges globally, KPMG International set out to learn how leading healthcare organizations around the world are successfully building and sustaining a culture of continuous improvement. As part of this report we have produced a short series of video interviews with a number of international contributors, who share their perspectives and learning.

Quality improvement (BMJ; Health Foundation, 2018 -)
The BMJ and the Health Foundation have launched a joint series of papers exploring how to improve the delivery of healthcare. The series aims to discuss the evidence for systematic quality improvement, provide knowledge and support to clinicians, and ultimately to help improve care for patients.

How do we ensure that innovation in health service delivery and organization is implemented, sustained and spread? (WHO: 2018)
This policy brief (i) reviews the main frameworks and factors that have been identified as supportive for the successful introduction of innovation in service organization and delivery and (ii) illustrates these factors using selected examples of service innovations in European countries.

Improving the quality of health services: tools and resources. Turning recommendations into practice (WHO, 2018)The World Health Organization (WHO) has released this document that compiles together a range of WHO resources with the aim of supporting the implementation of quality improvement approaches to make health services more effective, safe and people-centred. The compilation lists the main quality improvement tools and resources currently used within WHO’s Department of Service Delivery and Safety. However, as is noted, this compendium is not an exhaustive list of quality improvement interventions.

From PES to PDSA: A guide to using the patient experience survey portal for quality improvement (HQSC, 2018)From PES to PDSA outlines how to use the patient experience reporting portal for quality improvement.  Written collaboratively with the Commission's quality improvement team, this document breaks down Plan, Do, Study, Act cycles into well-defined steps so you can streamline quality improvement activities within your primary health organisation or general practice.

Building Capacity and Capability for Improvement [NHS]
This is a guide for NHS organisations seeking to begin or do more to build improvement capacity and capability in their organisations. It should be used in conjunction with Developing People – Improving Care an evidence-based, adaptive national framework published in December 2016 to guide action on improvement skill and capability building, leadership development and talent management for people in NHS-funded roles in England.

10 IHI Innovations to Improve Health and Health Care  (IHI, 2017)
About 10 years ago, IHI established a Research and Development team and a systematic process of 90-day innovation cycles to tackle some of the vexing issues in health care. A new publication, 10 IHI Innovations to Improve Health and Health Care, curates some key ideas that have emerged from this systematic approach, and reshaped how and what IHI has committed itself to over the years — including the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, among others. 

Making the case for quality improvement: lessons for NHS boards and leaders ( Kings Fund / Health Foundation, 2017)
This briefing makes the case for quality improvement to be at the heart of local plans for redesigning services. The briefing does this by drawing on existing literature and examples from within the NHS of where quality has been improved and describing how this was done. It describes the potential benefits from investing in quality improvement – including for patients, staff and the financial sustainability of the system. 

Embedding quality improvement skills: guides to build improvement capacity and capability (NHS Improvement, 2017)
These guides are for organisations seeking to begin or build on their improvement capacity and capability.

Leading large scale change: A practical guide to leading large scale change through complex health and social care environments (NHS, 2017)

Quality Improvement Essentials Toolkit (IHI, 2017)
IHI’s QI Essentials Toolkit includes the tools and templates you need to launch and manage a successful improvement project. Each of the ten tools in the toolkit includes a short description, instructions, an example, and a blank template.

BMJ Quality Improvement Series (BMJ, 2018)
The BMJ has, in conjunction with The Health Foundation, launched a joint series of paper on how to improve the quality of healthcare delivery.

What we know about designing an effective improvement intervention (but too often fail to put into practice) [BMJ Quality & Safety, 2017)       

Open innovation in health: A guide to transforming healthcare through collaboration [Nesta, 2017] 

Caring for Quality in Health: Lessons Learnt from 15 Reviews of Health Care Quality [OECD, 2017]

Building the foundations for improvement: how five UK trusts built quality improvement capability at scale within their organisations [Health Foundation]

Exploring the links between quality improvement strategies and organisational outcomes in four New Zealand district health boards [NZ MoH, 2016]

Performance Improvement Framework: Core Guide 3: Getting to great: Lead reviewer insights from the Performance Improvement Framework [NZ State Services Commission] 

Evaluation: what to consider. Commonly asked questions about how to approach quality improvement in health care [Health Foundation]

Communications in health care improvement - a tool kit [Health Foundation]

Using communications approaches to spread improvement [Health Foundation]

Overcoming challenges to improving quality [Health Foundation, 2012]

Findings from a survey of healthcare delivery innovation centers [Commonwealth Fund]

Improving quality and achieving equity: a guide for hospital leaders [Disparities Solutions Centre]

Roadmap to Reduce Disparities: a six-step framework for healthcare organisations to improve minority health and foster equity [Finding Answers: Disparities Research for Change]

The Art of Making Change - theories, approaches, tools and techniques for creating meaningful change [Leadership Centre, 2015]

A guide to quality improvement tools [HQIP, 2015]

Quality improvement made simple: what everyone should know about healthcare quality improvement [Health Foundation, 2016]

RCEM Quality Improvement Guide: a practical guide for clinicians undertaking quality improvement in Emergency Departments [RCEM, 2020]

Evidence scan: Quality improvement training for healthcare professionals [Health Foundation, 2016]

Crossing the quality chasm:a new health system for the 21st century [NAP. 2001]
see also 10 New Rules to accelerate healthcare redesign

Improving care delivery through Lean: implementation case studies [AHRQ, 2014]

The CAHPS Improvement Guide [AHRQ]

Improving Patient Safety in Hospitals: A Resource List for Users of the AHRQ Hospital Survey on Patient Safety Culture [AHRQ]
This document contains references to Web sites that provide practical resources hospitals can use to implement changes to improve patient safety culture and patient safety.

Standards for Quality Improvement Reporting Excellence [SQUIRE]

Designing and growing innovation: a case study [State Services Commission study of Canterbury District Health Board]

Experience Based Co-Design Toolkit [Kings Fund]

Health Service Co-Design Toolkit [Waitemata DHB, NZ]

Creative Approaches to Problem Solving: Methods Toolkit - [Q Improvement]
A fabulous free toolkit of 25 methods for creative problem solving. There are many of Helen Bevan's favourite tools here, all well explained & organised by objectives

Co-design: shared perspectives on authentic co-design: putting consumers and carers at the center of mental health reform (Co-design Initiative, 2016)

The quest for integrated health and social care: a case study in Canterbury, New Zealand [The Kings Fund]

Stewarding regional health transformation: a guide for changemakers [ReThink Health, 2015]

Performance Improvement Framework [NZ State Services Commission]

Who's who in healthcare sustainability? [Counties Manukau Health]

 see also

 

Case Studies, Posters and Examples of Innovative Practice:
NHS Improving QualityNHS Scotland


 

see also

 

Value-Based Health Care

 

Value-based health care
Harvard Business Review

Based on the research of Professor Michael Porter, Value-Based Health Care is a framework for restructuring health care systems around the globe with the overarching goal of value for patients.

Value-based health care is one of the most important topics in health care transformation today. Value-based approaches to organizing care are widely touted as critical to improving the health outcomes of patients worldwide and controlling runaway health care costs. Value-based health care's central tenant is that the overarching principle in redesigning health care delivery systems must be value for patients. We define value as the outcomes that matter to patients and the costs to achieve those outcomes.

 

There are six major elements that are necessary in a truly value-based system:
  1. Organize Care Around Medical Conditions
    Care delivery is organized around patients' medical conditions or segments of the population.

  2. Measure Outcomes & Cost for Every Patient
    Outcomes and cost are measured for every patient.
  3. Aligning Reimbursement with Value
    Reimbursement models that reward both better outcomes and efficiency of care, such as bundled payments.

  4. Systems Integration
    Regional delivery of care organized around matching the correct provider, treatment, and setting.

  5. Geography of Care
    National centers of excellence providing care for exceedingly complex patients.

  6. Information Technology
    An information technology system designed to support the major elements of the agenda.
 

Defining Value-based Healthcare in the NHS
Centre for Evidence-base Medicine (2019)

"Value-based healthcare is the equitable, sustainable and transparent use of the available resources to achieve better outcomes and experiences for every person."

‘Value’ is gaining prominence in healthcare systems facing increased demand for services with limited resources. However, value-based healthcare has not yet been embraced as part of the everyday language and business of the NHS in the way that evidence-based healthcare has.

The absence of an agreed definition of ‘value-based healthcare’ in the NHS, the lack of skills required to deliver value-based healthcare and a clear understanding of the barriers to effective development and implementation inhibits the health system in addressing problems such as overdiagnosis, too much medicine, poor allocation of resources and the introduction of inadequately evidenced technologies

This report sets out a route to defining value-based healthcare in the NHS, an assessment of the barriers to its development, and an understanding of what skills and training would support implementation. A stakeholder workshop informs the report with patients and leaders across the NHS and value sector.

 

Approaches to better value: improving quality and cost
The KingsFund, 2018

  • The NHS is increasingly focusing on how it can improve the value of its Services, to deliver the highest quality health outcomes for patients at the lowest possible cost.
  • This report shares learning and insight from three NHS hospital trusts that have developed organisation-wide strategies for value improvement. It draws on interviews, roundtables and site visits with senior leaders in the NHS who are committed to developing better value services.
  • Our report suggests a wide variety of approaches are being taken to improve value in the NHS. These include top-down programmes that focus on a wide range of clinical services from their inception, to value improvement strategies that are more organically grown from a few individual services until they cover a wider breath of hospital-based care.
  • While there are differences in how organisations are approaching value improvement, there are also several common conditions for success. These include fidelity to a clearly defined strategy that brings the various strands of value improvement work together; recognition that value improvement is a long-term commitment that will require considerable staff time and resources; and a new leadership approach that requires continuous engagement with frontline clinicians and managers.

Value-Based Healthcare Toolkit
Canadian Foundation for Healthcare Improvement: 2020

Value-Based Healthcare (VBHC) is becoming a leading approach to improving patient and health system outcomes around the world. It is one-way of organizing healthcare to transform health outcomes.

VBHC is about linking the dollars spent to outcomes that matter to patients, rather than to the volumes of services, processes or products that may or may not achieve those outcomes.

VBHC aims to deliver services that are high value, scale back or drop those that do not, and/or re-balance the mix of services to improve the ratio of outcomes to overall costs. The goal is better outcomes at the same or lower total cost.

The purpose of this toolkit is to provide information and guidance to those who are interested in learning about value-based healthcare (VBHC); those who are thinking about implementing it; and those who are ready to assess and improve their current VBHC initiatives.

Implementing Value-Based Health Care in Europe: Handbook for Pioneers
EIT Health, 2020

VBHC provides a methodology for measurable health and care outcomes that make the biggest difference to patients, while driving cost efficiencies within health services.

The EIT Health handbook and framework explores insights from pioneers in the field and defines the key steps critical to implementing VBHC in health services. Directed by Professor Gregory Katz, Chair of Innovation & Value in Health at the University of Paris School of Medicine, it aims to help health care providers fully realise the opportunity presented by VBHC and drive forward a medical culture shift in Europe.

 

Value-based healthcare - what is it and can it work in New Zealand?
HiNZ, 2018

Value-based healthcare drives accountability for outcomes and creates incentives for improving patient outcomes at lower costs. What would it take to move to this focus on quality, outcome and performance in our healthcare funding?


What is the future for value-based healthcare?
Deloitte, 2020

Across Europe there have there are distinct patterns of VBHC adoption with key therapy areas like oncology and rare diseases leading the way. In early adopter countries. VBHC is underpinned by system and policy leadership, supported by access to relevant datasets. However, there are a number of common reasons why VBHC has not yet been adopted at scale. We consider each of these reasons and identify potential catalysts to help organisations realise the true potential of VBHC.


Value-Based Healthcare in Practice: A Systematic Review
Journal of Healthcare Management , 2021

Value-based initiatives are growing in importance as strategic models of healthcare management, prompting the need for an in-depth exploration of their outcome measures. This systematic review aimed to identify measures that are being used in the application of the value agenda. Multiple electronic databases (PubMed/MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials) were searched. Eligible studies reported various implementations of value-based healthcare initiatives. A qualitative approach was used to analyze their outcome measurements. Outcomes were classified according to a tier-level hierarchy. In a radar chart, we compared literature to cases from Harvard Business Publishing. The value agenda effect reported was described in terms of its impact on each domain of the value equation. A total of 7,195 records were retrieved; 47 studies were included. Forty studies used electronic health record systems for data origin. Only 16 used patient-reported outcome surveys to cover outcome tiers that are important to patients, and 3 reported outcomes to all 6 levels of our outcome measures hierarchy. A considerable proportion of the studies (36%) reported results that contributed to value-based financial outcomes focused on cost savings. However, a gap remains in measuring outcomes that matter to patients. A more complete application of the value agenda by health organizations requires advances in technology and culture change management.

The Strategy That Will Fix Health Care 
Michael Porter and Thomas Lee, Harvard Business Review 2013

Based on the 2006 book by Teisberg and Porter ‘Redefining Health Care’ this HBR paper describes how the health system needs to make value the overarching goal of the health system, shifting the focus from volume to value or improving the outcomes that matter to patients relative to the cost of achieving those outcomes. The strategic agenda is based on six interdependent components: organizing around patients’ medical condition, measuring costs and outcomes for every patient, developing bundled prices for the full care cycle, integrating care across separate facilities, expanding geographic reach and building an enabling IT platform.

Value in Healthcare Laying the Foundation for Health System Transformation 2017
World Economic Forum in collaboration with The Boston Consulting Group

Value in Healthcare has been an ongoing project led by the World Economic Forum and more recently the Global coalition for Value in Healthcare has been established. This paper from 2017 described the foundation for health system transformation including the foundational principles (health outcomes that matter to patients and the costs across the full cycle of care, the identification of clearly defined population segments, the development of segment-specific interventions) and key enablers (informatics; benchmarking, research and tools; payments that help to improve patient value; new roles and organizational models) and public policy that shape the healthcare sector’s legal and regulatory environment. There are a range of other papers in the series available on the Global Coalition’s website here.

Value-based healthcare: A global assessment, 2016
The Economist Intelligence Unit

The Economist Intelligence Unit has published a number of case studies and policy papers and also conducted this study on value-based healthcare alignment across 25 countries - a qualitative study across four domains of enabling context, policies and institution in healthcare; measuring outcomes and costs; integrated and patient-focused care and outcome-based payment approach.

Value Based Health Care: Setting the scene for Australia
Deeble Institute issues brief, no 31, 2019

Established by the Australian Healthcare and Hospitals Association in 2019, the Australian Centre for Value-Based Health Care is pursing the creation of a system where health care is funded and delivered with a prime focus on outcomes achieved at an affordable cost for patients and the health system.

Victorian Dental Health Services
*video presentation

Dental Health Services Victorian won the 2019 European Value Based Health Care Europe primary care award. This is a link to a short presentation in the Australian Health Journal and provides insight into the challenges of implementing VBHC and also some of their early successes with decreases in failure to attend rates, dentists practicing at the top of their scope, increased preventative interventions.

The Diabeter

Established in 2006, the Dutch clinic network Diabeter has been a pioneer in value-based diabetes care, focusing on e-health solutions, delivering individualized, comprehensive care and supporting self care management. This website contains information about Diabeter and a white paper by BCG that describes how they have implemented the six components of the Porter value agenda.

How Dutch Hospitals Make Value-Based Health Care Work
A Boston Consulting Group case study

This describes how Santeon, a Dutch network of hospitals, began implementing VVBHC in 2015 among five patient groups with breast cancer, prostate cancer, lung cancer, stroke and hip arthritis. It describes the infrastructure, governance and approach to measurement and suggests key lessons for other hospitals (eg develop common understanding of value, start small and be pragmatic, build a safe learning environment, have medical professionals take the lead, implement with the patient). Breast Cancer is the most advanced group and they reduced reoperations due to positive surgical margins by 17%, postop complications after lumpectomy by 27%.

A case study by All. Can, an international multi-stakeholder initiative working to improve the efficiency of cancer care

The Martini-Klink in Germany is the biggest specialist prostate cancer centre worldwide (website here). This case study describes how they systematically measure the quality of care using outcomes that are most relevant to patients. Examples include rates of incontinence and erectile dysfunction following treatment. These data are shared with the healthcare professionals at the clinic to continually revise and improve care.

The European Commission report on defining value.

The European Commission produced a report on effective ways of investing in health and adopted an opinion on defining value in “value-based health care”. They proposed to define VBHC as a comprehensive concept built on four value-pillars: appropriate care to achieve patients’ personal goals (personal value), achievement of best possible outcomes with available resources (technical value), equitable resource distribution across all patient groups (allocative value) and contribution of healthcare to social participation and connectedness (societal value).

A Queensland Health video describing the importance of VBHC

This is a Metro North HHS video that reinforces the importance of optimal care pathways and guidelines and collecting data on the outcomes that matter to patients through the story of Peter. He is a hypothetical character with prostate cancer who received prostate surgery (at a cost of $21,000 and with a reduction in the quality of his life due to unwanted outcomes of incontinence and erectile dysfunction) rather than the recommended approach of regular monitoring for men with low risk prostate cancer.

 

 

Selected learning opportunities

 

Improving Together
Improving Together is a national learning programme that focusses on quality improvement for people delivering education, social services and health services. You can find out how improvement methodologies accelerate learning and innovation, and how it can be applied to improve the quality of social service delivery in New Zealand.

Improvement Knowledge and Skills Guide [ HSE, Ireland]
This guide will help to support the ongoing learning and professional development of all staff both clinical and non-clinical by providing a list of improvement knowledge and skills which can help to educate, train and guide staff on how to deliver improvement in the health service.

LEAN Thinking
LEAN Thinking is a methodology that will help you improve quality of care, increase efficiency of processes, and identify and eliminate waste. LEAN Thinking evolved in the manufacturing industry but is now routinely applied in the health sector. This course introduces the LEAN methodology and a number of associated tools to implement the methodology in your work environment.

Lifehack Resource Library
Guidelines and workshops to support design thinking to support better health outcomes. Lifehack is a space where people can come together to develop new approaches, projects and ventures, with young people at the centre of the process. We bridge backgrounds, skill sets and place, and empower young people and communities to redefine their own version of success. In short, Lifehack is the R&D ground for Youth Wellbeing interventions.

The School for Change Agents
Develop the skills to make a difference and create change in your organisation on this course targeted at health and care staff.

IHI Open School Video Library (videos)
The growing library of freely available IHI Open School videos is one way to learn from health care leaders and experts from around the world as they share bite-sized pearls of knowledge and advice. In the newly reorganized IHI Open School Video Library, browse by topics such as improvement capability; patient safety; person- and family-centered care; Triple Aim for populations; quality, cost, and value; and leadership.

Health Improvement Scotland QI Global Webex series
Hour long webinars from global leaders in health care transformation and innovation.

Risky Business
Exceptional talks sharing ideas on risk, culture, human performance, teams and leaders.

TedMed talks (videos)
TEDMED is the independently owned and operated health and medicine edition of the TED conference, dedicated to “ideas worth spreading.” TED Talks have been viewed online over two billion times around the world.
"TEDMED convenes and curates extraordinary people and ideas from all disciplines both inside and outside of medicine in pursuit of unexpected connections that accelerate innovation in health and medicine".

Stanford Centre for Professional Development: Innovation and Entrepreneurship Series
View online, without charge, webinars, seminars, and lectures presented by Stanford faculty, industry experts, and senior researchers.
see also Institute of Design at Stanford
A range of free resources, and learning experiences to develop design thinking. Includes a virtual "90 minute crash course in design thinking".

 


Staying current

 

Subscribe

Grey Matter
Research Review [NZ]
Health Improvement and Innovation Digest -
NZ Ministry of Health Library roundup of literature, research, tools and case studies
Health Roundtable Roundup
On the Radar [ACSQHC)
Health Quality & Safety Commission e-update

 

Follow (via twitter)


Health Affairs
Health Foundation
Health Quality and Safety Commission [NZ]
Health Research Council New Zealand [NZ]
Health Roundtable
Healthcare Improvement Scotland
Institute for Healthcare Improvement (IHI)
Ministry of Health (NZ)
National Institute for Health Innovation [NZ]
Nuffield Trust
Nursing Review New Zealand [NZ]
NZ Doctor [NZ]
Quality Watch [UK]
Research Review NZ [NZ]
TeamHQi [NZ]
The King's Fund

 


Innovation and improvement at Counties Manukau Health & Ko Awatea

 

Quality Improvement at Counties Manukau Health: A case study evaluation

 

Ko Awatea Publications

Health Transformation series

Creating Systems (Healthcare Transformation Book 1)
by David Galler , Jonathon Gray , Muir Gray [Kindle edition]
September 2015 LINK

Population Medicine (Healthcare Transformation Book 2)
by Jonathon Gray, Karina McHardy, Muir Gray  [Kindle edition]
June 2015 LINK

Creating Culture (Healthcare Transformation Book 3)
by Geraint Martin, Jonathon Gray, Mataroria Lyndon, Lynne Maher, Muir Gray [Kindle edition]
September 2015 LINK

Knowledge Management (Healthcare Transformation Book 4)
by Muir Gray , Jonathon Gray, Eli Rotenberg, Clare Nelson, Peter Murgatroyd & Lynne Armstrong [Kindle edition]
April 2017 LINK

Ko Awatea White Papers

 

Final Reports of Major Campaigns and Reports

Target CLAB Zero

20,000 days

Beyond 20,000 days

Handle the Jandal

Manaaki Hauora – Supporting Wellness

 

Evaluations and Joint Publications with HQSC

 

 

Ko Awatea Publications (articles, presentations etcetera) 

Health system and service level improvement

2022

2021

2020

2019

2018

2017

 2016

 2015

  2014

 2013

2012

 

The Medicine Stories Project

The Medicine Stories Project collection (PDF, 5.6 MB)

 

 Expert Views 

 

*external website


 

New Zealand

Ko Awatea [NZ]
Counties Manukau Health's centre for innovation and improvement

i3 [NZ]

Waitemata 's Instite for Innovation and Improvement
Publications, Resources,  and Projects

The National Institute of Health Innovation [NZ]
At NIHI we measure our success by our contribution to improving people’s health in New Zealand and around the globe.  We discover, develop, test and deliver innovative approaches to today’s most pressing health problems.  Our work is focused on preventing disease, improving people’s health, reducing health inequities and enabling the delivery of more effective and equitable healthcare.  We provide independent scientific evidence that supports individuals, communities, clinicians and policymakers.  Supported by The University of Auckland and Auckland UniServices Limited infrastructures, we are experts in providing researchers with complex project management, IT, data management and analytics support, delivery of commercial health projects and commercialisation/deployment of health initiatives.

Health Improvement and Innovation Resource Centre (HIIRC) [NZ]
* ceased operation 1 July 2015.  Archive only.
Improvement and innovation is occurring throughout New Zealand’s health care system. The HIIRC supported this by providing: an extensive knowledge library of literature directories of individuals and organisations access to improvement projects, tools and initiatives the latest news, events and innovations.  Whilst the site is no longer being updated the Ministry of Health library continues to curate and disseminate the Health Improvement and Innovation Resource Centre Digest .

** Archives of resources from the HIIRC site including project initaitves and case studies can be viewed as follows:
Hospital productivity
Maori health innovation
Primary care
Quality improvement
Improved access to elective surgery
More health and diabetes checks
Better help for smokers to quit
Increased immunisation
Shorter stays in ED
Faster cancer treatment


Health Innovation Hub [NZ]
Confidentially and alongside the clinicians, we provide industry with access to clinicians and their new ideas. We also provide innovative clinicians with advice on product design and health innovation funding options.

Health Quality and Safety Commission [NZ]
The Health Quality & Safety Commission works with health professionals, patients and consumers across health and disability services to improve the quality and safety of care. A range of resources including: Open Book - reports to alert providers to the key findings of adverse event reviews. The reports emphasise the changes implemented to stop the event happening again.

See also Resources for providers starting quality improvement projects [primary care]

Health Research Council of New Zealand [NZ]
The HRC supports research that has the potential to improve health outcomes and delivery of healthcare, and to produce economic gain for New Zealand.

Health Roundtable [NZ / Aus.]
We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to:
Provide opportunities for health executives to learn how to achieve Best Practice in their organisations

Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices

Promote interstate and international collaboration and networking amongst health organisation executives

Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address.

89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis.

Telehealth Resource Centre [NZ]
Brings together information about the various regulations and guidelines that apply to telehealth as well as explaining services the centre provides like free on-site visits and education workshops. Includes case studies and resources to support implementation.


Innovation hubs (international)


International Society for Quality in Health Care (ISQua)
ISQua's mission is to inspire, promote and support continuous improvement in the safety and quality of health care worldwide.

WHO Patient Safety portal
"Adverse events may result from problems in practice, products, procedures or systems. Patient safety improvements demand a complex system-wide effort, involving a wide range of actions in performance improvement, environmental safety and risk management, including infection control, safe use of medicines, equipment safety, safe clinical practice and safe environment of care"

World Innovation Summit for Health (WISH)
A global healthcare community dedicated to capturing and disseminating the best evidence-based ideas in healthcare, providing global solutions that will save both lives and much needed resources.

 

Australia

 

Australian Centre for Health Innovation [Aus.]
The Australian Centre for Health Innovation (CHI) connects diverse health, policy and industry communities to more effectively address the changing needs of healthcare and improve patient experience.

Australian Commission on Quality and Safety in HealthCare [Aus.]
The Australian Commission on Safety and Quality in Health Care (the Commission) was created by Health Ministers in 2006, and funded by all governments on a cost sharing basis, to lead and coordinate health care safety and quality improvements in Australia.

Australian Institute of Health Innovation [Aus.]
We are leading researchers investigating many aspects of health care. We are a major national resource for many people whose work is intrinsic to strengthening health systems, organisations and services.

ACI: NSW Agency for Clinical Innovation - see also the ACI Innovation Exchange [Aus.]
The Agency for Clinical Innovation (ACI) works with clinicians, consumers and managers to design and promote better healthcare for NSW.

Clinical Excellence Commission [Aus.]
The Clinical Excellence Commission (CEC) is responsible for leading safety and quality improvement in the NSW public health system. It was established in 2004 to promote and support improved clinical care, safety and quality across NSW.

Australasian Association for Quality in Health Care [Aus.]
It is a member-driven, not-for-profit organisation served by a volunteer Council comprised of representatives from all Australian States and Territories and New Zealand.

Health Issues Centre [Aus.]
We support and inform consumers and the health sector to partner for health care improvements.

 

United Kingdom

 
Advancing Quality Alliance (AQuA)
Is a NHS health and care quality improvement organisation who are at the forefront of transforming the safety and quality of healthcare.

AHSN Atlas of Solutions in Healthcare
 he AHSN Atlas is an online resource that shares some of the very best examples from across the Academic Health Science Networks of how to spread high impact innovation across the health and care system.

Cochrane [UK]
We are a global independent network of researchers, professionals, patients, carers, and people interested in health.

Healthcare Improvement Scotland [UK]
We produce a range of resources from evidence based reports to best practice and improvement guides. All our resources are designed to support healthcare improvement.

Healthcare Quality improvement Partnership [UK]
The Healthcare Quality Improvement Partnership (HQIP) was established in April 2008 to promote quality in healthcare, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales.

The Health Foundation [UK]
The Health Foundation is an independent charity working to improve the quality of health care in the UK. We are here to support people working in health care practice and policy to make lasting improvements to health services. We carry out research and in-depth policy analysis, run improvement programmes to put ideas into practice in the NHS, support and develop leaders and share evidence to encourage wider change.
see also Improvement Research Institute [UK]

The Health Innovation Assessment Portal (HIAP-Scotland)
The Health Innovation Assessment Portal (HIAP-Scotland) to encourage prospective providers of new and/or innovative products and solutions to put them forward. This will allow NHSScotland to assess how the solution might support NHSScotland's strategic aims, and what the associated costs and benefits would be

Health Quality Improvement Partnership [UK]
The Healthcare Quality Improvement Partnership (HQIP) is an independent organisation led by the Academy of Medical Royal Colleges, The Royal College of Nursing and National Voices. We were established in April 2008 to promote quality in healthcare, and in particular to increase the impact that clinical audit has on healthcare quality improvement.

Institute of Global Health innovation [UK - Imperial College London]
The Institute of Global Health Innovation (IGHI) works to design & diffuse high impact global healthcare innovations and to reduce health inequalities worldwide.

NHS Scotland, Quality Improvement Hub [UK]
Includes a section on quality and efficieny supporting the business case for safety.

The Nuffield Trust [UK]
The Nuffield Trust is an authoritative and independent source of evidence-based research and policy analysis for improving health care in the UK.

Quality Watch
A joint research programme of the Nuffield Trust and the Health Foundation monitoring how the quality of health and social care is changing over time. Highlights areas where improvement is possible.

Royal College of Emergency Medicine QI Resources [UK]
This page collates some of the most useful quality improvement resources for EDs.

Scottish Health Innovations Ltd. [UK]
Scottish Health Innovations Ltd works in partnership with NHSScotland to protect and develop new innovations that come from healthcare professionals.

Scottish Patient Safety Programme [UK]
National initiative that aims to improve the safety and reliability of healthcare and reduce harm, whenever care is delivered.

NHS Scotland Quality Improvement Hub [UK]
Contains resources, case studies, and networks for knowledge sharing.

The King's Fund [UK]
The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate.

THIS.Institute - The Healthcare Improvement Studies Institute [UK]
At THIS Institute we have an important goal: To strengthen the evidence-base for improving healthcare. Creating an evidence-base that supports replicable and scalable improvements to healthcare delivery and patient experiences.  Working in partnership with patients and NHS staff throughout the UK, we’re boosting research activity to provide more clarity on what works in improving healthcare, what doesn’t, and why. 

NHS Impact

NHS Impact is the new, single, shared NHS improvement approach. By creating the right conditions for continuous improvement and high performance, systems and organisations can respond to today's challenges, deliver better care for patients and give better outcomes for communities.  Includes a library of useful improvement resources.

 

United States

100 Million Healthier Lives [US]
100 Million Healthier Lives is an unprecedented collaboration of change agents who are fundamentally transforming the way we think and act to improve health, wellbeing and equity.
Initiatives:
SCALE 1.0: Becoming Communities of Solutions SCALE 1.0: The first phase of Spreading Community Accelerators through Learning and Evaluation (SCALE 1.0, January 2015 – January 2017) supported 24 communities across 21 states in the U.S. to accelerate their community transformation journey toward a Culture of Health. These 24 communities, who worked on a variety of health, wellbeing, and equity topics, went on to support 43 additional communities in a program called Pathway to Pacesetters.
Key lessons learned in SCALE 1.0 can be found in the following 5 synthesis reports:
1.Overview of SCALE & a Community of Solutions
2.Foundations of a Community of Solutions
3.Engaging Community Residents with Lived Experience
4.Leading for Abundance: Approach to Generative Sustainability
5.Using Improvement Methods & Design Thinking to Guide Action

Agency for Healthcare Research & Quality (AHRQ) [US]
The Agency for Healthcare Research and Quality's (AHRQ) mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used.

see also AHRQ Innovations Exchange
The Innovations Exchange is expanding efforts to scale up and spread innovations by sponsoring three Learning Communities (LCs) focused on the following high-priority topic areas: “Advancing the Practice of Patient- and Family-Centered Care in Hospitals,” “Reducing Non-Urgent Emergency Services,” and “Promoting Medication Therapy Management for At-Risk Populations.”

Centre for Health Care Innovation [US: Penn Medicine]
The Penn Medicine Center for Health Care Innovation facilitates the rapid, disciplined development, testing and implementation of new strategies to reimagine health care delivery for dramatically better value and patient outcomes.

The Center for Health Organization Transformation
The Center for Health Organization Transformation, or CHOT, is an industry-university cooperative research center (I/UCRC) funded by the National Science Foundation and health organizations to conduct research supporting major management, clinical, and information technology innovations in healthcare.

Health Care Improvement Foundation [US]
The Health Care Improvement Foundation (HCIF), was founded to support a responsive, coordinated health care delivery system that fulfills the needs of patients and consumers, and achieves better health. Through large-scale collaboration, HCIF works with health systems, community based organizations, payors and a variety of other stakeholders to find solutions to complex healthcare challenges, which any one stakeholder could not achieve alone.

Healthy Mendocino Promising Practices Database
The Promising Practices database informs professionals and community members about documented approaches to improving community health and quality of life. The ultimate goal is to support the systematic adoption, implementation, and evaluation of successful programs, practices, and policy changes. The database provides carefully reviewed, documented, and ranked practices that range from good ideas to evidence-based practices.

Improvement Science Learning Centre [US]
Developed by Brandon Bennett this curated collection of resources includes eLearning Modules, Videos, and a range of tools, guides and frameworks.

Institute for Health Care Improvement [IHI] [US]
The Institute for Healthcare Improvement (IHI), an independent not-for-profit organization based in Cambridge, Massachusetts, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide.

Institute for Healthcare Optimization [US]
An independent not-for-profit 501(c)(3) research, education and service organization focused on bringing the science and practice of operations management to healthcare delivery.

The Commonwealth Fund [US]
The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

Mayo Clinic's Centre for Innovation [US]
Mayo Clinic's Center for Innovation fuses design principles with the scientific method to uncover human needs in the health care environment, which include empathy, creativity, systems thinking and a human-centered focus.

National Academies of Sciences, Engineering and Medicine: Health and Medicine Division [US]
HMD’s aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely.

National Patient Safety Foundation [US]
The National Patient Safety Foundation’s vision is to create a world where patients and those who care for them are free from harm. A central voice for patient safety since 1997, NPSF partners with patients and families, the health care community, and key stakeholders to advance patient safety and health care workforce safety and disseminate strategies to prevent harm.

Network for Regional Healthcare Improvement [US]
The Network for Regional Healthcare Improvement (NRHI) is a national organization representing over thirty member Regional Health Improvement Collaboratives (RHICs). These multi-stakeholder organizations are working in their regions and collaborating across regions to transform the healthcare delivery system and achieve the Triple Aim: improving the patient experience of care, including quality and satisfaction; improving the health of populations; and reducing the per-capita cost of healthcare.

ReThink Health [US]
We work with visionary leaders to transform health at the regional level – their neighborhoods, cities, counties, or states. Our hope is that by demonstrating regional success, we inspire transformation across the country.

The Beryl Institute
The Beryl Institute is the global community of practice and premier thought leader on improving the patient experience in healthcare. *Full text access to resources is limited to Beryl Institute members.

Choosing Wisely [US]
Choosing Wisely aims to promote conversations between clinicians and patients by helping patients choose care that is: Supported by evidenceNot duplicative of other tests or procedures already receivedFree from harmTruly necessary.

Planetree [US]
Planetree, Inc. is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to transform how care is delivered



Canada

 

Accreditation Canada: Leading Practices Database
Leading Practices Database is proud to serve as the new location for innovative practices from the former Health Council of Canada Health Innovation Portal. The Leading Practices Database fosters inter-organizational learning and harvesting of new ideas. It includes nearly 1,000 practices recognized as being particularly innovative and effective in improving quality.

Canadian Foundation for Healthcare Improvement
A not-for-profit organization funded by the Government of Canada, dedicated to accelerating healthcare improvement. CFHI plays a unique, pan-Canadian role in supporting healthcare delivery innovation. We help teams from different jurisdictions work together on common improvement priorities, providing opportunities to share and implement evidence-informed solutions across regions, provinces and territories.

Canadian Health Human Resources Network Innovations Portal
CHHRN partnered with the Health Council of Canada to initiate and populate a health human resources (HHR) innovations portal to showcase innovative approaches to health human resource issues.

Canadian Patient Safety Institute
The Canadian Patient Safety Institute (CPSI) is a not-for-profit organization that exists to raise awareness and facilitate implementation of ideas and best practices to achieve a transformation in patient safety.

The Change Foundation
An independent health policy think tank, The Change Foundation is changing the debate, practice and experience in Ontario health care, prompting system-wide, patient-centred improvements.

 

Africa


The Ubora Institute
Africa’s first institute dedicated to the use of improvement science to achieve the best in health and health care for the people of Africa. Launched in February 2016, Ubora, which means “excellence” in Swahili, has already lined up work in partnership with IHI to support health systems in Ghana and Liberia.

 

Last updated  12 February 2024

Health Information Resources for Allied Health Professionals

The Healt New Zealand - Te Whatu Ora Library is dedicated to supporting the information needs of Health New Zealand - Te Whatu Ora, its partners and community to achieve better health outcomes for the people of Aotearoa. RESEARCH - OPEN ACCESS ALLIED HEALTH RESOURCES Care research: palliative care knowledge network (Aus.) Bringing relevant evidence and quality information to palliative care. CIRRIE (Database of International Rehabilitation Research) The CIRRIE Database of International Rehabilitation Research currently contains over 145,000 citations of international rehabilitation research published between 1990 and the present. see also the International Encyclopedia of Rehabilitation OTCATs : Occupational Therapy Critically Appraised Topics Provides access to the full text critically appraised topics (or CATs) relating to Occupational Therapy. OTSeeker – Occupational therapy database - Contains abstracts of systematic reviews and randomised controlled trials relevant to occupational therapy PEDRO – Physiotherapy evidence database - Physiotherapy Evidence Database. PEDro is a free database of over 15,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy PsychBite PsycBITE is a database that catalogues studies of cognitive, behavioural and other treatments for psychological problems and issues occurring as a consequence of acquired brain impairment (ABI). These studies are rated for their methodological quality, evaluating various aspects of scientific rigour. The website gives clinicians, students and researchers free access to the PsycBITE database, thus enabling you to search for articles which might be relevant for your clinical practice or your research in a time-efficient way. REHABDATA REHABDATA, produced by the National Rehabilitation Information Center, is the leading literature database on disability and rehabilitation. The database describes over 80,000 documents covering physical, mental, and psychiatric disabilities, independent living, vocational rehabilitation, special education, assistive technology, law, employment, and other issues as they relate to people with disabilities. The collection spans 1956 to the present. SpeechBITE: Speech Pathology Database for Best Interventions and Treatment Efficacy Provides open access to a catalogue of Best Interventions and Treatment Efficacy across the scope of Speech Pathology practice. It is an evidence based practice initiative between the University of Sydney and Speech Pathology Australia. Social care online - Social Care Online is the UK’s largest database of information and research on all aspects of social care and social work.

The Healt New Zealand - Te Whatu Ora Library is dedicated to supporting the information needs of Health New Zealand - Te Whatu Ora, its partners and community to achieve better health outcomes for the people of Aotearoa.   

RESEARCH - OPEN ACCESS ALLIED HEALTH RESOURCES

 

Care research: palliative care knowledge network (Aus.)
Bringing relevant evidence and quality information to palliative care.

CIRRIE (Database of International Rehabilitation Research)
The CIRRIE
Database of International Rehabilitation Research currently contains over 145,000 citations of international rehabilitation research published between 1990 and the present.  see also the International Encyclopedia of Rehabilitation

OTCATs : Occupational Therapy Critically Appraised Topics
Provides access to the full text critically appraised topics (or CATs) relating to Occupational Therapy.

OTSeeker – Occupational therapy database -  
Contains abstracts of systematic reviews and randomised controlled trials relevant to occupational therapy

PEDRO – Physiotherapy evidence database - Physiotherapy Evidence Database. PEDro is a free database of over 15,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy

PsychBite
PsycBITE is a database that catalogues studies of cognitive, behavioural and other treatments for psychological problems and issues occurring as a consequence of acquired brain impairment (ABI). These studies are rated for their methodological quality, evaluating various aspects of scientific rigour.  The website gives clinicians, students and researchers free access to the PsycBITE database, thus enabling you to search for articles which might be relevant for your clinical practice or your research in a time-efficient way.

REHABDATA
REHABDATA, produced by the National Rehabilitation Information Center, is the leading literature database on disability and rehabilitation. The database describes over 80,000 documents covering physical, mental, and psychiatric disabilities, independent living, vocational rehabilitation, special education, assistive technology, law, employment, and other issues as they relate to people with disabilities. The collection spans 1956 to the present.

SpeechBITE: Speech Pathology Database for Best Interventions and Treatment Efficacy
Provides open access to a catalogue of Best Interventions and Treatment Efficacy across the scope of Speech Pathology practice. It is an evidence based practice initiative between the University of Sydney and Speech Pathology Australia.

Social care online -
Social Care Online is the UK’s largest database of information and research on all aspects of social care and social work.

Pacific Health Clearinghouse: Research, Information and Resources

Introduction Data and Statistics Selected Databases Selected Journals Selected Texts Pacific Health Organisations and Websites Introduction Pacific Health Research Guidelines . Health Research Council of New Zealand (2014) see also Cochrane Library: Special Collections. Health of indigenous peoples see also 'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015] see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019) see also Ministry of Health Library: Key Resources - Pacific Health Co-designing health research in Aotearoa New Zealand (2024) Co-designing health research in Aotearoa New Zealand describes a Kaupapa Māori evaluation of five Healthier Lives’ projects. The report outlines the elements needed for authentic co-design of health research with Māori and Pacific communities. The accompanying short guide summarises the lessons learnt from this evaluation and features a conceptual ladder – the Co-design Research Integrity Poutama – which portrays and defines different levels of co-design. Data and Statistics National. Ministry of Health Pacific health data and statistics (various) Tupu Ola Moui: Pacific Health Chart Book (2012) Tupu Ola Moui presents key indicators for Pacific health including socioeconomic determinants, risk and protective factors, health status, the health system and health service utilisation. It identifies areas where Pacific children and adults experience poorer health outcomes but also areas where improvements are being made. The Health of Pacific Adults and Children (2013) This brief paper presents key findings about the health and wellbeing of Pacific adults and children in 2011/12. These results come from the New Zealand Health Survey. HISO 10001:2017 Ethnicity Data Protocols (2017) The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector. Statistics New Zealand Pacific peoples Health and Pacific peoples in New Zealand: Pacific progress Pasifika Futures Pasifika People in NZ – How We are Doing? (May, 2017) This report provides a current statistical overview of Pacific peoples in New Zealand. It provides demographic and background data on the current state of Pacific participation in the areas of education, health, employment, income, housing, leadership, culture and community participation. Pacific health statistics onlive via Healthspace The atlas collects together health and wellbeing indicators for Pacific Island people. Most indicators compare outcomes for Pacific Island people’s with the total population: oral health of children immunisation coverage quit (smoking attempts) This atlas is a work in progress. Further data will be added as it becomes available. Wiki New Zealand health data clearinghouse Wiki New Zealand sources data from other organisations, including corporations, public repositories, government departments and academics. We import that data into a powerful open source database, we carefully validate it and standardise it. We then make the data available in a series of standardised forms, both human and machine-readable, with rich metadata about the sources, licensing and datatypes. Health Roundtable We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to: Provide opportunities for health executives to learn how to achieve Best Practice in their organisations Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices Promote interstate and international collaboration and networking amongst health organisation executives Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address. 89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis. Bula Sautu – A window on quality 2021: Pacific health in the year of COVID-19 | Bula Sautu – He mata kounga 2021: Hauora Pasifika i te tau COVID-19 Health Quality & Safety Commission The latest in our ongoing Window on Quality series focuses on health for Pacific peoples, from maternity to end of life, using a life-course approach, and includes expert perspectives on how the health system is performing for Pacific peoples. Te Whatu Ora Te Mana Ola: The Pacific Health Strategy (023) Te Mana Ola is the first-ever Pacific Health Strategy for Aotearoa New Zealand. Te Mana Ola sets the direction and long-term priorities to achieve equity in Pacific health and wellbeing outcomes over the next 10 years. Selected Databases Pubmed The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences. Hint: When searchingPubmed for Pacific content. Search on Pacific as a keyword combined with New Zealand as a MeSH subject heading. You can also use: Samoa; Tonga; Fiji; Polynesian as MeSH subject headings. Other MeSH subject headings that may be relevant to your search include: Culture ; Medicine, traditional; Health service, indigenous; Cultural competency; Population groups; Socioeconomic factors Index New Zealand General index to New Zealand journals and newspapers from 1987 onwards. Indexes some Pacific serials. NZResearch New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand Publications New Zealand Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present Selected Journals HRC Pacific News HRC Pacific News is produced twice a year and includes articles about Pacific health research and describes HRC funded Pacific health research outcomes. It also includes profiles of Pacific health researchers and teams and provides important information about Pacific health research funding opportunities. Le Va: Igniting communities, creating change Le Va's purpose is to create opportunities for pacific families and communities to flourish through embracing Pacific solutions. Journal of Indigenous Wellbeing The Journal of Indigenous Wellbeing is a peer-reviewed, open-access, scholarly online journal that shares multi-disciplinary indigenous knowledge and research experience amongst indigenous health professionals, leaders, researchers and community members. Journal of Primary Health Care see the regular 'Vaikoloa' articles about Pacific health in the Continuing Development section of each issue Pacific Health Dialog Pacific Health Dialog - The Journal of Community Health and Clinical Medicine for the Pacific Region is the only Medline listed medical and public health journal published specifically for Pacific island countries. see Pacific Mental Health and Addictions - Pacific Health Dialogue (2009) . From 2018 issues of the Pacific Health Dialogue will be published on a new site (free registration required) Pacific Journal of Reproductive Health The Pacific Journal of Reproductive Health is an independent publication of the Pacific Society for Reproductive Health (PSRH) Charitable Trust and administered by the Pacific Women's Health Research Group, University of Otago. The Journal provides a platform for evidence dissemination for researchers and clinicians from the Pacific and Pacific-rim countries. Pacific Health Review Every quarter Pacific Health Review features the latest research in the Pacific Health area. see also the Community and health page of SPASIFIKmag.com. Whanake: The Pacific Journal of Community Development Selected Texts Ministry of Health Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025 Pacific health resources (Various Ministry publications and other useful resources relating to Pacific health) 'Ala Mo'ui: Pathways to Pacific Health and Wellbeing 2014–2018 (2014) see also Progress reports: December 2018 Taeo o Tautai: Pacific public health workforce development implementation plan, 2012-2017 by Le Va ; Ministry of Health Primary care for Pacific people: A Pacific and health systems approach (2012) Ala mo'ui : pathways to Pacific health and wellbeing : 2010-2014. (2010) *NB: A new Pacific Health Action Plan is being developed as the successor to ’Ala Mo’ui: Pathways to Pacific Health and Wellbeing - see https://www.health.govt.nz/publication/pacific-health-and-disability-action-plan Faiva Ora National Pasifika Disability Plan 2016-2021 (2017) Pacific cultural competencies: literature review (2008) Improving quality of care for Pacific peoples (2008) Pacific child health (2008) Pacific peoples and mental health (2008) Pacific youth health (2008) Development of disability services for Pacific peoples (various) Pacific peoples’ experience of disability : a paper for the Pacific Health and Disability Action Plan review. (2008) Pacific patterns in primary health care: A comparison of Pacific and all patient visits to doctors (2005) Improving access to primary care for Maori, and Pacific peoples : A literature review commissioned by the Health Funding Authority (2000) see also National Ethical Standards for Health and Disability Research and Quality Improvement Other texts Tofa Saili: A review of evidence about health equity for Pacific Peoples in New Zealand' Pacific Perspectives (2019) This report describes the health equity issues faced by Pacific families and communities. The report highlights approaches based on Pacific values and the strengths of Pacific communities. It is informed by the Pacific Aotearoa vision (Ministry of Pacific Peoples, 2019). Delivering better outcomes together: Policies that reflect our diverse cultures Deloitte, 2018 The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all. Annotate Pacific knowledge bibliography (SuperU, 2018) The Determinants of Health for Pacific Children and Young People in New Zealand (2014) (Determinants of Health for Children and Young People). New Zealand Child and Youth Epidemiology Service (2016) The Pacific International Health Conference 2014: Abstracts and presenter profiles (2014) Organisational guidelines for Disability Support Services: Working with Pasifika people with disabilities and their families. Le Va (2014) This Is Home: A 2014 update on the state of Pasifika people in New Zealand. Salvation Army (2014) Evaluation of the implementation and immediate outcomes of the Primary Health Care Strategy: the experiences of Pacific PHOs and Pacific populations (2013) More than Churches, Rugby & Festivals: A Report on the State of Pasifika People in New Zealand. Salvation Army (2013) Pacific identities and well-being: cross-cultural perspectives by Margaret Nelson Agee ... [et al.] (editors). Otago University Press, 2013. Available from CM Health Library: WA305 A265 2013 Health and Pacific peoples in New Zealand - Pacific progress. Dept. of Statistics (2011) Tuatua Tika: straight talk about Pacific peoples and smoking. Tala Pasifika (2010) Best health outcomes for Pacific peoples: practice implications. A resource booklet prepared for the Medical Council of New Zealand by Mauri Ora Associates (2010) Sport and recreation in New Zealand Pasifika communities. Victoria University of Wellington (2010) Pearls unlimited: Pacific peoples and alcohol. ALAC (2009) The health of Pacific children and young people in New Zealand. NZ Child and Youth Epidemiology Service (2008) Pacific models of mental health service delivery in New Zealand. Health Research Council (2004) Selected Print texts available from Counties Manukau Health Library Pacific identities and well-being: cross-cultural perspectives (2013) - Location: WA305 A265 2013 Tangata o le Moana: New Zealand and the People of the Pacific (2012) - Location DU424.5 T34 2012 .. more texts from the University of Auckland library: Search terms: Pacific Islanders - Medical Care - New Zealand Pacific health Organisations and Websites Ministry of Health. Pacific health organisations and websites (directory) Health Research Council of New Zealand: Pacific health research Pacific Perspectives Pacific Perspectives is a consultancy focused on the New Zealand health and education sectors. see Publications and Research Papers Le Va New Zealand’s national coordination service and workforce development programme for Pacific mental health, addictions, disabilities and general health see Le Va's Publications and resources library Ara Taiohi: Pacific resources Ara Taiohi is the peak body for the youth sector, created by New Zealand Aotearoa Adolescent Health and Development (NZAAHD) and the National Youth Workers Network Aotearoa (NYWNA). Whanau Ora: Pasifika resources Pacific health: Community & Public Health: a division of the Canterbury District Health Board Auckland University: Pasifika health: research, information and resources (directory) University of Otago. Pacific Islands research and student support unit see PIRSSU List of Publications Auckland University of Technology. Centre for Pacific health and development research see Publications and Resources from the Pacific Islands Families Study Massey University Pacific Research and Policy Centre see Massey Pasifika research from the Scopus database 2007 Secretariat of the Pacific Community. Public health division. last updated 19 February 2024

Introduction
Data and Statistics
Selected Databases
Selected Journals
Selected Texts
Pacific Health Organisations and Websites

 

Introduction

Pacific Health Research Guidelines . Health Research Council of New Zealand (2014)

see also Cochrane Library: Special Collections. Health of indigenous peoples

see also  'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015]

see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019)

see also Ministry of Health Library: Key Resources - Pacific Health

Co-designing health research in Aotearoa New Zealand (2024)

Co-designing health research in Aotearoa New Zealand describes a Kaupapa Māori evaluation of five Healthier Lives’ projects. The report outlines the elements needed for authentic co-design of health research with Māori and Pacific communities.  The accompanying short guide summarises the lessons learnt from this evaluation and features a conceptual ladder – the Co-design Research Integrity Poutama – which portrays and defines different levels of co-design.


 Data and Statistics

National.  Ministry of Health

Pacific health data and statistics (various) 

Tupu Ola Moui: Pacific Health Chart Book (2012)
Tupu Ola Moui presents key indicators for Pacific health including socioeconomic determinants, risk and protective factors, health status, the health system and health service utilisation. It identifies areas where Pacific children and adults experience poorer health outcomes but also areas where improvements are being made. 

The Health of Pacific Adults and Children (2013)
This brief paper presents key findings about the health and wellbeing of Pacific adults and children in 2011/12. These results come from the New Zealand Health Survey.

HISO 10001:2017 Ethnicity Data Protocols (2017)
The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector.

 

Statistics New Zealand

Pacific peoples 

Health and Pacific peoples in New Zealand: Pacific progress

 

Pasifika Futures

Pasifika People in NZ – How We are Doing? (May, 2017)
This report provides a current statistical overview of Pacific peoples in New Zealand. It provides demographic and background data on the current state of Pacific participation in the areas of education, health, employment, income, housing, leadership, culture and community participation.

Pacific health statistics onlive via Healthspace
The atlas collects together health and wellbeing indicators for Pacific Island people. Most indicators compare outcomes for Pacific Island people’s with the total population:
oral health of children
immunisation coverage
quit (smoking attempts)
This atlas is a work in progress. Further data will be added as it becomes available.

Wiki New Zealand health data clearinghouse
Wiki New Zealand sources data from other organisations, including corporations, public repositories, government departments and academics.  We import that data into a powerful open source database, we carefully validate it and standardise it. We then make the data available in a series of standardised forms, both human and machine-readable, with rich metadata about the sources, licensing and datatypes.

Health Roundtable
We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to:
Provide opportunities for health executives to learn how to achieve Best Practice in their organisations
Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices
Promote interstate and international collaboration and networking amongst health organisation executives

Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address.

89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis.

 

Te Whatu Ora

Te Mana Ola: The Pacific Health Strategy (023)

Te Mana Ola is the first-ever Pacific Health Strategy for Aotearoa New Zealand. Te Mana Ola sets the direction and long-term priorities to achieve equity in Pacific health and wellbeing outcomes over the next 10 years.

 

 

Selected Databases

Pubmed
The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences.
Hint: When searchingPubmed for Pacific content.  Search on Pacific as a keyword combined with New Zealand as a MeSH subject heading. You can also use: Samoa; Tonga; Fiji; Polynesian as MeSH subject headings.
Other MeSH subject headings that may be relevant to your search include:
Culture ; Medicine, traditional; Health service, indigenous; Cultural competency; Population groups; Socioeconomic factors

Index New Zealand
General index to New Zealand journals and newspapers from 1987 onwards. Indexes some Pacific serials.

NZResearch
New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand

Publications New Zealand
Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present

 

Selected Journals

HRC Pacific News
HRC Pacific News is produced twice a year and includes articles about Pacific health research and describes HRC funded Pacific health research outcomes.  It also includes profiles of Pacific health researchers and teams and provides important information about Pacific health research funding opportunities. 

Le Va: Igniting communities, creating change
Le Va's purpose is to create opportunities for pacific families and communities to flourish through embracing Pacific solutions.

Journal of Indigenous Wellbeing
The Journal of Indigenous Wellbeing is a peer-reviewed, open-access, scholarly online journal that shares multi-disciplinary indigenous knowledge and research experience amongst indigenous health professionals, leaders, researchers and community members.

Journal of Primary Health Care
see the regular 'Vaikoloa' articles about Pacific health in the Continuing Development section of each issue

Pacific Health Dialog
Pacific Health Dialog - The Journal of Community Health and Clinical Medicine for the Pacific Region is the only Medline listed medical and public health journal published specifically for Pacific island countries. see Pacific Mental Health and Addictions  - Pacific Health Dialogue (2009) . From 2018 issues of the Pacific Health Dialogue will be published on a new site (free registration required)

Pacific Journal of Reproductive Health  
The Pacific Journal of Reproductive Health is an independent publication of the Pacific Society for Reproductive Health (PSRH) Charitable Trust and administered by the Pacific Women's Health Research Group, University of Otago. The Journal provides a platform for evidence dissemination for researchers and clinicians from the Pacific and Pacific-rim countries.

Pacific Health Review
Every quarter Pacific Health Review features the latest research in the Pacific Health area.

see also the Community and health page of SPASIFIKmag.com.

Whanake: The Pacific Journal of Community Development

 

Selected Texts

Ministry of Health

Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025

Pacific health resources (Various Ministry publications and other useful resources relating to Pacific health)

'Ala Mo'ui: Pathways to Pacific Health and Wellbeing 2014–2018 (2014)
see also Progress reports:
December 2018

Taeo o Tautai: Pacific public health workforce development implementation plan, 2012-2017 by Le Va ; Ministry of Health

Primary care for Pacific people: A Pacific and health systems approach  (2012)

Ala mo'ui : pathways to Pacific health and wellbeing : 2010-2014.  (2010) *NB: A new Pacific Health Action Plan is being developed as the successor to ’Ala Mo’ui: Pathways to Pacific Health and Wellbeing - see https://www.health.govt.nz/publication/pacific-health-and-disability-action-plan

Faiva Ora National Pasifika Disability Plan 2016-2021 (2017)

Pacific  cultural competencies:  literature review (2008)

Improving quality of care for Pacific peoples  (2008) 

Pacific child health  (2008)

Pacific peoples and mental health (2008)

Pacific youth health (2008)

Development of disability services for Pacific peoples (various)

Pacific peoples’ experience of disability : a paper for the Pacific Health and Disability Action Plan review.  (2008)

Pacific patterns in primary health care: A comparison of Pacific and all patient visits to doctors (2005)

Improving access to primary care for Maori, and Pacific peoples : A literature review commissioned by the Health Funding Authority (2000)

 

see also National Ethical Standards for Health and Disability Research and Quality Improvement

 

Other texts

Tofa Saili: A review of evidence about health equity for Pacific Peoples in New Zealand'
Pacific Perspectives (2019)
This report describes the health equity issues faced by Pacific families and communities. The report highlights approaches based on Pacific values and the strengths of Pacific communities. It is informed by the Pacific Aotearoa vision (Ministry of Pacific Peoples, 2019).

Delivering better outcomes together: Policies that reflect our diverse cultures
Deloitte, 2018
The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all.

Annotate Pacific knowledge bibliography (SuperU, 2018)

The Determinants of Health for Pacific Children and Young People in New Zealand (2014) (Determinants of Health for Children and Young People). New Zealand Child and Youth Epidemiology Service (2016)

The Pacific International Health Conference 2014: Abstracts and presenter profiles (2014)

Organisational guidelines for Disability Support Services: Working with Pasifika people with disabilities and their families.  Le Va (2014)

This Is Home: A 2014 update on the state of Pasifika people in New Zealand.  Salvation Army (2014)

Evaluation of the implementation and immediate outcomes of the Primary Health Care Strategy: the experiences of Pacific PHOs and Pacific populations (2013)

More than Churches, Rugby & Festivals: A Report on the State of Pasifika People in New Zealand. Salvation Army (2013)

Pacific identities and well-being: cross-cultural perspectives by Margaret Nelson Agee ... [et al.] (editors).  Otago University Press, 2013.  Available from CM Health Library: WA305 A265 2013 

Health and Pacific peoples in New Zealand - Pacific progress.  Dept. of Statistics (2011)

Tuatua Tika: straight talk about Pacific peoples and smoking. Tala Pasifika (2010)

Best health outcomes for Pacific peoples: practice implications.  A resource booklet prepared for the Medical Council of New Zealand by Mauri Ora Associates (2010)

Sport and recreation in New Zealand Pasifika communities. Victoria University of Wellington (2010)

Pearls unlimited: Pacific peoples and alcohol. ALAC (2009)

The health of Pacific children and young people in New Zealand. NZ Child and Youth Epidemiology Service (2008) 

Pacific models of mental health service delivery in New Zealand. Health Research Council (2004)

Selected Print texts available from Counties Manukau Health Library

  Pacific identities and well-being: cross-cultural perspectives (2013) - Location: WA305 A265 2013

  Tangata o le Moana: New Zealand and the People of the Pacific (2012) -  Location DU424.5  T34 2012

 .. more texts from the University of Auckland library:  Search terms: Pacific Islanders - Medical Care - New Zealand
 

 

Pacific health Organisations and Websites

Ministry of Health.  Pacific health organisations and websites (directory)

Health Research Council of New Zealand: Pacific health research

Pacific Perspectives
Pacific Perspectives is a consultancy focused on the New Zealand health and education sectors.
      see Publications and Research Papers

 

Le Va
New Zealand’s national coordination service and workforce development programme for Pacific mental health, addictions, disabilities and general health
        see Le Va's Publications and resources library

Ara Taiohi: Pacific resources
Ara Taiohi is the peak body for the youth sector, created by New Zealand Aotearoa Adolescent Health and Development (NZAAHD) and the National Youth Workers Network Aotearoa (NYWNA).

Whanau Ora: Pasifika resources

Pacific health: Community & Public Health: a division of the Canterbury District Health Board

Auckland University: Pasifika health: research, information and resources (directory) 

University of Otago.  Pacific Islands research and student support unit
        see PIRSSU List of Publications

Auckland University of Technology. Centre for Pacific health and development research
        see Publications and Resources from the Pacific Islands Families Study

Massey University Pacific Research and Policy Centre
        see  Massey Pasifika research from the Scopus database 2007 

Secretariat of the Pacific Community.  Public health division. 
      

last updated 19 February 2024

 

Maaori Health Clearinghouse: Research, Information and Resources

Introduction Data and Statistics Selected Databases Selected Journals Selected Texts Maaori Health Organisations and Websites Introduction Maaori Health website Provide leads and introduction to every topic relating to Maaori Health. Ministry of Health Treaty of Waitangi principles The principles of Te Tiriti o Waitangi, as articulated by the Courts and the Waitangi Tribunal, provide the framework for how we will meet our obligations under Te Tiriti in our day-to-day work. The 2019 Hauora report recommends the following principles for the primary health care system[4]. These principles are applicable to wider health and disability system. The principles that apply to our work are as follows. Tino rangatiratanga: The guarantee of tino rangatiratanga, which provides for Māori self-determination and mana motuhake in the design, delivery, and monitoring of health and disability services. Equity: The principle of equity, which requires the Crown to commit to achieving equitable health outcomes for Māori. Active protection: The principle of active protection, which requires the Crown to act, to the fullest extent practicable, to achieve equitable health outcomes for Māori. This includes ensuring that it, its agents, and its Treaty partner are well informed on the extent, and nature, of both Māori health outcomes and efforts to achieve Māori health equity. Options: The principle of options, which requires the Crown to provide for and properly resource kaupapa Māori health and disability services. Furthermore, the Crown is obliged to ensure that all health and disability services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care. Partnership: The principle of partnership, which requires the Crown and Māori to work in partnership in the governance, design, delivery, and monitoring of health and disability services. Māori must be co-designers, with the Crown, of the primary health system for Māori. 'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry' Waitangi Tribunal. 2019 "The Waitangi Tribunal said in a report released today that the Crown had breached the Treaty of Waitangi by failing to set up and run the primary health system in a way that reduced the gap between Maori and non-Maori health outcomes." He Korowai Oranga: Maaori Health Strategy "He Korowai Oranga is a living strategy. Updating this website with evidence, data and case studies will be integral activities in its second decade. Over time, this web-based strategy will become a ‘hub of innovation’ for Māori health." Pae Tū: Hauora Māori Strategy (2023) As part of the health system transformation a range of strategies have been developed to help guide our health system to achieve pae ora, healthy futures. One of those is Pae Tū: Hauora Māori Strategy. It has been produced by Manatū Hauora and Te Aka Whai Ora. Māori Health Priorities Report (2022) This Māori Health Priorities report draws focus to the biggest contributors to health loss and health inequity for Māori, and also represent the greatest potential for intervention. This report was commissioned by Te Aka Whai Ora to inform our positioning on the priorities for the interim New Zealand Health Plan (iNZHP) for Māori. He Korowai Oranga: Maaori Health Strategy (2014) "He Korowai Oranga is a living strategy. Updating this website with evidence, data and case studies will be integral activities in its second decade. Over time, this web-based strategy will become a ‘hub of innovation’ for Māori health." Equity of Health for Maaori: a framework Te ao Māori framework The Health Quality & Safety Commission has developed a te ao Māori framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards across Aotearoa New Zealand. The initial framework concept is shown below, followed by a brief description. The aim of the framework is to improve the quality of care afforded to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. There are two downloadable PDFs at the bottom of this page, which include the basic framework concept plus a backgrounder on how and why it was developed. We are currently developing resources to support providers with implementation of the framework and will publish them here in due course. We would like to acknowledge and thank our partner providers who gave their information freely in the hope that much-needed change could happen and be sustained over time. Te ao Māori framework concepts Wairuatanga The holistic nature of Māori health, which links physical illness to emotional and spiritual wellbeing. Hence wairuatanga is in the middle position of the framework, which makes culture a central focus in the design of services. The goal of wairuatanga is to embed tikanga Māori and cultural safety into the health system. Pātuitanga The growing and fostering of strong partnerships with Māori, which is fundamental to ensuring the right concepts are included in the design and delivery of services. Whānau Whānau need and improving health outcomes for whānau are the drivers to why services are created and designed. Rangatiratanga The inclusion of Māori leadership in decision-making processes when services are designed. Te ao Māori framework design Each of the outer sections have two koru representing tapu and noa. The haehae lines bind each section together and connect and interact with each other. The inside koru of each concept opens into wairuatanga, which allows wairuatanga to flow seamlessly throughout the entire framework. The outside koru opens into te ao Mārama. The pītau design on the edge of the outer sections represents new beginnings and is the interconnection between te ao Māori and te ao Mārama. Downloadable attachments Te ao Māori framework (356 KB, pdf) Te ao Māori framework background document (1.2 MB, pdf) Te Hiringa Hauora Research Framework ( e Hiringa Hauora. Health Promotions Agency) The Te Hiringa Hauora Research Framework is designed to guide and enable shared understanding of what best practice health promotion research in Aotearoa New Zealand is and what it seeks to achieve. This Framework presents a way of working at the interface of mātauranga Māori and Western science, using both knowledge systems to generate new knowledge and evidence that contribute towards healthy and decolonising futures for Māori, Pacific peoples, and all New Zealanders.” Source: Te Hiringa Hauora Guidelines for Researchers on Health Research Involving Maaori - Revised July 2010 Health Research Council. 'Māori Health Advancement Guidelines' (2019) Alignment with the Māori Health Advancement criterion as well as other assessment criteria will strengthen an application to the Health Research Council. Importantly, the new approach will give applicants clearer guidance and a framework in which they can contribute to improving Maori health, while enabling the HRC to clearly evaluate the degree to which its investment delivers on this objective. These guidelines support health researchers in describing how their proposed research fits within the criterion. see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019) The evaluation hikoi: a Maori overview of programme evaluation ( Te Ropu Whariki, 2009) This book aims to: • Provide the reader with an overview of the issues surrounding public health programme evaluation by and for Maori • Give examples of the range of approaches that might be useful • Highlight areas that evaluators may need to consider. There are many different models and frameworks that can be used to guide indigenous researchers. Our approach has been to grapple with what it means, as Maori, to carry out formative, process and impact evaluation. Co-designing health research in Aotearoa New Zealand (2024) Co-designing health research in Aotearoa New Zealand describes a Kaupapa Māori evaluation of five Healthier Lives’ projects. The report outlines the elements needed for authentic co-design of health research with Māori and Pacific communities. The accompanying short guide summarises the lessons learnt from this evaluation and features a conceptual ladder – the Co-design Research Integrity Poutama – which portrays and defines different levels of co-design. see also: Carlson, Teah, Helen Moewaka Barnes, and Tim McCreanor. "Kaupapa Māori evaluation: A collaborative journey." Evaluation Matters—He Take Tō Te Aromatawai 3 (2017): 67-99. Cram, Fiona, Kataraina Pipi, and Kirimatao Paipa. "Kaupapa Māori evaluation in Aotearoa New Zealand." New directions for evaluation 2018.159 (2018): 63-77. http://cjc-rcc.ucalgary.ca/index.php/cjpe/article/view/31085/25237 Evaluation and Research Committee Report on the SPEaR Best Practice Māori Guidelines Hui 2007 The Social Policy, Evaluation and Research Committee (SPEaR) advocates the need for kaupapa Māori principles, and sets out specific guidelines for “best practice approaches”. These guidelines are defined as five key principles of working with Māori, which are: “integrity, respect, responsiveness, competency and reciprocity.” Te Ara Tika - Guidelines for Maaori Research Ethics Te Pūtahitanga: A Tiriti–led Science-Policy Approach for Aotearoa New Zealand | Ngā Pae o te Māramatanga (2021) This paper examines the interface between science and policymaking and calls for a policy approach that is enabled by, and responsive to, Te Tiriti o Waitangi and Mātauranga Māori. For a science sector to have its greatest reach and impact for all citizens, it must demonstrate relevance, accessibility and inclusion. In Aotearoa, there has been concern about the exclusion of Māori and Pacific expertise from science advice and key decision-making roles. Te Tiriti offers a powerful framework for connecting systems and communities of knowledge in ways that are mutually beneficial and future focused. Māori Health Review A to Z guide The A to Z guide will provide you with direct access to over 300 articles on specific Māori health topics featured in Māori Health Review and other Ministry publications. Maaori Health on Health Navigator Improving Māori health is an important area of focus for all health services and providers within New Zealand. Here you can find a range of resources about Māori health including an overview, videos, apps and health information. see also Understanding Maaori Research Methodologies [podcast] see also Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research [NZMJ; 2017) Excellent health research is essential for good health outcomes, services and systems. Health research should also build towards equity and in doing so ensure that no one is left behind. As recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisational approach to this endeavour. However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work. In this viewpoint paper we provide an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori. We also describe an equity-based approach to responsiveness to Māori and highlight four key areas that require careful consideration, namely: (1) relevance to Māori; (2) Māori as participants; (3) promoting the Māori voice, and; (4) human tissue. Finally, we argue for greater engagement with responsiveness to Māori activities as part of our commitment to achieving equitable health outcomes. see also Bridging cultural perspectives (2018) This report describes the He Awa Whiria – Braided Rivers model of using Western science and mātauranga Māori knowledge side-by-side for research and evaluation in the social sector. Western science and methods are often given prominence over all other systems of knowledge. While Māori do well in society, there continues to be an over-representation of Māori in negative statistics. If the social sector is to achieve a research-based understanding of the underlying causes of this situation, we need to acknowledge a te ao Māori worldview. see also Tuku Iho Culture in Māori Health Service Provision (2019) This report provides critical understanding of the notion of culture, cultural safety, cultural competency and cultural fluency especially central to Māori health service provision in Aotearoa. see also Maaori Health Research on twitter https://twitter.com/maori_health see also Cochrane Library: Special Collections. Health of indigenous peoples. see also 'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015] seel also Ka hao te rangatahi: life course approaches in Aotearoa Expert panel. An expert panel explores how Maori researchers undertake life course research, analyse data and work with families, whanau and community (2018) see also Consolidated criteria for strengthening reporting of health research involving indigenous peoples: the CONSIDER statement. The CONSIDER statement is a collaborative synthesis and prioritization of national and international research statements and guidelines. The CONSIDER statement provides a checklist for the reporting of health research involving Indigenous peoples to strengthen research praxis and advance Indigenous health outcomes. see also Ministry of Health Library: Key Resources - Maori Health Data and Statistics National. Ministry of Health Maaori health data and stats: Statistical publications and data sets on Maaori health Wai 2575 Māori Health Trends Report data and resources (2019) The Ministry of Health’s Māori Health Insights team has produced the Māori Health Trends Report, to inform the Wai 2575 Health Services and Outcomes Kaupapa Inquiry (Wai 2575) Ngā Tikanga Paihere Ngā Tikanga Paihere draws on 10 tikanga (Te Ao Māori/Māori world concepts) to help you establish goals, boundaries, and principles that guide and inform your data practice. By asking yourself questions inspired by ngā tikanga at the beginning of your data use, Ngā Tikanga Paihere helps you: guide your safe, responsible, and culturally appropriate use of data ensure your data use is carefully considered ensure your data practices occur in good faith. HISO 10001:2017 Ethnicity Data Protocols (2017) The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector. Health system quality dashboard Health & Quality Safety Commission (NZ). In partnership with Te Tumu Whakarae, HQSC has developed a new specific Māori Health Equity Report, using distinct data. see also Te Mana Raraunga [ Māori Data Sovereignty Network ] " We advocate for Māori rights and interests in data to be protected as the world moves into an increasingly open data environment" What is Maori Data Sovereignty? Data Sovereignty typically refers to the understanding that data is subject to the laws of the nation within which it is stored. Indigenous Data Sovereignty perceives data as subject to the laws of the nation from which it is collected. Māori Data Sovereignty recognises that Māori data should be subject to Māori governance. Māori Data Sovereignty supports tribal sovereignty and the realisation of Maori and Iwi aspirations. Wai 2575 Māori Health Trends Report (2019) The Ministry of Health’s Māori Health Insights team has produced the Māori Health Trends Report, including several subject-specific modules, to inform the Wai 2575 Health Services and Outcomes Kaupapa Inquiry (Wai 2575). The report shows changes of Māori health over the years 1990–2015. Te Ao Mārama 2016 Here is an updated collection of our statistics about Māori well-being and development from a Māori perspective. It is available in te reo Māori: Tirohia tēnei whārangi i te reo Māori. ‘Te ao mārama’ is a Māori concept relating to wisdom and understanding. It derives from the myth in which Tāne separated his Sky Father Ranginui and Earth Mother Papatuānuku to create ‘te ao mārama’ or the world of light. This allowed Tāne and his brothers to grow and better understand the world around them. Statistics New Zealand collected information relating to Māori well-being in the 2013 Te Kupenga Survey. Since 2014, our annual survey Tatauranga Umanga Māori provides information about economic activity of Māori authorities. Tatau Kahukura: Māori Health Chart Book 2015 (3rd Edition) Presents a snapshot of the health of Māori compared with non-Māori. The chart book presents key indicators relating to the socioeconomic determinants of health, risk and protective factors for health, health status, health service use and the health system. Statistics New Zealand Maaori Health Maaori health and well being Te Kupenga Te Kupenga, a survey of Maaori well-being. Te Kupenga collected information on a wide range of topics to give an overall picture of the social, cultural, and economic well-being of Maaori in New Zealand. The survey also provides important information about the health of the Maaori language and culture. The first release of information from Te Kupenga 2013 provides overview statistics on four areas of Maaori cultural well-being: wairuatanga (spirituality) tikanga (Maaori customs and practices) te reo Maaori (the Maaori language) whanaungatanga (social connectedness). District Health Board Maaori Health Profiles 2015 District Health Board Maaori Health Profiles 2015 in Te Reo Maaori health statistics online via healthspace The atlas collects together health, behaviour and socio-economic indicators for Māori. Most indicators compare Māori outcomes with those of non-Māori: immunisation coverage oral health participation and attainment in science subjects (for students in years 11-13) quit (smoking) attempts risk behaviour (smoking/ gambling) intentional self-harm diabetes (crude rates derived from the virtual diabetes register) Wiki New Zealand health data clearinghouse Wiki New Zealand sources data from other organisations, including corporations, public repositories, government departments and academics. We import that data into a powerful open source database, we carefully validate it and standardise it. We then make the data available in a series of standardised forms, both human and machine-readable, with rich metadata about the sources, licensing and datatypes. Health Roundtable We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to: Provide opportunities for health executives to learn how to achieve Best Practice in their organisations Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices Promote interstate and international collaboration and networking amongst health organisation executives Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address. 89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis. Selected Databases Pubmed The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences. Hint: When searching Pubmed for Māori content. Search on Māori as a word in the title of the article. Other MeSH subject headings that may be relevant to your search include: Culture ; Medicine, traditional; Health service, indigenous; Cultural competency; Population groups; Socioeconomic factors Index New Zealand General index to New Zealand journals and newspapers from 1987 onwards. Indexes some Pacific serials. NZResearch New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand Publications New Zealand Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present Selected Journals e-Pānui Get the latest Maaori health research news in the HRC's new e-newsletter, e-Pānui Journal of Indigenous Wellbeing The Journal of Indigenous Wellbeing is a peer-reviewed, open-access, scholarly online journal that shares multi-disciplinary indigenous knowledge and research experience amongst indigenous health professionals, leaders, researchers and community members. Maaori Health Review Every quarter Maaori health review features the latest research in the Maaori health area MAI Journal: A Journal of Indigenous Scholarship The latest issue of MAI Journal: A New Zealand Journal of Indigenous Scholarship (Volume 2, 2) is now available. The theme of health and social wellbeing and the need to reduce Maaori health disparities features prominently in four of the articles in this issue. Pacific Health Dialog Pacific Health Dialog - The Journal of Community Health and Clinical Medicine for the Pacific Region is the only Medline listed medical and public health journal published specifically for Oceania. see Vol. 17 no. 1. (1999) Māori health in New Zealand Selected Texts Ministry of Health Maaori health publications. Ministry of Health publications on Māori health He Korowai Oranga: Māori Health Strategy sets the overarching framework that guides the Government and the health and disability to achieve the best health outcomes for Māori, with the overarching aim of pae ora – healthy futures for Māori. Whakamaua: Māori Health Action Plan 2020-2025 guides the Ministry, the whole health and disability system, and government to give effect to He Korowai Oranga. It sets out a suite of outcomes, objectives and priority areas for action that will contribute to the achievement of pae ora – healthy futures for Māori. Hui Whakaoranga is a series of hui focused on taking a generational approach to Māori health development and is a key part of the ongoing commitment to Whakamaua: Māori Health Action Plan 2020-2025. These hui provide a significant opportunity for iwi, hapū, Māori communities and the health and disability sector to connect, share aspirations, and set out milestones for achieving Pae Ora – healthy futures for Māori. This also involves exploring how to continue building effective partnerships and networks. Updated COVID-19 Māori Response Action Plan (2020) see also National Ethical Standards for Health and Disability Research and Quality Improvement District Health Boards DHB Maaori health profiles and health summaries District health boards (DHBs) are required to improve the health of Māori and reduce health disparities for Māori compared to other population groups in New Zealand. This page provides DHB Māori Health Profiles and DHB Māori Health Profile Summaries for all DHBs (bilingual in te reo Māori and English). The Independent Māori Statutory Board. Māori Value reports. The reports make up a platform for the Board’s work to support Māori wellbeing outcomes, as set out in the Schedule of Issues of Significance and Māori Plan (2017). The five value reports each represent a Māori value: Rangatiratanga, Manaakitanga, Kaitiakitanga, Whanaungatanga, Wairuatanga. They measure Māori wellbeing in line with Māori experience and from a strengths-based view. Other texts Creating a Māori Indigenous Model of Evaluation Founded on Māori Indigenous Values PhD Thesis: Māori Indigenous Evaluation, 2023 Abstract Values and evaluation inform and influence all aspects of our lives. However, what is evaluation, and how do evaluation methodologies influence outcomes? This research examines how evaluation systems express and reflect their designers' and developers' values, ideologies, social mores, and political worldviews. Māori values are known as ‘taonga’, cultural treasures that formed the basis of their evaluation approaches across all elements of societal life, including health, education, justice, and the economy. Over the last two hundred years, Māori evaluation systems have been denigrated and discredited through the process of colonisation. Eurocentric evaluation systems have been used as political tools to assess, measure, define, and control Māori and Indigenous communities worldwide. Regardless of such methods, Māori and Indigenous communities continue to bear the brunt of intergenerational trauma and suffer the burden of sociocultural, economic, and ecological inequities. We must then ask how Māori and Indigenous values and worldviews can improve evaluation Why are Māori Indigenous values-centred models of evaluation needed today? How can we gather and honour Mātauranga Māori to create a cohesive model of evaluation? Informed by Kaupapa Māori philosophies and praxis, this research spans the hinengaro/psyche, whānau/families, hapu/communities, iwi/nations, and Te Ao/global systems are integrated with the experiential knowledge of Māori and Indigenous evaluation specialists. The creation of Pou Kapua, the largest totem in Aotearoa, provided a unique Mātauranga Māori methodology to support the design of the Pou Mārama model of evaluation. Pou Mārama is a Māori values-centric approach that honours Te Tiriti o Waitangi and the kaingākau of Taha Wairua (spiritual and ethical harmony), Aroha (care and compassion), Mana (heartfelt commitment), Tiaki (protection and preservation), and Ora (intergenerational well-being). Through the Pou Mārama methodology, the principles of Whānaungatanga support respectful and collaborative relationships, and Manaakitanga encourages a complex adaptive systems approach. Kaitiakitanga translates interdisciplinary knowledge into creative and transformative solutions. Finally, Rangatiratanga focuses on demonstrating courageous leadership, supporting authentic measures of well-being, and achieving transformational outcomes - for our people and our planet. Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health (2021) This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing). Ngā Taero a Kupe: Whānau Māori experiences of in-hospital adverse events (2020) Health Quality & Safety Commission | Kupu Taurangi Hauora o Aotearoa The study found that whānau Māori had strong views about the way they were treated when accessing health care. For example, many whānau perceptions of the health care system was poor and as a result whānau were reluctant to access care unless absolutely necessary. The need for change is critical to the quality of care that whānau Māori experience within the Aotearoa New Zealand health and disability system. he report name, Ngā Taero a Kupe, refers to the kareao (supplejacks), tataramoa (brambles), tūmata-kuru (spear grass) and ongaonga (nettles), which are called ‘The Obstructions of Kupe’. These are physical and mental difficulties or blockages. They occur when cultural safety and cultural competency are not observed. Baseline Data Capture: Cultural Safety, Partnership and Health Equity Initiatives FINAL REPORT (2020) The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA) The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA), is pleased to release an independent report outlining findings of the current state of cultural safety and health equity delivered by doctors practicing in Aotearoa New Zealand and experienced by patients and whānau. Māori patients’ experiences are the focus of the report, however many of the challenges and solutions will be applicable to other ethnic groups and populations who experience inequitable healthcare. The Independent Māori Statutory Board. Māori Value reports. The reports make up a platform for the Board’s work to support Māori wellbeing outcomes, as set out in the Schedule of Issues of Significance and Māori Plan (2017). The five value reports each represent a Māori value: Rangatiratanga, Manaakitanga, Kaitiakitanga, Whanaungatanga, Wairuatanga. They measure Māori wellbeing in line with Māori experience and from a strengths-based view. Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research (2020) Australia and New Zealand Journal of Public Health This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’ Kaupapa Māori evaluation of the CCDHB Health Care Home Programme (Tiaho Limited, 2020) While the HCH model holds promise, changes are needed. A summary of changes and guidance for the change process are provided at the end of this report. A model of care must be considered within the wider context of which it is intended to operate. This requires close consideration of systemic structures and funding configurations that may serve to either enable or restrict provider delivery of the model, the strengthening of respectful relationships, high quality, timely and appropriate ethnicity data, a strong commitment to equity and to Te Tiriti o Waitangi and close and authentic involvement of the community served so that tangata whenua are empowered to thrive. A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity HQSC, 2019 Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. A window on the quality of Aotearoa New Zealand’s health care 2019 – a view on Māori health equity (Window 2019) highlights a number of areas where change is needed in the health system. The report is divided into three chapters. The first analyses inequity between how Māori and non-Māori access and receive health services, and the effects on equity of improvement activities in our system. The second chapter asks why these inequities exist, and the third chapter addresses opportunities for improvement. 'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry' Waitangi Tribunal. 2019 "The Waitangi Tribunal said in a report released today that the Crown had breached the Treaty of Waitangi by failing to set up and run the primary health system in a way that reduced the gap between Maori and non-Maori health outcomes." He oranga mo Aotearoa: Māori wellbeing for all Deloitte, 2018 We consider various Māori wellbeing frameworks and measurements, the barriers to Māori wellbeing and the drivers and changes that could improve it. Delivering better outcomes together: Policies that reflect our diverse cultures Deloitte, 2018 The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all. Te Ohonga Ake The Health Status of Māori Children and Young People in New Zealand Series Two (Health Status of Children and Young People). (2017) This report is based on an Indicator Framework developed in 2007 in which the indicators for each of the three reports in the series were identified. The indicators in this year’s report were developed from Craig et al’s indicators for the individual and whānau health and wellbeing stream. They are presented in the following sections: Issues in infancy  Issues for all ages 0–24 year olds  Conditions of the respiratory system  Common communicable diseases  Unintentional injury  Reproductive health  Mental health Kia Pū Te Wai O Pareira: Catalysts of Whānau Health and Wellbeing in West Auckland (2017) The Whānau Rangatiratanga Frameworks: Approaching whānau wellbeing from within Te Ao Māori (2016) Kaupapa Māori models of Psychological Therapy and Mental Health Services (2016) He Puāwaitanga o Ngā Tamāriki: West Auckland Whānau talk about child wellbeing (2016) Te Ohonga Ake The Determinants of Health for Māori Children and Young People in New Zealand Series Two (2016) Maaori Access to Health Services (i) Improving Maaori access to health care: Research report (2014) (ii) Improving Maaori access to cancer, diabetes and cardiovascular health care: Key informant interviews (2014) (iii) Improving Maaori access to cancer health care: Literature review (2014) (iv) Improving Maaori access to diabetes health care: Literature review (2014) (v) Improving Maaori access to cardiovascular health care: Literature review (2014) Maaori health: issues relating to healthcare services (2014) Improving Maaori health and reducing inequalities between Maaori and non-Maaori: Has the primary health care strategy worked for Maaori? An evaluation of the period 2003-2010 (2013) The health and wellbeing of Maaori New Zealand secondary students in 2012: Te Ara Whakapiki Taitamariki: Youth '12 (2013) Inquiry into the determinants of wellbeing for tamariki Maaori. Report of the Maaori Affairs Committee (2013) Hauora Kotahitanga - Maaori health experiences as models for co-operative co-existence between indigenous and non-indigenous people [thesis] (2013) Health sector: Results of the 2010/11 audits - Part 5: reducing health disparities for Maaori. (2012) Office of the Auditor General Maaori health promotion - a comprehensive definition and strategic considerations. Health Promotion Forum of New Zealand (2010) Trends in wellbeing for Maaori families 1981-2006 (2010) Kaumātua Ngā Kuia: Taonga Aroha: The Life and Living in Advanced Age; A Cohort Study in New Zealand (LILACSNZ) (2009) Best health outcomes for Maaori: practice implications (2008) Maaori whaanau experiences of neonatal care experiences (2008) Hauora: Maaori standards of health IV: a study of the years 2000-2005 (2007) Improving access to primary care for Maaori, and Pacific peoples : A literature review commissioned by the Health Funding Authority (2000) Māori Health Organisations and Websites Maaori Health links Ministry of Health directory of links to related Māori health websites Whaanau Ora Research website Katoa Ltd Katoa Ltd is a Maaori - Indigenous research organisation that undertakes Kaupapa Maaori (by Maaori, for Maaori) research and evaluation, as well as offering a range of research and evaluation training see Maaori Health: A dashboard for monitoring Ngāti Kahungunu Health and Well-being, 2013-14 see Maaori access to health services Funded by the Ministry of Health, The aim of this project was to answer the question, How can access to health services be improved for Māori? The focus of the project was on cancer, diabetes, and cardiovascular disease, and there were three objectives. Increase the health sector’s understanding of the issues affecting Māori access to health services Provide an evidence base for action to improve access to health services for Māori Provide solutions to improve access to health services for Māori In addition to literature reviews on interventions to improve access to diabetes, cardiovascular and cancer health care, key informants were interviewed for their views about improving access to health services. Individual reports were produced in each area, as well as an overall research report on improving Māori access to health care Kaupapa Maaori Nau mai ki te pae tukutuku o Kaupapa Maaori he wāhanga tēnei hai whakawhitiwhiti kōrero, whakaaro hoki mo ngā take katoa e hāngai hito ana ki te Kaupapa Maaori. He mea whakarite tēnei pae tukutuku hai āwhina i te whanaketanga o ngā mahi a ngā whānau, hapū, iwi. Welcome to the Kaupapa Maori and Rangahau website. This is a site dedicated to a discussion of issues related to Kaupapa Māori. This website has been established to assist in the development of whānau, hapū and iwi. Ngā Pae o te māramatanga As New Zealand's Maaori Centre of Research Excellence, we are pursuing a unique vision for achieving full participation by Māori in all aspects of society and the economy. Te Rau Ora Aims: Be the lead agency to improve Māori Health and Indigenous Wellbeing via health workforces, strategies and systems that implement Pae Ora (Ministry of Health, 2014); Strengthen health workforces to decrease Māori inequity and increase Māori wellbeing and potential. Includes access to publications and resources. The He Pikinga Waiora (Enhancing Wellbeing) Implementation Framework (HPW) The He Pikinga Waiora (Enhancing Wellbeing) Implementation Framework (HPW) was developed to facilitate effective and accelerated development and implementation of health intervention for chronic diseases. The framework is centred on Indigenous knowledge, methods, and philosophy (in New Zealand, Kaupapa Māori) and also integrates best practice from the international research: culture centredness, community engagement, systems thinking, and integrated knowledge translation Te Whānau o Waipareira Research Unit Wai-Research undertakes a research programme that supports Te Whānau o Waipareira Trust to evidence the best outcomes for whānau. In line with Te Whānau o Waipareira’s 25 year generational strategy, the priority for the research programme is to drive innovation that empowers whānau to prosper. Whāriki Research Group Te Rōpū Whāriki works in partnership with the SHORE Centre. Its Director, Helen Moewaka Barnes (Ngati Wai, Ngati Hine) is also Associate Director of the SHORE Centre. MIHI (Maaori/Indigenous Health Institute) The opening of the Maaori/Indigenous Health Institute (MIHI) represents a major milestone in the development of Māaori-focussed teaching and research at the School of Medicine and Health Sciences, University of Otago, Christchurch. Ngai Tahu Maāori Health Research Centre The Ngai Tahu Maaori Health Research Unit is a partnership between Te Runanga o Ngai Tahu and the Dunedin School of Medicine of the University of Otago. The Unit collects, collates, interprets and publishes information, data and statistics on Maaori health issues - an essential part of Maaori health development. The research focuses for the Unit are: hauora rangatahi (young people's health); hauora wahine (Maaori women's health) and oranga niho (dental health). Tōmaiora Maaori Health research Unit. University of Auckland Taupua Waiora Centre for Maaori Health Research Taupua Waiora was formally launched as the AUT University Centre for Maaori Health Research in February 2006. The Centre carries out research in three main areas - Maaori access to health services, Maaori health promotion and Maaori health workforce development. The Taupua Waiora Mission is 'To make a significant and distinctive contribution to reducing inequalities in health between Maaori and non-Maaori and improving Maaori health outcomes'. Maaori Health Symposium 2015: Selected presentations last updated 19February 2024

Introduction
Data and Statistics
Selected Databases
Selected Journals
Selected Texts
Maaori Health Organisations and Websites

 

Introduction  

Maaori Health website
Provide leads and introduction to every topic relating to Maaori Health. Ministry of Health

Treaty of Waitangi principles

The principles of Te Tiriti o Waitangi, as articulated by the Courts and the Waitangi Tribunal, provide the framework for how we will meet our obligations under Te Tiriti in our day-to-day work. The 2019 Hauora report recommends the following principles for the primary health care system[4]. These principles are applicable to wider health and disability system. The principles that apply to our work are as follows.

  • Tino rangatiratanga: The guarantee of tino rangatiratanga, which provides for Māori self-determination and mana motuhake in the design, delivery, and monitoring of health and disability services.
  • Equity: The principle of equity, which requires the Crown to commit to achieving equitable health outcomes for Māori.
  • Active protection: The principle of active protection, which requires the Crown to act, to the fullest extent practicable, to achieve equitable health outcomes for Māori. This includes ensuring that it, its agents, and its Treaty partner are well informed on the extent, and nature, of both Māori health outcomes and efforts to achieve Māori health equity.
  • Options: The principle of options, which requires the Crown to provide for and properly resource kaupapa Māori health and disability services. Furthermore, the Crown is obliged to ensure that all health and disability services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care.
  • Partnership: The principle of partnership, which requires the Crown and Māori to work in partnership in the governance, design, delivery, and monitoring of health and disability services. Māori must be co-designers, with the Crown, of the primary health system for Māori.
  •  

'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry'
Waitangi Tribunal. 2019
"The Waitangi Tribunal said in a report released today that the Crown had breached the Treaty of Waitangi by failing to set up and run the primary health system in a way that reduced the gap between Maori and non-Maori health outcomes."

He Korowai Oranga: Maaori Health Strategy
"He Korowai Oranga is a living strategy. Updating this website with evidence, data and case studies will be integral activities in its second decade. Over time, this web-based strategy will become a ‘hub of innovation’ for Māori health."

Pae Tū: Hauora Māori Strategy (2023)

 

As part of the health system transformation a range of strategies have been developed to help guide our health system to achieve pae ora, healthy futures. One of those is Pae Tū: Hauora Māori Strategy. It has been produced by Manatū Hauora and Te Aka Whai Ora. 

Māori Health Priorities Report (2022)

 

This Māori Health Priorities report draws focus to the biggest contributors to health loss and health inequity for Māori, and also represent the greatest potential for intervention.  This report was commissioned by Te Aka Whai Ora to inform our positioning on the priorities for the interim New Zealand Health Plan (iNZHP) for Māori.



He Korowai Oranga: Maaori Health Strategy (2014)
"He Korowai Oranga is a living strategy. Updating this website with evidence, data and case studies will be integral activities in its second decade. Over time, this web-based strategy will become a ‘hub of innovation’ for Māori health."

 

Equity of Health for Maaori: a framework


Te ao Māori framework

The Health Quality & Safety Commission has developed a te ao Māori framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards across Aotearoa New Zealand. The initial framework concept is shown below, followed by a brief description.

The aim of the framework is to improve the quality of care afforded to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. 

There are two downloadable PDFs at the bottom of this page, which include the basic framework concept plus a backgrounder on how and why it was developed. 

We are currently developing resources to support providers with implementation of the framework and will publish them here in due course.

We would like to acknowledge and thank our partner providers who gave their information freely in the hope that much-needed change could happen and be sustained over time.

Te ao Māori framework concepts

Wairuatanga

The holistic nature of Māori health, which links physical illness to emotional and spiritual wellbeing.  Hence wairuatanga is in the middle position of the framework, which makes culture a central focus in the design of services. The goal of wairuatanga is to embed tikanga Māori and cultural safety into the health system.

Pātuitanga

The growing and fostering of strong partnerships with Māori, which is fundamental to ensuring the right concepts are included in the design and delivery of services.

Whānau

Whānau need and improving health outcomes for whānau are the drivers to why services are created and designed. 

Rangatiratanga

The inclusion of Māori leadership in decision-making processes when services are designed.

Te ao Māori framework design

Each of the outer sections have two koru representing tapu and noa. The haehae lines bind each section together and connect and interact with each other.

The inside koru of each concept opens into wairuatanga, which allows wairuatanga to flow seamlessly throughout the entire framework. 

The outside koru opens into te ao Mārama. The pītau design on the edge of the outer sections represents new beginnings and is the interconnection between te ao Māori and te ao Mārama.

Downloadable attachments

Te Hiringa Hauora Research Framework ( e Hiringa Hauora. Health Promotions Agency)
The Te Hiringa Hauora Research Framework is designed to guide and enable shared understanding 
of what best practice health promotion research in Aotearoa New Zealand is and what it seeks to 
achieve. This Framework presents a way of working at the interface of mātauranga Māori and 
Western science, using both knowledge systems to generate new knowledge and evidence that 
contribute towards healthy and decolonising futures for Māori, Pacific peoples, and all New 
Zealanders.” Source: Te Hiringa Hauora

 

Guidelines for Researchers on Health Research Involving Maaori - Revised July 2010

Health Research Council. 'Māori Health Advancement Guidelines' (2019)
 Alignment with the Māori Health Advancement criterion as well as other assessment criteria will strengthen an application to the Health Research Council. Importantly, the new approach will give applicants clearer guidance and a framework in which they can contribute to improving Maori health, while enabling the HRC to clearly evaluate the degree to which its investment delivers on this objective.  These guidelines  support health researchers in describing how their proposed research fits within the criterion. 

see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019)

The evaluation hikoi: a Maori overview of programme evaluation ( Te Ropu Whariki, 2009)

This book aims to:

• Provide the reader with an overview of the issues surrounding public health programme evaluation by and for Maori

• Give examples of the range of approaches that might be useful

• Highlight areas that evaluators may need to consider. There are many different models and frameworks that can be used to guide indigenous researchers. Our approach has been to grapple with what it means, as Maori, to carry out formative, process and impact evaluation. 

Co-designing health research in Aotearoa New Zealand (2024)

Co-designing health research in Aotearoa New Zealand describes a Kaupapa Māori evaluation of five Healthier Lives’ projects. The report outlines the elements needed for authentic co-design of health research with Māori and Pacific communities.  The accompanying short guide summarises the lessons learnt from this evaluation and features a conceptual ladder – the Co-design Research Integrity Poutama – which portrays and defines different levels of co-design.


see also:

Carlson, Teah, Helen Moewaka Barnes, and Tim McCreanor. "Kaupapa Māori evaluation: A collaborative journey." Evaluation Matters—He Take Tō Te Aromatawai 3 (2017): 67-99.

Cram, Fiona, Kataraina Pipi, and Kirimatao Paipa. "Kaupapa Māori evaluation in Aotearoa New Zealand.New directions for evaluation 2018.159 (2018): 63-77.
http://cjc-rcc.ucalgary.ca/index.php/cjpe/article/view/31085/25237


Evaluation and Research Committee Report on the SPEaR Best Practice Māori Guidelines Hui 2007 

The Social Policy, Evaluation and Research Committee (SPEaR) advocates the need for kaupapa Māori principles, and sets out specific guidelines for “best practice approaches”. These guidelines are defined as five key principles of working with Māori, which are:
“integrity, respect, responsiveness, competency and reciprocity.”

 

Te Ara Tika - Guidelines for Maaori Research Ethics

Te Pūtahitanga: A Tiriti–led Science-Policy Approach for Aotearoa New Zealand | Ngā Pae o te Māramatanga (2021)
This paper examines the interface between science and policymaking and calls for a policy approach that is enabled by, and responsive to, Te Tiriti o Waitangi and Mātauranga Māori. For a science sector to have its greatest reach and impact for all citizens, it must demonstrate relevance, accessibility and inclusion.

In Aotearoa, there has been concern about the exclusion of Māori and Pacific expertise from science advice and key decision-making roles. Te Tiriti offers a powerful framework for connecting systems and communities of knowledge in ways that are mutually beneficial and future focused.

Māori Health Review A to Z guide
The A to Z guide will provide you with direct access to over 300 articles on specific Māori health topics featured in Māori Health Review and other Ministry publications.

Maaori Health on Health Navigator
Improving Māori health is an important area of focus for all health services and providers within New Zealand. Here you can find a range of resources about Māori health including an overview, videos, apps and health information.

 

see also Understanding Maaori Research Methodologies [podcast]

see also Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research [NZMJ; 2017)
Excellent health research is essential for good health outcomes, services and systems. Health research should also build towards equity and in doing so ensure that no one is left behind. As recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisational approach to this endeavour. However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work. In this viewpoint paper we provide an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori. We also describe an equity-based approach to responsiveness to Māori and highlight four key areas that require careful consideration, namely: (1) relevance to Māori; (2) Māori as participants; (3) promoting the Māori voice, and; (4) human tissue. Finally, we argue for greater engagement with responsiveness to Māori activities as part of our commitment to achieving equitable health outcomes.

see also Bridging cultural perspectives (2018)
This report describes the He Awa Whiria – Braided Rivers model of using Western science and mātauranga Māori knowledge side-by-side for research and evaluation in the social sector. Western science and methods are often given prominence over all other systems of knowledge. While Māori do well in society, there continues to be an over-representation of Māori in negative statistics. If the social sector is to achieve a research-based understanding of the underlying causes of this situation, we need to acknowledge a te ao Māori worldview.

see also Tuku Iho Culture in Māori Health Service Provision (2019)
This report provides critical understanding of the notion of culture, cultural safety, cultural competency and cultural fluency especially central to Māori health service provision in Aotearoa.

see also Maaori Health Research on twitter https://twitter.com/maori_health

see also Cochrane Library: Special Collections. Health of indigenous peoples.

see also  'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015]

seel also Ka hao te rangatahi: life course approaches in Aotearoa Expert panel.  
An expert panel explores how Maori researchers undertake life course research, analyse data and work with families, whanau and community (2018)

see also Consolidated criteria for strengthening reporting of health research involving indigenous peoples: the CONSIDER statement.
The CONSIDER statement is a collaborative synthesis and prioritization of national and international research statements and guidelines. The CONSIDER statement provides a checklist for the reporting of health research involving Indigenous peoples to strengthen research praxis and advance Indigenous health outcomes.

 

 

see also Ministry of Health Library: Key Resources - Maori Health

 

Data and Statistics

National.  Ministry of Health

Maaori health data and stats: Statistical publications and data sets on Maaori health

Wai 2575 Māori Health Trends Report data and resources (2019)
The Ministry of Health’s Māori Health Insights team has produced the Māori Health Trends Report, to inform the Wai 2575 Health Services and Outcomes Kaupapa Inquiry (Wai 2575)

Ngā Tikanga Paihere

Ngā Tikanga Paihere draws on 10 tikanga (Te Ao Māori/Māori world concepts) to help you establish goals, boundaries, and principles that guide and inform your data practice. 

By asking yourself questions inspired by ngā tikanga at the beginning of your data use, Ngā Tikanga Paihere helps you:

guide your safe, responsible, and culturally appropriate use of data
ensure your data use is carefully considered
ensure your data practices occur in good faith.

HISO 10001:2017 Ethnicity Data Protocols (2017)
The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector.

Health system quality dashboard
Health & Quality Safety Commission (NZ).
In partnership with Te Tumu Whakarae, HQSC has developed a new specific Māori Health Equity Report, using distinct data.

 

see also

Te Mana Raraunga [ Māori Data Sovereignty Network ]
" We advocate for Māori rights and interests in data to be protected as the world moves into an increasingly open data environment"

What is Maori Data Sovereignty?


Data Sovereignty typically refers to the understanding that data is subject to the laws of the nation within which it is stored.
Indigenous Data Sovereignty perceives data as subject to the laws of the nation from which it is collected.
Māori Data Sovereignty recognises that Māori data should be subject to Māori governance.
Māori Data Sovereignty supports tribal sovereignty and the realisation of Maori and Iwi aspirations.

 

Wai 2575 Māori Health Trends Report (2019) 
The Ministry of Health’s Māori Health Insights team has produced the Māori Health Trends Report, including several subject-specific modules, to inform the Wai 2575 Health Services and Outcomes Kaupapa Inquiry (Wai 2575). The report shows changes of Māori health over the years 1990–2015.  

Te Ao Mārama 2016
Here is an updated collection of our statistics about Māori well-being and development from a Māori perspective. It is available in te reo Māori: Tirohia tēnei whārangi i te reo Māori.

‘Te ao mārama’ is a Māori concept relating to wisdom and understanding. It derives from the myth in which Tāne separated his Sky Father Ranginui and Earth Mother Papatuānuku to create ‘te ao mārama’ or the world of light. This allowed Tāne and his brothers to grow and better understand the world around them.

Statistics New Zealand collected information relating to Māori well-being in the 2013 Te Kupenga Survey. Since 2014, our annual survey Tatauranga Umanga Māori provides information about economic activity of Māori authorities.

Tatau Kahukura: Māori Health Chart Book 2015 (3rd Edition)
Presents a snapshot of the health of Māori compared with non-Māori. The chart book presents key indicators relating to the socioeconomic determinants of health, risk and protective factors for health, health status, health service use and the health system.


Statistics New Zealand

Maaori Health
Maaori health and well being
Te Kupenga
Te Kupenga, a survey of Maaori well-being. Te Kupenga collected information on a wide range of topics to give an overall picture of the social, cultural, and economic well-being of Maaori in New Zealand. The survey also provides important information about the health of the Maaori language and culture. 

The first release of information from Te Kupenga 2013 provides overview statistics on four areas of Maaori cultural well-being:

  • wairuatanga (spirituality)
  • tikanga (Maaori customs and practices)
  • te reo Maaori (the Maaori language)
  • whanaungatanga (social connectedness).
District Health Board Maaori Health Profiles 2015 
District Health Board Maaori Health Profiles 2015 in Te Reo
 
Maaori health statistics online via healthspace
The atlas collects together health, behaviour and socio-economic indicators for Māori. Most indicators compare Māori outcomes with those of non-Māori:
immunisation coverage
oral health
participation and attainment in science subjects (for students in years 11-13)
quit (smoking) attempts
risk behaviour (smoking/ gambling)
intentional self-harm
diabetes (crude rates derived from the virtual diabetes register) 

Wiki New Zealand health data clearinghouse
 Wiki New Zealand sources data from other organisations, including corporations, public repositories, government departments and academics.
We import that data into a powerful open source database, we carefully validate it and standardise it. We then make the data available in a series of standardised forms, both human and machine-readable, with rich metadata about the sources, licensing and datatypes.

Health Roundtable
We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to:
Provide opportunities for health executives to learn how to achieve Best Practice in their organisations
Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices
Promote interstate and international collaboration and networking amongst health organisation executives

Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address.

89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis.

 

  

Selected Databases  

Pubmed
The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences.
Hint: When searching Pubmed for Māori content.  Search on Māori as a word in the title of the article.
Other MeSH subject headings that may be relevant to your search include:
Culture ; Medicine, traditional; Health service, indigenous; Cultural competency; Population groups; Socioeconomic factors

Index New Zealand
General index to New Zealand journals and newspapers from 1987 onwards. Indexes some Pacific serials.

NZResearch
New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand

Publications New Zealand
Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present

 

Selected Journals

e-Pānui
Get the latest Maaori health research news in the HRC's new e-newsletter, e-Pānui

Journal of Indigenous Wellbeing
The Journal of Indigenous Wellbeing is a peer-reviewed, open-access, scholarly online journal that shares multi-disciplinary indigenous knowledge and research experience amongst indigenous health professionals, leaders, researchers and community members.

Maaori Health Review
Every quarter Maaori health review features the latest research in the Maaori health area

MAI Journal: A Journal of Indigenous Scholarship
The latest issue of MAI Journal: A New Zealand Journal of Indigenous Scholarship (Volume 2, 2) is now available. The theme of health and social wellbeing and the need to reduce Maaori health disparities features prominently in four of the articles in this issue.

Pacific Health Dialog
Pacific Health Dialog - The Journal of Community Health and Clinical Medicine for the Pacific Region is the only Medline listed medical and public health journal published specifically for Oceania.
see Vol. 17 no. 1. (1999) Māori health in New Zealand


Selected Texts

Ministry of Health

Maaori health publications.  Ministry of Health publications on Māori health

He Korowai Oranga: Māori Health Strategy sets the overarching framework that guides the Government and the health and disability to achieve the best health outcomes for Māori, with the overarching aim of pae ora – healthy futures for Māori. 

Whakamaua: Māori Health Action Plan 2020-2025 guides the Ministry, the whole health and disability system, and government to give effect to He Korowai Oranga. It sets out a suite of outcomes, objectives and priority areas for action that will contribute to the achievement of pae ora – healthy futures for Māori. 

Hui Whakaoranga is a series of hui focused on taking a generational approach to Māori health development and is a key part of the ongoing commitment to Whakamaua: Māori Health Action Plan 2020-2025.

These hui provide a significant opportunity for iwi, hapū, Māori communities and the health and disability sector to connect, share aspirations, and set out milestones for achieving Pae Ora – healthy futures for Māori. This also involves exploring how to continue building effective partnerships and networks.

Updated COVID-19 Māori Response Action Plan (2020)

see also National Ethical Standards for Health and Disability Research and Quality Improvement

 

District Health Boards 

DHB Maaori health profiles and health summaries
District health boards (DHBs) are required to improve the health of Māori and reduce health disparities for Māori compared to other population groups in New Zealand. This page provides DHB Māori Health Profiles and DHB Māori Health Profile Summaries for all DHBs (bilingual in te reo Māori and English).

The Independent Māori Statutory Board.

Māori Value reports.
The reports make up a platform for the Board’s work to support Māori wellbeing outcomes, as set out in the Schedule of Issues of Significance and Māori Plan (2017).

The five value reports each represent a Māori value: Rangatiratanga, Manaakitanga, Kaitiakitanga, Whanaungatanga, Wairuatanga. They measure Māori wellbeing in line with Māori experience and from a strengths-based view.

 


Other texts

 

Creating a Māori Indigenous Model of Evaluation Founded on Māori Indigenous Values
PhD Thesis: Māori Indigenous Evaluation, 2023

Abstract

Values and evaluation inform and influence all aspects of our lives. However, what is evaluation, and how do evaluation methodologies influence outcomes? This research examines how evaluation systems express and reflect their designers' and developers' values, ideologies, social mores, and political worldviews. Māori values are known as ‘taonga’, cultural treasures that formed the basis of their evaluation approaches across all elements of societal life, including health, education, justice, and the economy. Over the last two hundred years, Māori evaluation systems have been denigrated and discredited through the process of colonisation. Eurocentric evaluation systems have been used as political tools to assess, measure, define, and control Māori and Indigenous communities worldwide. Regardless of such methods, Māori and Indigenous communities continue to bear the brunt of intergenerational trauma and suffer the burden of sociocultural, economic, and ecological inequities. We must then ask how Māori and Indigenous values and worldviews can improve evaluation 

Why are Māori Indigenous values-centred models of evaluation needed today? How can we gather and honour Mātauranga Māori to create a cohesive model of evaluation? Informed by Kaupapa Māori philosophies and praxis, this research spans the hinengaro/psyche, whānau/families, hapu/communities, iwi/nations, and Te Ao/global systems are integrated with the experiential knowledge of Māori and Indigenous evaluation specialists. The creation of Pou Kapua, the largest totem in Aotearoa, provided a unique Mātauranga Māori methodology to support the design of the Pou Mārama model of evaluation. Pou Mārama is a Māori values-centric approach that honours Te Tiriti o Waitangi and the kaingākau of Taha Wairua (spiritual and ethical harmony), Aroha (care and compassion), Mana (heartfelt commitment), Tiaki (protection and preservation), and Ora (intergenerational well-being). Through the Pou Mārama methodology, the principles of Whānaungatanga support respectful and collaborative relationships, and Manaakitanga encourages a complex adaptive systems approach. Kaitiakitanga translates interdisciplinary knowledge into creative and transformative solutions. Finally, Rangatiratanga focuses on demonstrating courageous leadership, supporting authentic measures of well-being, and achieving transformational outcomes - for our people and our planet. 

 

Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health (2021)
This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

 

Ngā Taero a Kupe: Whānau Māori experiences of in-hospital adverse events (2020)
Health Quality & Safety Commission | Kupu Taurangi Hauora o Aotearoa
The study found that whānau Māori had strong views about the way they were treated when accessing health care. For example, many whānau perceptions of the health care system was poor and as a result whānau were reluctant to access care unless absolutely necessary.  The need for change is critical to the quality of care that whānau Māori experience within the Aotearoa New Zealand health and disability system.  he report name, Ngā Taero a Kupe, refers to the kareao (supplejacks), tataramoa (brambles), tūmata-kuru (spear grass) and ongaonga (nettles), which are called ‘The Obstructions of Kupe’. These are physical and mental difficulties or blockages. They occur when cultural safety and cultural competency are not observed.


Baseline Data Capture: Cultural Safety, Partnership and Health Equity Initiatives FINAL REPORT (2020)
The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA)
The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA), is pleased to release an independent report outlining findings of the current state of cultural safety and health equity delivered by doctors practicing in Aotearoa New Zealand and experienced by patients and whānau. Māori patients’ experiences are the focus of the report, however many of the challenges and solutions will be applicable to other ethnic groups and populations who experience inequitable healthcare.

The Independent Māori Statutory Board. Māori Value reports.
The reports make up a platform for the Board’s work to support Māori wellbeing outcomes, as set out in the Schedule of Issues of Significance and Māori Plan (2017).

The five value reports each represent a Māori value: Rangatiratanga, Manaakitanga, Kaitiakitanga, Whanaungatanga, Wairuatanga. They measure Māori wellbeing in line with Māori experience and from a strengths-based view.

Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research (2020)
Australia and New Zealand Journal of Public Health
This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’

Kaupapa Māori evaluation of the CCDHB Health Care Home Programme (Tiaho Limited, 2020)

While the HCH model holds promise, changes are needed. A summary of changes and guidance for the change process are provided at the end of this report. A model of care must be considered within the wider context of which it is intended to operate. This requires close consideration of systemic structures and funding configurations that may serve to either enable or restrict provider delivery of the model, the strengthening of respectful relationships, high quality, timely and appropriate ethnicity data, a strong commitment to equity and to Te Tiriti o Waitangi and close and authentic involvement of the community served so that tangata whenua are empowered to thrive. 

 

A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity
HQSC, 2019
Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. 

A window on the quality of Aotearoa New Zealand’s health care 2019 – a view on Māori health equity (Window 2019) highlights a number of areas where change is needed in the health system. The report is divided into three chapters. The first analyses inequity between how Māori and non-Māori access and receive health services, and the effects on equity of improvement activities in our system. The second chapter asks why these inequities exist, and the third chapter addresses opportunities for improvement.

'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry'
Waitangi Tribunal. 2019
"The Waitangi Tribunal said in a report released today that the Crown had breached the Treaty of Waitangi by failing to set up and run the primary health system in a way that reduced the gap between Maori and non-Maori health outcomes."

He oranga mo Aotearoa: Māori wellbeing for all
Deloitte, 2018
We consider various Māori wellbeing frameworks and measurements, the barriers to Māori wellbeing and the drivers and changes that could improve it.

Delivering better outcomes together: Policies that reflect our diverse cultures
Deloitte, 2018
The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all.

Te Ohonga Ake The Health Status of Māori Children and Young People in New Zealand Series Two (Health Status of Children and Young People). (2017)
This report is based on an Indicator Framework developed in 2007 in which the indicators for each of the three reports in the series were identified. The indicators in this year’s report were developed from Craig et al’s indicators for the individual and whānau health and wellbeing stream. They are presented in the following sections: Issues in infancy

 Issues for all ages 0–24 year olds

 Conditions of the respiratory system

 Common communicable diseases

 Unintentional injury

 Reproductive health

 Mental health

Kia Pū Te Wai O Pareira: Catalysts of Whānau Health and Wellbeing in West Auckland (2017)                           

The Whānau Rangatiratanga Frameworks: Approaching whānau wellbeing from within Te Ao Māori (2016)

Kaupapa Māori models of Psychological Therapy and Mental Health Services (2016)

He Puāwaitanga o Ngā Tamāriki: West Auckland Whānau talk about child wellbeing (2016)

Te Ohonga Ake The Determinants of Health for Māori Children and Young People in New Zealand Series Two (2016)

Maaori Access to Health Services

(i) Improving Maaori access to health care: Research report (2014)

(ii) Improving Maaori access to cancer, diabetes and cardiovascular health care: Key informant interviews (2014)

(iii) Improving Maaori access to cancer health care: Literature review (2014)

(iv) Improving Maaori access to diabetes health care: Literature review (2014)

(v) Improving Maaori access to cardiovascular health care: Literature review (2014)

Maaori health: issues relating to healthcare services (2014)

Improving Maaori health and reducing inequalities between Maaori and non-Maaori: Has the primary health care strategy worked for Maaori? An evaluation of the period 2003-2010 (2013)

The health and wellbeing of Maaori New Zealand secondary students in 2012: Te Ara Whakapiki Taitamariki: Youth '12 (2013)

Inquiry into the determinants of wellbeing for tamariki Maaori.  Report of the Maaori Affairs Committee (2013)

Hauora Kotahitanga  - Maaori health experiences as models for co-operative co-existence between indigenous and non-indigenous people [thesis] (2013)

Health sector: Results of the 2010/11 audits - Part 5: reducing health disparities for Maaori. (2012) Office of the Auditor General

Maaori health promotion - a comprehensive definition and strategic considerations.  Health Promotion Forum of New Zealand (2010)

Trends in wellbeing for Maaori families 1981-2006 (2010)

Kaumātua Ngā Kuia: Taonga Aroha: The Life and Living in Advanced Age; A Cohort Study in New Zealand (LILACSNZ) (2009)

Best health outcomes for Maaori: practice implications (2008)

Maaori whaanau experiences of neonatal care experiences (2008)

Hauora: Maaori standards of health IV: a study of the years 2000-2005 (2007)

Improving access to primary care for Maaori, and Pacific peoples : A literature review commissioned by the Health Funding Authority (2000)

 

Māori Health Organisations and Websites

 

Maaori Health links
Ministry of Health directory of links to related Māori health websites

Whaanau Ora Research website

Katoa Ltd
Katoa Ltd is a Maaori - Indigenous research organisation that undertakes Kaupapa Maaori (by Maaori, for Maaori) research and evaluation, as well as offering a range of research and evaluation training
see Maaori Health: A dashboard for monitoring Ngāti Kahungunu Health and Well-being, 2013-14
see Maaori access to health services
Funded by the Ministry of Health, The aim of this project was to answer the question, How can access to health services be improved for Māori? The focus of the project was on cancer, diabetes, and cardiovascular disease, and there were three objectives.

Increase the health sector’s understanding of the issues affecting Māori access to health services
Provide an evidence base for action to improve access to health services for Māori
Provide solutions to improve access to health services for Māori
In addition to literature reviews on interventions to improve access to diabetes, cardiovascular and cancer health care, key informants were interviewed for their views about improving access to health services. Individual reports were produced in each area, as well as an overall research report on improving Māori access to health care

Kaupapa Maaori
Nau mai ki te pae tukutuku o Kaupapa Maaori he wāhanga tēnei hai whakawhitiwhiti kōrero, whakaaro hoki mo ngā take katoa e hāngai hito ana ki te Kaupapa Maaori. He mea whakarite tēnei pae tukutuku hai āwhina i te whanaketanga o ngā mahi a ngā whānau, hapū, iwi.  Welcome to the Kaupapa Maori and Rangahau website. This is a site dedicated to a discussion of issues related to Kaupapa Māori. This website has been established to assist in the development of whānau, hapū and iwi.

Ngā Pae o te māramatanga
As New Zealand's Maaori Centre of Research Excellence, we are pursuing a unique vision for achieving full participation by Māori in all aspects of society and the economy.

Te Rau Ora
Aims: Be the lead agency to improve Māori Health and Indigenous Wellbeing via health workforces, strategies and systems that implement Pae Ora (Ministry of Health, 2014);  Strengthen health workforces to decrease Māori inequity and increase Māori wellbeing and potential. Includes access to publications and resources.

The He Pikinga Waiora (Enhancing Wellbeing) Implementation Framework (HPW)
The He Pikinga Waiora (Enhancing Wellbeing) Implementation Framework (HPW) was developed to facilitate effective and accelerated development and implementation of health intervention for chronic diseases. The framework is centred on Indigenous knowledge, methods, and philosophy (in New Zealand, Kaupapa Māori) and also integrates best practice from the international research: culture centredness, community engagement, systems thinking, and integrated knowledge translation

Te Whānau o Waipareira Research Unit
Wai-Research undertakes a research programme that supports Te Whānau o Waipareira Trust to evidence the best outcomes for whānau. In line with Te Whānau o Waipareira’s 25 year generational strategy, the priority for the research programme is to drive innovation that empowers whānau to prosper.

Whāriki Research Group
Te Rōpū Whāriki works in partnership with the SHORE Centre. Its Director, Helen Moewaka Barnes (Ngati Wai, Ngati Hine) is also Associate Director of the SHORE Centre.

MIHI (Maaori/Indigenous Health Institute)
The opening of the Maaori/Indigenous Health Institute (MIHI) represents a major milestone in the development of Māaori-focussed teaching and research at the School of Medicine and Health Sciences, University of Otago, Christchurch.

Ngai Tahu Maāori Health Research Centre
The Ngai Tahu Maaori Health Research Unit is a partnership between Te Runanga o Ngai Tahu and the Dunedin School of Medicine of the University of Otago. The Unit collects, collates, interprets and publishes information, data and statistics on Maaori health issues - an essential part of Maaori health development. The research focuses for the Unit are: hauora rangatahi (young people's health); hauora wahine (Maaori women's health) and oranga niho (dental health).

Tōmaiora Maaori Health research Unit.  University of Auckland

Taupua Waiora Centre for Maaori Health Research
Taupua Waiora was formally launched as the AUT University Centre for Maaori Health Research in February 2006. The Centre carries out research in three main areas - Maaori access to health services, Maaori health promotion and Maaori health workforce development. The Taupua Waiora Mission is 'To make a significant and distinctive contribution to reducing inequalities in health between Maaori and non-Maaori and improving Maaori health outcomes'.

Maaori Health Symposium 2015: Selected presentations

 

 last updated 19February 2024

Asian Health Clearinghouse: Research, Information and Resources

Introduction Data and Statistics Selected Databases Selected Journals Selected Texts Asian Health Organisations and Websites Introduction Assuming no dramatic change in immigration policy in the next decade, the Asian population as a proportion of New Zealand’s population will continue to increase. The Asian population is projected to grow at about three times the rate of the total population to 2026, reaching about 790,000 in that year. Given the likelihood that regional settlement patterns will be similar to those experienced in the previous quarter century, about two-thirds of this population will live in Auckland – with an estimated Asian population of 525,000 in 2026, comprising about 28 percent of Auckland’s population. For a detailed analysis of Auckland's Asian population patterns and forecasts see Asian Auckland: the multiple meanings of diversity (2015) Asian and migrant health see also 'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015] see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019) The Asian Health Research Review is an excellent source of the latest international research, news and local developments. A decade of Asian and ethnic minority health research in New Zealand: findings from a scoping review New Zealand Medical Journal. ol 134 No 1542: 17 September 2021. Conclusion Overall, the evidence base on A/EM health in New Zealand is weak as there is limited information on health conditions and its determinants of minority groups, including their patterns of health service use. The nature and content of A/EM health research requires further substantive development in terms of understanding the health and its determinants of this ever increasing and heterogenous population group. Data and Statistics National. Ministry of Health Asian health data and statistics see also Asian Health Chart Book (2006) This Asian Health Chart Book 2006 is the first comprehensive review of Asian health, and the first to systematically examine inequalities between Asian ethnic groups and between migrant and established Asian communities. The report adopts an indicator approach in order to focus attention on specific health issues of particular importance to Asian peoples. Information is presented on more than 80 indicators covering four domains: health status, health risk profile, social determinants of health, and patterns of health service utilisation. HISO 10001:2017 Ethnicity Data Protocols (2017) The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector. Statistics New Zealand Asian peoples Health Roundtable We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to: Provide opportunities for health executives to learn how to achieve Best Practice in their organisations ; Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices ; Promote interstate and international collaboration and networking amongst health organisation executives Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address. 89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis. Selected Databases Pubmed The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences. Hint: When searching Pubmed for Asian content use the Subject heading Asian Continental Ancestry Group. Index New Zealand General index to New Zealand journals and newspapers from 1987 onwards. NZResearch New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand Publications New Zealand Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present Selected Journals Asian Health Research Review This Review features key medical articles from global Asian Health journals with commentary from Dr Annette Mortensen, Dr Geeta Gala, Professor Shanthi Ameratunga, Associate Professor Elsie Ho and Dr Roshini Peiris-John. TANI newsletter TANI newsletter provides information to both Asian communities and the service providers and shares their successful stories in terms of enhancing community health & wellbeing. Selected Texts Ministry of Health Asian and migrant health publications see also National Ethical Standards for Health and Disability Research and Quality Improvement Health needs assessment of Asian people living in the Auckland region (2012) This report, by Dr Suneela Mehta, was commissioned by the Northern DHB Support Agency on behalf of the Auckland Regional Settlement Strategy Migrant Health Action Plan, which represents Waitemata, Auckland and Counties Manukau DHBs. It is the most comprehensive report to date examining the health status and health service use of Chinese, Indian and Other Asian communities in the Auckland region. The report includes analyses of health issues that have not previously been addressed in detail for Asian communities in Auckland, such as mental health, health of older people, family violence, patient safety and disability. Asian health in Aotearoa: 2011-2013: trends since 2002-2003 and 2006- 2007 (2016) This report examines time trends in the health status of Asian participants interviewed in recent New Zealand Health Surveys, which recruit nationally representative samples of the resident New Zealand population. Asian health in Aotearoa in 2006-2007: Trends since 2002-2003 (2010) This study by Assoc. Prof. Robert Scragg was commissioned by the Northern DHB Support Agency (NDSA) on behalf of the Auckland Regional Settlement Strategy Health Steering group which represents Waitemata, Auckland and Counties Manukau District Health Boards. It provides an overview of the health status of Asian communities in 2006-07, in comparison with the rest of the New Zealand population; and at the same time provide information on trends in health status among the Asian communities since 2002-03. International Benchmarking of Asian Health Outcomes for Waitemata and Auckland DHBs This benchmarking report has been developed to profile and assess the health of Waitemata and Auckland districts' Asian population in an international context - considering their health status against our high level outcomes to maximise life expectancy and reduce inequalities in health outcomes. It is important to note that the Asian population is made up of many individual population groups and each of these groups has differing and specific health needs. Where possible, these difference are explored further in this report. The report has been developed alongside a supplementary Asian Health Benchmarking Technical Report. Asian Health Support Services Asian Health Action Plan Final report on healthcare needs of Asian people: surveys of Asian people and health professionals in the North and West Auckland (2001) Other texts Document, audio and video resources on Asian Wellbeing (Asian Family Services) New Zealand Asian Wellbeing & Mental Health Report 2021 Asian Family Services The settlement outcomes of migrant youth: a bibliography of New Zealand and international literature [ New Zealand Immigration 2017] Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders [2017] Asian Auckland: the multiple meanings of diversity [Asia new Zeakand Foundation 2015] Asian People's Strategy 2015-2020 : draft for consultation [Plunket, 2015] Challenges for Asian health and Asian health promotion in New Zealand (2015) Centre for Asian and Ethnic Minority Health Research (CAHRE) National Symposium 2014: Working together to Improve Asian and Ethnic Minority Health and Wellbeing (2014) Conference Proceedings from the Second International Asian Health and Wellbeing Conference (2006) Conference Proceedings from Inaugural International Asian Health Conference (2004) The Impact of Gambling and Problem Gambling on Asian Families and Communities in New Zealand (2012) Talking Therapies for Asian People: Best and promising practice guide for mental health and addiction services (2010) Diverse communities: exploring the migrant and refugee experience in New Zealand (2008) Walking a tightrope: Asian health research in New Zealand (2007) Asian health in New Zealand - progress and challenges (2006) Asian Childrens health (2005) Mental health issues for Asians in New Zealand: a literature review (2003) see also CALD Resources: Asian, Migrant and Refugee Health Publications Asian Health Organisations and Websites Asian Family Services Asian Family Services was established in 1998 to provide counselling, public health education and support for all Asians in New Zealand. Asian Forum 2017 ANA holds a one-day Asian nutrition and physical activity forum biennially. This event is designed to support those working to promote public health nutrition and physical activity in Asian communities with new research, resources, and tools. This forum was held in Auckland on Wednesday 1st November 2017 Asian Health Asian Health Services Asian Health Services (AHS) was established to support Waitemata District Health Board's services to deliver culturally appropriate, accessible, responsive and effective services to our growing Asian migrant and refugee communities. Asian Public Health [Auckland Regional Public Health Service] Auckland Chinese Medical Association [ACMA] ACMA, the Auckland Chinese Medical Association, is an association of New Zealand Registered Medical Practitioners that aims to be beneficial to the community by serving as a voice on matters of medical or health concern, particularly for Chinese New Zealanders. We hold regular clinical meetings and dinners for our members, a scientific conference every two years, are involved in promoting health within the community, and advocate in health policy. Centre for Asian and Ethnic Minority Health Research (Auckland University) Centre for Migrant and Refugee Research (Auckland University of Technology) The Centre for Migrant and Refugee Research (CMRR), undertakes, promotes and distributes research that advances understanding of issues that can improve access to healthcare and promote good health among the migrant and refugee populations in New Zealand. Counties Manukau Health’s Asian Health Forum The Counties Manukau Pan Asian Health Interest Group (PAHIG) was created to provide a forum where Asian communities can come together to share their views and advice on health and wellbeing matters and provide input into our future health services. The group’s 13 members include CM Health staff, community members from the education sector and non-governmental organisations such as The Asian Network Inc (TANI), and Plunket. With extensive links with key Asian community stakeholders and local and regional professional networks, PAHIG can support health services planning, implementation or evaluation by ensuring relevant Asian community leaders and community groups are engaged for cultural input and advice. Members include (2105): Carlos Lam Yang, Rani Joseph, Kar Po Chong, Jennifer Goddard, Priya Shahi, Edith Padavatan, Tomoko Yamaguchi, Derek Luo, Kitty Ko, Chee-Khiang Sng, Renuka Bhat, Vasu Moses, Vishal Rishi, Vivien Cheung eCALD eCALDTM resources and courses have been developed by Waitemata DHB’s Asian Health Support Services to address the lack of CALD cultural competence training and information for the New Zealand health workforce. The provision of eCALDTM courses and resources "for working with patients" is funded by the Ministry of Health as part of the Northern Regional Alliance’s Asian, Migrant and Refugee Health Action Programme. see also Asian Health Week 2015 Waitemata DHB is showcasing the latest research and information on the health status of Asian populations in New Zealand and advances in preparing a culturally and linguistically diverse workforce nationwide in a free seminar series in August. Asian peoples are now 24 % of the Auckland region health population. The week-long seminar will provide an overview of the research that has been conducted in the area of Asian Health in New Zealand by leading academics and clinical leaders. Follow the links for the full programme (32 pages, PDF), Opening Celebration Event invitation (2 pages, includes map, PDF), Opening Day agenda (1 page PDF), and Workforce Forum invitation (3 pages, includes agenda and map, PDF). Presentations from Asian Health Week last updated 12 February 2024

Introduction
Data and Statistics
Selected Databases
Selected Journals
Selected Texts
Asian Health Organisations and Websites

 

Introduction  

Assuming no dramatic change in immigration policy in the next decade, the Asian population as a
proportion of New Zealand’s population will continue to increase. The Asian population is projected to grow at about three times the rate of the total population to 2026, reaching
about 790,000 in that year. Given the likelihood that regional settlement patterns will be similar to those experienced in the previous quarter century, about two-thirds of this
population will live in Auckland – with an estimated Asian population of 525,000 in 2026, comprising about 28 percent of Auckland’s population. For a detailed analysis of Auckland's
Asian population patterns and forecasts see Asian Auckland: the multiple meanings of diversity (2015)

Asian and migrant health

see also  'Research to action: Improving the lives of New Zealanders though health research' [Health Research Council of New Zealand. 2015]

see also 'The New Zealand Health Research Prioritisation Framework' (Health Research Council of New Zealand, 2019)

The Asian Health Research Review is an excellent source of the latest international research, news and local developments.

A decade of Asian and ethnic minority health research in New Zealand: findings from a scoping review
New Zealand Medical Journal.  ol 134 No 1542: 17 September 2021.
Conclusion
Overall, the evidence base on A/EM health in New Zealand is weak as there is limited information on health conditions and its determinants of minority groups, including their patterns of health service use. The nature and content of A/EM health research requires further substantive development in terms of understanding the health and its determinants of this ever increasing and heterogenous population group.

 

Data and Statistics

National. Ministry of Health

Asian health data and statistics

see also Asian Health Chart Book (2006)
This Asian Health Chart Book 2006 is the first comprehensive review of Asian health, and the first to systematically examine inequalities between Asian ethnic groups and between migrant and established Asian communities. The report adopts an indicator approach in order to focus attention on specific health issues of particular importance to Asian peoples. Information is presented on more than 80 indicators covering four domains: health status, health risk profile, social determinants of health, and patterns of health service utilisation.

HISO 10001:2017 Ethnicity Data Protocols (2017)
The Ethnicity Data Protocols describe the standard procedures for collecting, recording and using data on the ethnicity of people treated by or working in the New Zealand health and disability sector.

 

Statistics New Zealand

Asian peoples


Health Roundtable
We are a non-profit membership organisation of health services across Australia and New Zealand. We exist to:
Provide opportunities for health executives to learn how to achieve Best Practice in their organisations ;
Collect, analyse and publish information comparing organisations and identifying ways to improve operational practices ;
Promote interstate and international collaboration and networking amongst health organisation executives

Members are provided with a wide range of documents and presentations that identify innovations in health care practice, as well as comparative information and meeting notes. Any staff member from a member health service can access these reports by registering for access with their health service email address.

89 health service organisations across Australia and New Zealand are currently members of The Health Roundtable. Many health service members have multiple facilities. A total of 155 facilities currently provide data for comparative analysis.

  

Selected Databases  

Pubmed
The United States National Library of Medicine's premier bibliographic database providing information from Medicine, Nursing, Dentistry, Veterinary Medicine, Allied Health and Pre-Clinical Sciences.
Hint: When searching Pubmed for Asian content use the Subject heading Asian Continental Ancestry Group.

Index New Zealand
General index to New Zealand journals and newspapers from 1987 onwards.

NZResearch
New Zealand’s most comprehensive selection of research papers and related resources. This site include peer-reviewed and other research from universities, polytechnics, and research organisations throughout New Zealand

Publications New Zealand
Publications New Zealand is a record of publications from or about New Zealand, from the earliest days of publishing through to the present

 

Selected Journals

Asian Health Research Review
This Review features key medical articles from global Asian Health journals with commentary from Dr Annette Mortensen, Dr Geeta Gala, Professor Shanthi Ameratunga, Associate Professor Elsie Ho and Dr Roshini Peiris-John.

TANI newsletter
TANI newsletter provides information to both Asian communities and the service providers and shares their successful stories in terms of enhancing community health & wellbeing.


Selected Texts

Ministry of Health

Asian and migrant health publications

 

see also National Ethical Standards for Health and Disability Research and Quality Improvement

Health needs assessment of Asian people living in the Auckland region (2012)
This report, by Dr Suneela Mehta, was commissioned by the Northern DHB Support Agency on behalf of the Auckland Regional Settlement Strategy Migrant Health Action Plan, which represents Waitemata, Auckland and Counties Manukau DHBs. It is the most comprehensive report to date examining the health status and health service use of Chinese, Indian and Other Asian communities in the Auckland region. The report includes analyses of health issues that have not previously been addressed in detail for Asian communities in Auckland, such as mental health, health of older people, family violence, patient safety and disability.

Asian health in Aotearoa: 2011-2013: trends since 2002-2003 and 2006- 2007 (2016)
This report examines time trends in the health status of Asian participants interviewed in recent New Zealand Health Surveys, which recruit nationally representative samples of the resident New Zealand population.

Asian health in Aotearoa in 2006-2007: Trends since 2002-2003 (2010)
This study by Assoc. Prof. Robert Scragg was commissioned by the Northern DHB Support Agency (NDSA) on behalf of the Auckland Regional Settlement Strategy Health Steering group which represents Waitemata, Auckland and Counties Manukau District Health Boards. It provides an overview of the health status of Asian communities in 2006-07, in comparison with the rest of the New Zealand population; and at the same time provide information on trends in health status among the Asian communities since 2002-03.



International Benchmarking of Asian Health Outcomes for Waitemata and Auckland DHBs

This benchmarking report has been developed to profile and assess the health of Waitemata and Auckland districts' Asian population in an international context - considering their health status against our high level outcomes to maximise life expectancy and reduce inequalities in health outcomes. It is important to note that the Asian population is made up of many individual population groups and each of these groups has differing and specific health needs. Where possible, these difference are explored further in this report. The report has been developed alongside a supplementary Asian Health Benchmarking Technical Report.

Asian Health Support Services

Asian Health Action Plan

Final report on healthcare needs of Asian people: surveys of Asian people and health professionals in the North and West Auckland (2001)

Other texts

Document, audio and video resources on Asian Wellbeing (Asian Family Services)

New Zealand Asian Wellbeing & Mental Health Report 2021
Asian Family Services

The settlement outcomes of migrant youth: a bibliography of New Zealand and international literature [ New Zealand Immigration 2017]

Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders [2017]

Asian Auckland: the multiple meanings of diversity [Asia new Zeakand Foundation 2015]

Asian People's Strategy 2015-2020 : draft for consultation [Plunket, 2015]

Challenges for Asian health and Asian health promotion in New Zealand (2015)

Centre for Asian and Ethnic Minority Health Research (CAHRE) National Symposium 2014: Working together to Improve Asian and Ethnic Minority Health and Wellbeing (2014)

Conference Proceedings from the Second International Asian Health and Wellbeing Conference (2006)

Conference Proceedings from Inaugural International Asian Health Conference (2004)

The Impact of Gambling and Problem Gambling on Asian Families and Communities in New Zealand (2012)

Talking Therapies for Asian People: Best and promising practice guide for mental health and addiction services (2010)

Diverse communities: exploring the migrant and refugee experience in New Zealand (2008)

Walking a tightrope: Asian health research in New Zealand (2007)

Asian health in New Zealand - progress and challenges (2006)

Asian Childrens health (2005)

Mental health issues for Asians in New Zealand: a literature review (2003)

see also CALD Resources: Asian, Migrant and Refugee Health Publications

 

Asian Health Organisations and Websites

Asian Family Services
Asian Family Services was established in 1998 to provide counselling, public health education and support for all Asians in New Zealand.

Asian Forum 2017
ANA holds a one-day Asian nutrition and physical activity forum biennially. This event is designed to support those working to promote public health nutrition and physical activity in Asian communities with new research, resources, and tools.  This forum was held in Auckland on Wednesday 1st November 2017

Asian Health

Asian Health Services
Asian Health Services (AHS) was established to support Waitemata District Health Board's services to deliver culturally appropriate, accessible, responsive and effective services to our growing Asian migrant and refugee communities.

Asian Public Health [Auckland Regional Public Health Service]

Auckland Chinese Medical Association [ACMA]
ACMA, the Auckland Chinese Medical Association, is an association of New Zealand Registered Medical Practitioners that aims to be beneficial to the community by serving as a voice on matters of medical or health concern, particularly for Chinese New Zealanders. We hold regular clinical meetings and dinners for our members, a scientific conference every two years, are involved in promoting health within the community, and advocate in health policy.

Centre for Asian and Ethnic Minority Health Research (Auckland University)

Centre for Migrant and Refugee Research (Auckland University of Technology)
The Centre for Migrant and Refugee Research (CMRR), undertakes, promotes and distributes research that advances understanding of issues that can improve access to healthcare and promote good health among the migrant and refugee populations in New Zealand.

Counties Manukau Health’s Asian Health Forum
The Counties Manukau Pan Asian Health Interest Group (PAHIG) was created to provide a forum where Asian communities can come together to share their views and advice on health and wellbeing matters and provide input into our future health services. The group’s 13 members include CM Health staff, community members from the education sector and non-governmental organisations such as The Asian Network Inc (TANI), and Plunket. With extensive links with key Asian community stakeholders and local and regional professional networks, PAHIG can support health services planning, implementation or evaluation by ensuring relevant Asian community leaders and community groups are engaged for cultural input and advice.
Members include (2105): Carlos Lam Yang, Rani Joseph, Kar Po Chong, Jennifer Goddard, Priya Shahi, Edith Padavatan, Tomoko Yamaguchi, Derek Luo, Kitty Ko, Chee-Khiang Sng, Renuka Bhat, Vasu Moses, Vishal Rishi, Vivien Cheung


eCALD
eCALDTM resources and courses have been developed by Waitemata DHB’s Asian Health Support Services to address the lack of CALD cultural competence training and information for the New Zealand health workforce. The provision of eCALDTM courses and resources "for working with patients" is funded by the Ministry of Health as part of the Northern Regional Alliance’s Asian, Migrant and Refugee Health Action Programme.

see also
Asian Health Week 2015
Waitemata DHB is showcasing the latest research and information on the health status of Asian populations in New Zealand and advances in preparing a culturally and linguistically diverse workforce nationwide in a free seminar series in August.

Asian peoples are now 24 % of the Auckland region health population. The week-long seminar will provide an overview of the research that has been conducted in the area of Asian Health in New Zealand by leading academics and clinical leaders.

Follow the links for the full programme (32 pages, PDF), Opening Celebration Event invitation (2 pages, includes map, PDF), Opening Day agenda (1 page PDF), and Workforce Forum invitation (3 pages, includes agenda and map, PDF).

Presentations from Asian Health Week

 

 last updated 12 February 2024

Health Equity Clearinghouse

Contents What is Health Equity? New Zealand Resources Websites Toolkits and Guidelines Selected Reading Selected Journals International Resources Websites Toolkits and Guidelines Selected Reading Selected Journals What is Health Equity? Health equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically (WHO) The concept acknowledges that not only are differences in health status unfair and unjust, but they are also the result of differential access to the resources necessary for people to lead healthy lives (NZ MoH) A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity | Health Quality & Safety Commission (hqsc.govt.nz) Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. Te ao Māori framework The Health Quality & Safety Commission has developed a te ao Māori framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards across Aotearoa New Zealand. The initial framework concept is shown below, followed by a brief description. The aim of the framework is to improve the quality of care afforded to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. There are two downloadable PDFs at the bottom of this page, which include the basic framework concept plus a backgrounder on how and why it was developed. We are currently developing resources to support providers with implementation of the framework and will publish them here in due course. We would like to acknowledge and thank our partner providers who gave their information freely in the hope that much-needed change could happen and be sustained over time. Te ao Māori framework concepts Wairuatanga The holistic nature of Māori health, which links physical illness to emotional and spiritual wellbeing. Hence wairuatanga is in the middle position of the framework, which makes culture a central focus in the design of services. The goal of wairuatanga is to embed tikanga Māori and cultural safety into the health system. Pātuitanga The growing and fostering of strong partnerships with Māori, which is fundamental to ensuring the right concepts are included in the design and delivery of services. Whānau Whānau need and improving health outcomes for whānau are the drivers to why services are created and designed. Rangatiratanga The inclusion of Māori leadership in decision-making processes when services are designed. Te ao Māori framework design Each of the outer sections have two koru representing tapu and noa. The haehae lines bind each section together and connect and interact with each other. The inside koru of each concept opens into wairuatanga, which allows wairuatanga to flow seamlessly throughout the entire framework. The outside koru opens into te ao Mārama. The pītau design on the edge of the outer sections represents new beginnings and is the interconnection between te ao Māori and te ao Mārama. Downloadable attachments Te ao Māori framework (356 KB, pdf) Te ao Māori framework background document (1.2 MB, pdf) Editorial from the NZMJ (2021): 'Closing the gaps: health equity by 2040' The main goals of the “once in a generation” Health and Disability System Review, which has led to a major system restructuring that’s now in its early stages, included better health outcomes for all and greater health equity, despite the review accepting that most of a person’s health status is determined by factors outside the system. In July this year, the Association of Salaried Medical Specialists (ASMS) and the Christchurch Charity Hospital Trust (CCHT) co-hosted a conference of health professionals to discuss the broader range of policies that are needed to address health inequities and improve health outcomes for all. This article outlines some of the key issues and recommendations to government emanating from that conference and contain in our report, Creating Solutions Te Ara Whai Tika: a roadmap to health equity by 2040. Māori Health Priorities Report (2022) This Māori Health Priorities report draws focus to the biggest contributors to health loss and health inequity for Māori, and also represent the greatest potential for intervention. This report was commissioned by Te Aka Whai Ora to inform our positioning on the priorities for the interim New Zealand Health Plan (iNZHP) for Māori. Health Equity at CM Health Health equity at ADHB Fact and action sheets on health inequities [University of Otago and New Zealand Medical Association] These fact and action sheets were prepared in the lead up to a visit by Sir Michael Marmot in July 2011, hosted by the New Zealand Medical Association. The purpose of these sheets includes an attempt at a brief stocktake on health inequities in New Zealand, both on what the current state of play is and what the future policy priorities might be. Equity is the new black—and black lives matter (2020) Editorial from New Zealand Medical Journal "There is overwhelming evidence of inequities in health outcomes for Māori—you need look no further than the previous issue of NZMJ or the Wai 2575 Māori Health Trends Report. COVID-19 also presents a concern for the likely disproportionate impact on Māori. Council encourages all doctors, employers, training and professional organisations to consider the findings in the cultural safety Report, draw on the data, and use this as a basis for achieving long-term, positive change for the benefit of all patients and whānau. While the Report offers an insight into current practice, it is only the first step on a long journey. It sets a baseline for ourselves and our stakeholders to use when developing programmes, strategies and policies that support us to drive change." Racism Whiria te Muka Tangata: Anti-Racism Systems Change. Ministry of Health. 2023 This publication outlines a preliminary systems change model that provides an organisational and system-level blueprint for anti-racism action in health. Evolution of Racism and Anti-Racism – Lessons for the Aotearoa New Zealand Health System (Stage One Literature Review) Minsitry of Health 2022 Evolution of Racism and Anti-Racism – Lessons for the Aotearoa New Zealand Health System. This is the first literature review in the Ao Mai te Rā series. This review traces how understandings of racism and anti-racism have shifted over time and explores various concepts, language and definitions that have been used to date. The review considers how we might frame and think about racism and anti-racism within the Aotearoa New Zealand context and has been used to inform the Ministry’s position statement and working definitions for racism and anti-racism in health. Best Practice Approaches to Addressing Racism – Lessons for the Aotearoa New Zealand Health System (Stage Two Literature Review) Minstry of Health. 2023 This is the second literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review explores best practice approaches to addressing racism in all its forms. Anti-Racism Maturity Models – Lessons for the Aotearoa New Zealand Health System (Stage Three Literature Review) Ministry of Health. 2023 This is the third and final literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review examines the key features and characteristics of an anti-racism maturity model approach. Evolution of Racism and Anti-Racism Literature review and Summary Document (2022) Position statement and working definitions for racism and anti-racism in the health system in Aotearoa New Zealand (2022) Understanding 'white privilege?' Racism and White Defensiveness in Aotearoa: A Pākehā Perspective (2018) Māori health: 'We have to be talking about racism' (2018) Videos Māori lives matter [HQSC] In this presentation from the Health Quality & Safety Commission's Ō tātou hiranga advance care planning hui, Hector Matthews shines the spotlight on Māori inequity and the systemic biases that perpetuate inequities. He challenges us to confront some uncomfortable truths about inequity and explore ways we can truly place people’s cultural framework at the centre of their care and wellbeing. Dr Lance O'Sullivan on a mission for health equity [Ko Awatea ] Dr Lance O'Sullivan is at Middlemore Hospital working on a new health equity programme. In a 2016 interview on Te Karere he talks about his belief that regardless of race, age or income, people should have the same health opportunities as the next. What is Health Equity? [Health Equity Institute] This three-minute motion graphic video explains how social, economic, and environmental conditions can create health inequities and how these inequities can affect health disparities. What Is Health Equity, and Why Does It Matter? [IHI] David R. Williams, Professor of Public Health at the Harvard T.H. Chan School of Public Health, has been researching health inequities in the United States for two decades. In this video, he sits down with Don Berwick, MD, President Emeritus and Senior Fellow at IHI, to talk about health equity and why it’s important. Social Media twitter #healthequity New Zealand Resources Websites Equity [Ministry of Health] Equity Explorer [HSQC] The Equity Explorer provides information on how health and health care varies between groups of people, and between district health board (DHB) areas of Aotearoa New Zealand (NZ). Two types of group are compared: ethnic groups and groups based on socioeconomic status (deprivation). The health conditions compared are diabetes, asthma and gout. Maori Health Clearinghouse Pacific Health Clearinghouse Asian Health Clearinghouse Health system quality dashboard Health & Quality Safety Commission (NZ). In partnership with Te Tumu Whakarae, HQSC has developed a new specific Māori Health Equity Report, using distinct data. Toolkits and Guidelines Hospital Ethnicity Data Audit Toolkit | Ministry of Health (2021) A resource for assessing the quality of ethnicity data in New Zealand hospital settings, and supports quality improvement in this area. The scope of the Toolkit (also known as HEDAT) includes four tools to assess the quality of ethnicity data and systems for data collection, recording and output within a hospital setting, and provides guidance on quality improvement activities. The Toolkit helps hospitals assess health care ethnicity data against the HISO 10001:2017 Ethnicity Data Protocols and, more broadly, against current best practice. Medicine access equity monitoring and outcomes framework (NZ: 2021) Pharmac We’re establishing baseline measures of inequity for access to funded medicines for our priority conditions. These reports mark the first time we have measured equity of access to funded medicines for these key long-term conditions. Our insights are drawn from dispensing data for Māori and Pacific peoples to treat: asthma cardiovascular conditions chronic obstructive pulmonary disease (COPD) gout type 2 diabetes. We are publishing our insights to raise awareness of current medicine access inequities. We hope they spark discussions on medicine access equity across the health sector. We welcome any feedback on our insights. Creating Solutions Te Ara Whai Tika: A roadmap to health equity by 2040. (NZ: 2021) Associated of Salaried Medical Specialists The Creating Solutions Te Ara Whai Tika report by the Association of Salaried Medical Specialists Toi Mata Hauora, recommends a national goal of achieving health equity for all New Zealanders by 2040 and lays out a roadmap of policies to get there. It follows presentations, discussions, and input from more than 200 health professionals who attended a virtual conference co-hosted by ASMS and the Canterbury Charity Hospital Trust, established by Dame Sue and Associate Professor Phil Bagshaw. Achieving Equity in Health Outcomes: Highlights of selected papers [NZ; 2018] Both in New Zealand and globally, our ability to address equity challenges in health has significantly improved over the past decades. In the Western world life expectancy has increased for all populations. However persistent disparities in health access, quality of services and outcomes remain. In Aotearoa New Zealand, Māori and Pacific and those in low socioeconomic groups remain the most disadvantaged. The Government has mandated the Ministry of Health to take a bold approach that delivers tangible changes to system behaviour with measurable results in a three to five-year horizon. An approach that operates on a repeating cycle based around deepening the understanding of equity gaps, shifting thinking about where priorities for investment of time and resources lie, followed by increasing direct action to address inequalities is being developed. This paper traces the beginnings of health equity and the philosophical and ethical foundations that sit behind it. It looks at a selection of the international and local literature to help understand definitions of equity. It considers how framing and thinking about the concept of equity and approaches to addressing equity have evolved, and how progress to address equity can be measured. The Health Equity Assessment Tool: a User's Guide [NZ] The Health Equity Assessment Tool: A User's Guide, has been developed by the University of Otago, Wellington, to help facilitate the use of the Health Equity Assessment Tool (HEAT). The Health Equity Assessment Tool: A User's Guide gives a brief overview of inequalities in health, introduces the HEAT and its use, presents an in-depth look at each of the HEAT questions, and provides case examples of the tool's use. This publication is an essential guide for those working in the health and disability to apply a strong equity focus to their work. Equity of Health Care for Māori: A Framework [NZ] This framework guides health practitioners, health organisations and the health system to achieve equitable health care for Māori through leadership, knowledge and commitment. Quality improvement: no quality without equity? [NZ; 2017] This ‘think piece’ from the Health Quality & Safety Commission signals our intention to tackle health inequities. Central Region Equity Framework TAS, 2019 The Central RegionEquity Framework has been developed by theCentral Regionand was endorsed by the Central Region Chief Executives in April 2019. The Central Region is a combination of MidCentral DHB, Hawke’s Bay DHB, Whanganui DHB, Wairarapa DHB, Hutt Valley DHB and Capital and Coast DHB. The Central Region Service Planning Forum (CRSPF) commissionshealth and disability services that aim to improve health outcomes and achieve equity for all populations living in the central region district health board areas. This Framework1provides guidance to the CRSPF on strengthening their commissioning to achieve equity within activities identified within the Central Region’s Regional Service Plan (RSP). In the Central Region, equity in health is based on the WHO definition of equity –the absence of avoidable or remediable difference among groupsof people. The concept acknowledges that these differences in health status are unfair and unjust. However,they are also the result of differential access to the resources necessary for people to lead healthy lives. Peoplewho are poor, have chronic conditions/diseases, live with disabilities, live rurallyand are of different ethnicities, will have poorer health, greater exposure to health risks and poorer access to health services2.These variables are unlikely to exist in isolationasthey are deeplyinterwoven.The concept of intersectionality is vital when exploring the fundamental causes of inequity.In New Zealand, inequalities between Māori and non-Māori are the most consistent and compelling inequities in health. The Central Region Chief Executives and the Central Region Māori General Managers hold the view that these differences are not random.They exist because of institutional racism3and the impact of colonisation and its continuing processes4.Achieving equity for Māoriis a priority, as the health gaps across the life-coursearesignificant for Māori.The Treaty of Waitangi was signed to protect the interests of Māori. It is not in the interest of Māorito be disadvantaged in any measure of social or economic wellbeing5.A companionTreaty of Waitangi document will be developed, with the purpose of providing direction to the Central Region DHBs on what they need to do to meet theirTreaty of Waitangi obligations. HE PIKINGA WAIORA IMPLEMENTATION FRAMEWORK University of Waikato, 2016 The Framework has indigenous self-determination at its core. All four elements have conceptual fit with Kaupapa Māori aspirations and all have demonstrated evidence of positive implementation outcomes. A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities in Australia, Canada, New Zealand, and the United States. Cross-tabulations demonstrated that cultural centeredness (p=.008) and community engagement (p=.009) explained differences in diabetes outcomes and community engagement (p=.098) explained difference in blood pressure outcomes. The Framework is intended as a planning tool to guide the successful development and implementation of interventions. Funders can use the Framework to assess the likely effectiveness of proposed interventions. Community organizations can use the Framework to work with researchers or policy makers to strengthen each of the four elements. Pitama, S., Huria, T., & Lacey, C. (2014). Improving Maori health through clinical assessment: Waikare o te Waka o Meihana. The New Zealand Medical Journal (Online), 127(1393). Health professionals play an important role in addressing indigenous health inequalities. This paper describes the further development and a new conceptualisation of the Meihana model (2007) and the Hui process (2011), which together have formed the indigenous health framework in the University of Otago, Christchurch undergraduate medical education programme for 4th–6th year medical students over the past 5 years. The components of the framework are defined followed by description of their application to clinical assessment. The indigenous health framework has been evaluated by medical students, health practitioners, Māori patients and whanau over this time and has been rated favourably as a clinically relevant framework that supports health practitioners to work effectively with Māori patients and whānau. Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health - Wilson - 2021 - Journal of Clinical Nursing Conclusions This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing). Literature Review to Inform the Development of a Culturally Appropriate Assessment Model for Māori (2022) Introduction The purpose of this literature review is to inform the development of a culturally appropriate assessment model that meets the need of Māori and whānau and will enable a holistic assessment of needs and inform the provision of care and support services. Capturing relevant findings from the literature will ensure that the processes undertaken to develop a culturally appropriate model are evidence based. The findings of the review are intended to assist the Francis Health project team and wider steering group in how best to approach this work. The wider project is underpinned by a kaupapa Māori approach, one framework being utilised is the Te Pā Harakeke Framework. This literature review as an input contributes to Te Puawai in the framework. Te Puawai references the flower head of the harakeke plant and refers to the processes used within each function to give effect to the strategy of the kaupapa. Largely, it seeks to inform ways to weave Kaupapa Māori approaches with interRAI assessment to enable positive outcomes for Māori. The literature review is one of many information streams that is feeding into the project. The scope of the literature review includes: − Approaches undertaken to make established assessment tools culturally appropriate − Approaches undertaken to develop assessment tools that are compliant with Te Ao Māori − How to implement relational Māori models of health within an assessment tool Whānau Ora Health Impact Assessment Ministry of Health, 2007 The Whānau Ora Health Impact Assessment tool was published in April 2007 by the Ministry of Health and builds on the Public Health Advisory Committee’s, ‘A Guide to HIA: A Policy Tool for New Zealand’ (2005). The Whānau Ora HIA tool follows the same methodology: Screening, Scoping, Appraisal and Reporting and Evaluation. It follows the same methodology: Screening, Scoping, Appraisal and Reporting and Evaluation. It was developed for use by policy makers as a tool for assessing the positive and negative impact of their policies on Māori and to identify ways in which these could be enhanced or adapted. It complements other resources aimed at promoting Māori health including the Health Equity Audit Tool. It was produced in response to the fact that the Māori population experiences significantly poorer health outcomes than the rest of New Zealand’s population and as a way to support delivery of the Ministry of Health’s strategic vision to improve health outcomes and reduce inequalities for Māori outlined in He Korowai Oranga: Māori Health Strategy 2002. At the heart of the tool is the concept of ‘Whānau ora’, which means, ‘Māori families being supported to achieve their maximum health and well being’. Its overarching aim is to ensure equity in health for Māori. Reducing Inequalities in Health Ministry of Health, 2002 Summary In New Zealand, ethnic identity is an important dimension of health inequalities. Maori health status is demonstrably poorer than other New Zealanders; actions to improve Maori health also recognise Treaty of Waitangi obligations of the Crown. Pacific peoples also have poorer health than Pakeha. In addition, gender and geographical inequalities are important areas for action. Addressing these socioeconomic, ethnic, gender and geographic inequalities requires a population health approach that takes account of all the influences on health and how they can be tackled to improve health. This approach requires both intersectoral action that addresses the social and economic determinants of health and action within health and disability services themselves. Reducing Inequalities in Health proposes principles that should be applied to whatever activities we undertake in the health sector to ensure that those activities help to overcome health inequalities. The proposed framework for intervention entails developing and implementing comprehensive strategies at four levels. Structural – tackling the root causes of health inequalities, that is, the social, economic, cultural and historical factors that fundamentally determine health. Intermediary pathways – targeting material, psychosocial and behavioural factors that mediate the impact of structural factors on health. Health and disability services – undertaking specific actions within health and disability services. Impact – minimising the impact of disability and illness on socioeconomic position. Intervention at these four levels should be undertaken nationally, regionally and locally by policy-makers, funders and providers. The framework can be used to review current practice and ensure that actions contribute to improving the health of individuals and populations and to reducing inequalities in health. It also highlights the importance of factors outside the direct control of the health sector in shaping the health of our population. Those outside the health sector – particularly The Treasury, the social welfare, education, housing and labour market sectors, and local government – can contribute significantly to the task of reducing inequalities in health. Success in reducing inequalities in health brings positive results for the individual, the economy and society. It enables New Zealanders to live healthier, longer lives. In turn, a healthier population will increase the country’s prosperity. Te Rōpū Whakakaupapa Urutā Analysis of Health Sector Equity Tools Te Rōpū Whakakaupapa Urutā There is an existing suite of equity tools that clearly articulate and define the ways in which equity can be placed at the heart of the health system. Equity resources The following frameworks, guidelines and statements have informed the principles that underpin our recommendations and specific actions: Te Rōpū Whakakaupapa Urutā Position Statement He Pikinga Waiora Implementation Framework (Healthier Lives NSC, 2016) Governance for Health Equity (World Health Organisation, 2013) He Ara Hauora Māori: A Pathway to Māori Health Equity (Medical Council of NZ, 2019) Equity Tools Reducing Inequalities in Health Framework Health Equity Assessment Tool - A Users Guide Whānau Ora Health Impact Assessment Equity of Healthcare for Māori: Framework Central Region DHB's Equity Framework Analysis of Equity Tools In preparation for the restart of the health system and recovery from COVID-19. Te Rōpū Whakakaupapa Urutā has carried out a quick review and analysis of the existing equity tools currently available to the health sector. Our analysis provides information about each tool's development, origins, what the tool is, how long it has been in the system, examples of where the tools have been implemented and a view of their usefulness. As we plan for a restart of the health services and a desire to reset the system so that it achieves equity for Māori, being aware of these tools and using/adapting them might be helpful. All tools to some degree use an intervention logic: problem definition, engagement with stakeholders, intervention planning, monitoring and evaluation. Additionally they are likely to be more useful in specific contexts. For example: The Equity of Health Care for Māori, the Central Region DHBs Equity Framework and the Health Equity Assessment Tool and its’ users guide are health services focused. The Whānau Ora Health Impact Assessment can be used at both a policy and project level with its strength being on the health impacts resulting from other sector activities. The Reducing Health Inequalities Framework is a useful background document which identifies that actions needs to be in four areas: system, intermediary environments, health services and impact of ill health and disability it is best used with another tool that is more intervention focused. Our quick review and analysis is available here (doc attached) Selected Reading Maranga Mai! = The dynamics and impacts of white supremacy, racsim and colonisation upon tangata whenua in Aotearoa New Zealand Te Kaahui Tika Tangata, the New Zealand Human Rights Commission (2022) The report provides a crucial perspective on extremely challenging issues which will define Aotearoa for years to come. It compels us to acknowledge the white supremacy and institutional racism woven into the fabric of the colony as immigrants settled in these islands,” said Te Amokapua Chief Human Rights Commissioner Paul Hunt. Maranga Mai outlines the immense harm caused to Māori by more than 180 years of colonisation – resulting in discrimination, violence and impoverishment A three-year Truth, Reconciliation and Justice Commission, as recommended by the report, would aid understanding of the injustices affecting Māori and help with the healing and reconciliation. It would also provide a path to realising constitutional certainty before the bicentenary of Te Tiriti in 2040, he said. Maranga Mai explains that to be free of discrimination and to determine their own future, tangata whenua want tino rangatiratanga under Te Tiriti restored, as well as their indigenous rights under the United Nations Declaration on the Rights of Indigenous Peoples (Undrip). Maranga Mai recommended: Committing to constitutional transformation. Establishing a Truth, Reconciliation and Justice Commission. Establishing an independent body or bodies to uphold Te Tiriti and indigenous rights. Appointing an Indigenous Rights Commissioner and exploring the option for an independent Indigenous Rights Commission. Ki te whaiao, ki te ao Mārama Community Engagement Report for developing a National Action Plan Against Racism Te Kaahui Tika Tangata, the New Zealand Human Rights Commission (2022) The report describes the long history of racism in Aotearoa affecting tangata whenua and ethnic and religious communities. It has more than 40 recommendations, including: Eliminating racism in key sectors (housing, employment, work and income, health, education, criminal justice). Addressing the land issues of tangata whenua in a Tiriti-based way. Constitutional transformation. Education about the history of colonisation and racism in Aotearoa. A campaign encouraging the public to take anti-racist action. Requiring or incentivising public and private organisations to take anti-racist action. Mortality outcomes and inequities experienced by rural Māori in Aotearoa New Zealand The Lancet (2022) The excess Māori all-cause mortality across the rural: urban spectrum is consistent with existing literature documenting other Māori health inequities. A similar but more pronounced pattern of inequities is observed for amenable mortality that reflects ethnic differences in access to, and quality of, health care. The excess all-cause and amenable mortality experienced by rural Māori, compared to their urban counterparts, suggests that there are additional challenges associated with living rurally. A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill New Zeland Medical Journal (2022) The Pae Ora (Healthy Futures) Bill is the framework for a reformed health system intended to embed Te Tiriti o Waitangi and centre equity. The Bill is informed by the Wai 2575 Health Kaupapa Waitangi Tribunal Inquiry and the Health and Disability System Review, both of which established an urgent mandate to transform the health sector. This desktop review explores to what extent the proposed Bill is likely to uphold Te Tiriti. Is racism in energency care contributing to higher Māori mortality rates? Emergency Medicine Australasia (2022) "If we want to see health equity for Māori, we cannot continue to ignore the reasons these inequities persist. We need to talk maturely about racism. The opposite of racist is not ‘not racist’ but anti-racist. Being ‘not racist’ is not a neutral place to stand but perpetuates the status quo. The skills to be anti-racist and to embed anti-racist practice and policies are learnable. It is a journey we can walk together as a profession and as a college." see also: Curtis E, Paine SJ, Jiang Y et al. Examining emergency department inequities in Aotearoa New Zealand: findings from a national retrospective observational study examining Indigenous emergency care outcomes. Emerg. Med. Australas. 2022; 34: 16–23. The whitewashing of contracts: Unpacking the discourse within Māori health provider contracts in Aotearoa/New Zealand Health and Social Care in the Community (2021) Success of the proposed health reforms and the Māori Health Authority should require dismantling of non-Māori ways of commissioning and contracting, otherwise there is the continued risk of discriminatory contracting practices limiting the expression of self-determination for Māori health providers. The Choosing Wisely campaign and shared decision-making with Māori New Zealand Medical Journal (2021) This work identified some structural issues in Choosing Wisely New Zealand that have limited the campaign’s ability to mitigate health inequities for Māori and helped to define a potentially transformative way forward. There was wide agreement among our participants that shared decision-making is not just a quality practice, but that it also has the potential to address health inequity among Māori by facilitating participation in healthcare that better meets self-identified need. “Practitioner dependent” factors like consumer trust, autonomy, good relationships and rapport with health providers and culturally appropriate resources are important and are as demanding of attention as systemic causes of health inequity, such as inadequate access to services, the social determinants of health and the structural determinants of health, including racism. Barriers and facilitators for Māori in accessing hospital services in Aotearoa New Zealand New Zealand Medical Journal (2021) Māori health inequities result from systematic failures in the provision of healthcare by the public health system and historical structural failures that have led to the inequitable distribution of the social determinants of wellbeing for Māori compared to non-Māori. He Tamariki Kokoti Tau: Tackling preterm incidence and outcomes of preterm births by ethnicity in Aotearoa New Zealand 2010‐2014. International Journal of Gynecology & Obstetrics.(2021) Conclusion This study demonstrates that the Aotearoa New Zealand maternity system privileges whiteness, suggesting that clinical pathways for evidence-based medical care are not delivered systemically and equitably for all. Health pathways that focus on equity as a fundamental right will enhance health outcomes for Māori women and their infants. The human and health costs of failure to implement pro-Tiriti and pro-equity health policies: let’s act as if we know this New Zealand Medical Journal. Vol 134 No 1542: 17 September 2021 After a twenty-year period of relative stability in the health system, we are entering a period of very considerable change. These changes are driven, in part, by a clearly stated desire on the part of government for fairer health outcomes for Māori. Inequities in people with gout: a focus on Māori (Indigenous People) of Aotearoa New Zealand / Te Karu, L., Dalbeth, N., & Stamp, L. K. Therapeutic Advances in Musculoskeletal Disease (2021) Health equity can be defined as the absence of systematic disparities in health between more and less advantaged social groups. Gout is one of the most common forms of arthritis and disproportionally affects Indigenous peoples, including Māori in Aotearoa New Zealand. Inequities in gout management are well documented and clearly evidenced in Indigenous populations. For example, while gout occurs at a younger age and is more severe in Māori, there is less regular dispensing of urate-lowering therapies. Indigenous peoples are also under-represented in clinical trials. Herein, we will review inequities in gout using Aoteoaroa New Zealand as an example. We will explore reasons for health inequities and challenges that need to be faced to achieve health equity. Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health (2021) This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing). My role in tackling health inequalities: a frameworkl for allied health professionals KingdFund (2021) The King’s Fund has worked with AHPs from across the UK to develop a framework to support any AHP to think through and understand their contribution to tackling health inequalities, whatever their role. The framework details how AHPs can raise awareness, take action and optimise advocacy through six lenses: self; patients; clinical teams, pathway and service groups; communities and networks; systems; and nurturing the future. The framework is designed to support AHPs to do whatever they can – large or small – to tackle health inequalities. Rapua Te Ara Matua: Equity report Waikato DHB (2021) WDHB endorsed the report, taking active ownership and explicitly acknowledging their DHB is: "embedded in a healthcare system which has privileged the needs of the majority while failing to meet the needs of all" "Waikato DHB is party to the systematic failure to adequately address and eliminate equity gaps and provide services that are culturally competent and holistic for Tangata Whenua" The report provides a clear view of the inequities experienced by Maori people and Pacific people and the systemic failure they continue to receive. While some of the data is undoubtedly confronting- the reality is this is what our priority populations endure on a daily basis. Among other actions, the report identified (and we may have heard this before..) "Maori-led structural change was needed within the DHB to address the gaps in health equity." Telehealth as a tool for equity: pros, cons and recommendations NZMJ. Issue: Vol 134 No 1530: 19 February 2021 In this viewpoint, we consider whether telehealth is an equity-positive tool that might help to overcome some important barriers to health care access for Māori and Pacific people. We consider the equity ramifications of a shift toward models of care that maximise the use of telehealth solutions, and our recommendations regard how we might best achieve the equity-positive potential of telehealth for Māori and Pacific people. Achieving Equity in Health Outcomes: Summary of a discovery process. Ministry of Health. 2019. In 2018, the Ministry of Health initiated a work programme on achieving equity in health outcomes. Specifically, this programme aims to ensure that equity is at the heart of the way New Zealand’s health and disability system operates and to promote the cultural shift needed to achieve that. This report provides a brief summary of phase one of the Achieving Equity Work Programme: The Discovery Phase. The aim of the discovery phase was to identify where practical and coordinated effort could be undertaken to achieve a measurable shift in health equity in the next three to five years. Through an examination of the literature; a review of evidence; and consideration of what people said needs to be tackled in the health and disability system, common challenges and opportunities for achieving health equity in Aotearoa/New Zealand have been explored. The Waitangi Tribunal’s WAI 2575 Report: Implications for Decolonizing Health Systems Health and Human Rights Journal (2020) Te Tiriti o Waitangi, a treaty negotiated between Māori (the Indigenous peoples of Aotearoa) and the British Crown, affirmed Māori sovereignty and guaranteed the protection of hauora (health). The Waitangi Tribunal, established in 1975 to investigate alleged breaches of the agreement, released a major report in 2019 (registered as WAI 2575) about breaches of te Tiriti within the health sector in relation to primary care, legislation, and health policy. This article explores the implications of this report for the New Zealand health sector and the decolonial transformation of health systems. The tribunal found that the Crown has systematically contravened obligations under te Tiriti across the health sector. We complement the tribunal’s findings, through critical analysis, to make five substantive recommendations: (1) the adoption of Tiriti-compliant legislation and policy; (2) recognition of extant Māori political authority (tino rangatiratanga); (3) strengthening of accountability mechanisms; (4) investment in Māori health; and (5) embedding equity and anti-racism within the health sector. These recommendations are critical for upholding te Tiriti obligations. We see these requirements as making significant contributions to decolonizing health systems and policy in Aotearoa and thereby contributing to aspirations for health equity as a transformative concept. Baseline Data Capture: Cultural Safety, Partnership and Health Equity Initiatives FINAL REPORT (2020) The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA), is pleased to release an independent report outlining findings of the current state of cultural safety and health equity delivered by doctors practicing in Aotearoa New Zealand and experienced by patients and whānau. Māori patients’ experiences are the focus of the report, however many of the challenges and solutions will be applicable to other ethnic groups and populations who experience inequitable healthcare. Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health. Journal of Clinical Nursing. (2021) This study highlights the importance and relevance of relational ap-proaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust- based relation-ships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empa-thy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (impor-tance of spiritual wellbeing). Racism and health in Aotearoa New Zealand: a systematic review of quantitative studies (2020) Quantitative racism and health research in New Zealand consistently finds that self-reported racial discrimination is associated with a range of poorer health outcomes and reduced access to and quality of healthcare. This review confirms that experience of racial discrimination is an important determinant of health in New Zealand, as it is internationally. There is a pressing need for effectively designed interventions to address the impacts of racism on health. Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research (2020) Australia and New Zealand Journal of Public Health This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’ Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition [NZ] International Journal for Equity in Health There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care...A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. Tofa Saili: A review of evidence about health equity for Pacific Peoples in New Zealand' Pacific Perspectives (2019) This report describes the health equity issues faced by Pacific families and communities. The report highlights approaches based on Pacific values and the strengths of Pacific communities. It is informed by the Pacific Aotearoa vision (Ministry of Pacific Peoples, 2019). A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity HQSC, 2019 Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. A window on the quality of Aotearoa New Zealand’s health care 2019 – a view on Māori health equity (Window 2019) highlights a number of areas where change is needed in the health system. The report is divided into three chapters. The first analyses inequity between how Māori and non-Māori access and receive health services, and the effects on equity of improvement activities in our system. The second chapter asks why these inequities exist, and the third chapter addresses opportunities for improvement. Addressing equity in intergenerational wellbeing: Valuing community perspectives Deloitte and Victoria University of Wellington, 2019. Our partners at Victoria University of Wellington’s School of Government look at New Zealand’s wellbeing frontier and the importance of bringing in community perspectives to build effective policy. Understanding inequalities: summary report. The impact of inequalities in the early years on outcomes over the life course: Using international evidence to identify creative policy solutions. Growing up in New Zealand, 2019. The findings from the Growing Up in New Zealand study demonstrate that Maori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course. By the time they start school (at age 5 years) many are already falling behind their peers in terms of preparedness for formal education and readiness to engage in learning. The study has shown that inequalities in developmental opportunities and outcomes have their origins in early in life. Risk factors for early vulnerability cluster and there is no one single proxy marker of disadvantage. Additionally, morbidity and poor outcomes cluster. Persistent adversity is associated with a graded likelihood of poor outcomes (across the population). Further service use is not meeting measured need. Currently, access to early life universal services may be widening inequalities. A proportional-universalism approach to services is required if they are to meet real need and reduce inequalities. 'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry' Waitangi Tribunal. Our stage one report addresses claims concerning the way the primary health care system in New Zealand has been legislated, administered, funded, and monitored by the Crown since the passing of the New Zealand Public Health and Disability Act 2000 (‘the Act’) Statistics. In our report we explore whether the persistent inequitable health outcomes suffered by Māori are indicators of Treaty breach. In doing so, we ask whether a cause of the inequitable health statistics suffered by Māori is the legislative and policy framework of the primary health care system itself. n approaching our task, we identified four main thematic issues to focus on for this stage of the inquiry : the Treaty-compliance of the Act and framework ; funding arrangements for primary health care ; accountability arrangements for primary health care ; and the nature of Treaty partnership arrangements in the primary health care sector. He oranga mo Aotearoa: Māori wellbeing for all Deloitte We consider various Māori wellbeing frameworks and measurements, the barriers to Māori wellbeing and the drivers and changes that could improve it. Delivering better outcomes together: Policies that reflect our diverse cultures Deloitte The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all. The health equity measurement framework: a comprehensive model to measure social inequities in health International Journal for Equity in Health201918:36 Clinical research trials achieving equitable health outcomes for Māori. ACTA International Clinical Trials Conference 2019. Assoc Prof Matire Harwood.Dept General Practice, FMHS, University of Auckland Includes discussion of the model for 'Explaining Ethnic Determinants of Health'. Ethnic bias and clinical decision-making among New Zealand medical students: an observational study [NZ] BMC Medical EducationBMC series – 201818:18 (2018) Lessons for Achieving Health Equity Comparing Aotearoa/New Zealand and the United States [NZ] Health Policy 2019 To authentically commit to achieving health equity, nations should: 1) Explicitly design quality of care and payment policies to achieve equity, holding the healthcare system accountable through public monitoring and evaluation, and supporting with adequate resources; 2) Address all determinants of health for individuals and communities with coordinated approaches, integrated funding streams, and shared accountability metrics across health and social sectors; 3) Share power authentically with racial/ethnic minorities and promote indigenous peoples’ self-determination; 4) Have free, frank, and fearless discussions about impacts of structural racism, colonialism, and white privilege, ensuring that policies and programmes explicitly address root causes. Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research (2017). N Z Med J. 2017 Nov 10;130(1465):96-103. Excellent health research is essential for good health outcomes, services and systems. Health research should also build towards equity and in doing so ensure that no one is left behind. As recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisational approach to this endeavour. However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work. In this viewpoint paper we provide an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori. We also describe an equity-based approach to responsiveness to Māori and highlight four key areas that require careful consideration, namely: (1) relevance to Māori; (2) Māori as participants; (3) promoting the Māori voice, and; (4) human tissue. Finally, we argue for greater engagement with responsiveness to Māori activities as part of our commitment to achieving equitable health outcomes. The Determinants of Health for Pacific Children and Young People in New Zealand (2014) (Determinants of Health for Children and Young People). New Zealand Child and Youth Epidemiology Service (2016) Te Ohonga Ake The Determinants of Health for Māori Children and Young People in New Zealand Series Two (2016) New Zealand Child and Youth Epidemiology Service (2016) The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study[NZ] BMC Public Health 12.1 (2012): 1. Geography matters: the prevalence of diabetes in the Auckland Region by age, gender and ethnicity [NZ] New Zealand Medical Journal 2016; 129 (1436): 25-37 Health equity in the New Zealand health care system: a national survey. [NZ] International Journal for Equity in Health 10.1 (2011): 1. Health equity: what does it mean for child health [NZ] New Zealand Medical Journal 2011; 124 (1347) Health inequalities: unfair, measurable and remediable? The case of New Zealand. [NZ] Paper prepared for the WHO Commission on Social Determinants of Health. Policy implementation for health equity in Aotearoa: examining healthy eating and physical activity programmes in Maaori and Pasifika communities [NZ] Paper prepared by Arnell Hinkle (2010) Solutions to child poverty in New Zealand [NZ] Report prepared for the Office of the Children;s Commissioner (2012) The politics of Māori health (2016) The Social, Cultural and Economic Determinants of Health in New Zealand: Action to Improve Health A Report from the National Advisory Committee on Health and Disability (National Health Committee) (1998) The principal findings of this report are:  social, cultural and economic factors are the main determinants of health  there are persisting health inequalities as a result of socioeconomic factors in New Zealand and some evidence that these may be worsening  current trends in many socioeconomic factors in New Zealand are likely to widen health inequalities further  there are good reasons for intervening to reduce socioeconomic inequalities in health  there are evidence-based interventions for reducing these inequalities Selected Journals Australia and New Zealand Journal of Public Health Maori Health Review [NZ] Pacific Health Review [NZ] Asian Health Review [NZ] International Resources Websites Equity [World Health Organisation] Health Equity Initiative [HEI] Toolkits and Guidelines What are health inequalities? The Kings Fund, 2020 Interventions to tackle health inequalities need to reflect the complexity of how health inequalities are created and perpetuated, otherwise they could be ineffective or even counterproductive. For example, efforts to tackle inequalities of health status associated with behavioural risks (such as poor diets) should address the wider network of factors that influence these behaviours (such as access to affordable healthy food, marketing and advertising regulations) and the impact that these behaviours have on health outcomes (such as access to clinical services). Health inequalities are not inevitable and the gaps are not fixed. Evidence shows that a comprehensive approach to tackling them can make a difference. Concerted, systematic action is needed across multiple fronts to address the causes of health inequalities. This includes, but goes well beyond, the health and care system. This explainer provides an overview of how health inequalities are experienced in England’s population Health inequalities: place-based approaches to reduce inequalities: Guidelines to support local action on health inequalities. Public Health England, 2019 This guidance aims to reinforce a common understanding of the complex causes and costs of health inequalities and provide a practical framework and tools for places to reduce health inequalities. The accompanying documents include a slide set providing a summary and examples of how to use a place-based approach to reduce health inequalities. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity National Academy of Sciences. 2019 This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity. Incorporating concerns for equity into health resource allocation. A guide for practitioners [UK] “Unfair differences in health care access, quality or health outcomes exist between and within countries around the world, and improving health equity is an important social objective for many governments and international organizations. This paper summaries the methods for analysing health equity available to policymakers regarding the allocation of health sector resources.” 100 Million Healthier Lives [US] 100 Million Healthier Lives is an unprecedented collaboration of change agents across sectors who are pursuing an unprecedented result. Mission: 100 million people living healthier lives by 2020. Vision: to fundamentally transform the way the world thinks and acts to improve health, wellbeing, and equity to get to breakthrough results. Together, we are systematically creating a community of solutions to the most intractable challenges that stand in the way of achieving health, wellbeing and equity across the globe. Includes guidelines and resources. Achieving Health Equity: A Guide for Health Care Organisations [US] This white paper provides guidance on how health care organizations can reduce health disparities related to racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. The IHI White Paper includes: A framework, with five key components, for health care organizations to improve health equity in the communities they serve: Make health equity a strategic priority Develop structure and processes to support health equity work Deploy specific strategies to address the multiple determinants of health on which health care organizations can have a direct impact Decrease institutional racism within the organization Develop partnerships with community organizations to improve health and equity Guidance for measuring health equity A case study of one health care organization that has strategically integrated work to improve health equity throughout their system A self-assessment tool for health care organizations to gauge their current focus on and efforts to improve health equity Equity of Care: a Toolkit for Eliminating Health Care Disparities [US] This toolkit is a user-friendly “how-to” guide to help accelerate the elimination of health care disparities and ensure our leadership teams and board members reflect the communities we serve. Fair Foundations [Aus.] Fair Foundations: The VicHealth framework for health equity is a planning tool for health promotion policy and practice. It outlines the social determinants of health inequities, suggesting entry points for action. Health Equity and Prevention Primer [US] Health inequities are more than disparities or differences in health and safety outcomes. Inequity describes unfairness and the systematic nature of disparities. The Health Equity and Prevention Primer (HEPP) serves as a web-based training series for public health practitioners and advocates interested in policy advocacy, community change, and multi-sector engagement to achieve health equity. The Primer helps practitioners integrate a health equity lens into their initiatives in pursuit of overall health and safety. Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities [US] This document was created to provide examples of strategies and surveillance data which can be used to inform obesity prevention initiatives. Improving Health Equity Through Data Collection AND Use: a Guide for Hospital Leaders [US] To meet the needs of their diverse populations, hospitals and health systems will need to bridge the gap between collecting meaningful patient data and reviewing the data to identify inequities in health care provision and utilization, and to implement simple yet effective interventions to improve care for patients. Improving Quality and Achieving Equity: a Guide for Hospital Leaders [US] This guide for hospital leaders presents the evidence for racial and ethnic disparities in health care and provides the rationale for addressing them with a focus on quality, cost, risk management, and accreditation. The guide also highlights case studies and model practices, and recommends activities and resources that can help hospitals identify and address disparities in order to achieve equity for patients. Improving Quality and Achieving Equity: the Role of Cultural Competence in Reducing Racial and Ethnic Disparities in Health Care [US] This report identifies aspects of cultural competence that are synergistic with current efforts to develop a system that delivers higher-quality care and discusses strategies by which the quality and cultural competence movements could be linked. A Practitioner's Guide for Advancing Health Equity [US] Designed to help public health practitioners advance health equity through community prevention strategies. While health disparities can be addressed at multiple levels, this guide focuses on policy, systems, and environmental improvements designed to improve the places where people live, learn, work, and play. It is designed for those who are new to the concept of health equity, as well as those who are already working to create equitable environments. Roadmap to Reduce Disparities [US] A US guide for health care organisations to improve minority health and foster equity, which includes a 6-step framework for incorporating disparities-reduction into quality improvement processes. What Makes Us Healthy [UK] A new series of infographics and accompanying blogs and commentaries to describe and explain the social determinants of health in an accessible and engaging way.These determinants include political, social, economic, environmental and cultural factors which shape the conditions in which we are born, grow, live, work and age. Creating a healthy population requires greater action on these factors, not simply on treating ill health further down stream. Selected Reading Five Essential Conditions for Health Equity Public Health Wales (2023) This report uses the WHO Five Essential Conditions, an innovative rights- and evidence based multi[1]sectoral policy action framework, aiming to address complex and persistent health gaps, accelerate action and increase opportunities to achieve healthy prosperous lives for all, leaving no one behind. Health Equity Measurement: Considerations for Selecting a Benchmark Robert Wood Johnson Foundation (2023) This brief summarizes the advantages and disadvantages of four common approaches to health equity benchmarking. Health equity frameworks as a tool to support public health action: A rapid review of the literature. National Collaborating Centre for Determinants of Health (2023) Much is known about the existence of health inequities across Canada, and the underlying structural drivers of these inequities. Less is known about how to advance equity across the public health system. Health equity frameworks are one tool to disrupt systems of oppression and promote health equity. This report presents the results of a review conducted to answer the question: which health equity frameworks exist that can be used to inform public health planning, decision making and service delivery? The enduring effects of racism on health: Understanding direct and indirect effects over time SSM - Population Health (2022) We examine the role of racism as a key driver of ethnic inequalities in health. We examine the direct and indirect effects of racism on mental and physical health. Racism severely and negatively impacts health over time and across the life course. Repeated exposure to racism leads to accumulation of disadvantage and poorer health. Policy and academic debates must focus on the fundamental role of racism on health. Understanding Indigenous Health Inequalities through a Social Determinants Model National Collaborating Centre for Indigenous Health (Canada) (2022) “The authors begin by providing a brief overview of Indigenous health inequalities, followed by a description of social determinants across the life course. They then explain how root (structural), core (systemic), and stem (immediate) environments influence Indigenous health at individual, community, and population levels. Loppie and Wien highlight the importance of Indigenous self-determination and cultural resurgence as vital pathways to wellness.” An overview of reviews on strategies to reduce health inequalities International Journal for Equity in Health(2020) The strategies that facilitate the reduction of health inequalities must be intersectoral and multidisciplinary in nature, including all sectors of the health system. It is essential to continue generating interventions focused on strengthening health systems in order to achieve adequate universal health coverage, with a process of comprehensive and quality care. Driving forward health equity – the role of accountability, policy coherence, social participation and empowerment WHO, 2019 A scientific expert review process coordinated by the WHO European Office for Investment for Health and Development of the WHO Regional Office for Europe identified societal and institutional factors that singly and in combination offer new explanations on why progress on health equity has not been as fast as had been hoped when the association between individual determinants and inequities was first established. These four key drivers of health equity are: accountability, policy coherence, social participation and, underlying them, empowerment. Work on these drivers informs the Health Equity Status Report initiative (HESRi) and has resulted in three independent companion papers each elaborating further on one of the common goods for health equity – accountability, policy coherence and social participation – as well as this summary paper. A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop—in Brief National Academy of Sciences. 2019 On April 1, 2019, the National Academies of Sciences, Engineering, and Medicine held a public workshop, A Health Equity Approach to Obesity Efforts, in Washington, DC. The workshop explored the history of health equity issues in demographic groups that have above-average obesity risk, and considered principles and approaches to address these issues as part of obesity prevention and treatment efforts. Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions. This publication briefly summarizes the presentations and discussions from the workshop. Advancing Equity in Health Systems by Addressing Racial Justice Stanford Social Innovation review. 25 June, 2019 Lessons on racial equity underscore the need to set explicit aims, build coalitions, and flatten hierarchies in order to strengthen healthcare’s role in undoing systems of oppression. Inclusion of equity in economic analyses of public health policies: systematic review and future directions (2017) Twenty‐nine relevant studies were identified. The majority of studies comparing two or more interventions left interpretation of the size of the health and financial inequality differences to the reader. Newer approaches include: i) use of health inequality measures to quantify health inequalities; ii) inclusion of financial impacts, such as out‐of‐pocket expenditures; and iii) use of equity weights. Improving Health Equity: 5 Guiding Principles for Health Care Leaders [US: IHI] (2018) In January 2017, a team from IHI argued that health care organizations must make health equity a strategic priority. The authors identified five key steps for health care organizations: make health equity a leader-driven priority, develop structures and processes that support equity, take specific actions that address the social determinants of health, confront institutional racism within the organization, and partner with community organizations. Insiders’ Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals [Canada] (2019) A Framework for Educating Health Professionals to Address the Social Determinants of Health [US] Better Health Through Equity: Case Studies in Reframing Public Health Work (2015) [US] Closing The Gap in A Generation: Health Equity Through Action on the Social Determinants of Health (Commission on the Social Determinants of Health, CSDH 2008) Equity and Excellence: Liberating the NHS [UK] Evidence review: Settings for addressing the social determinants of health inequities [Aus.] Fair Society, Healthy Lives (The Marmot Review): Strategic Review of Health Inequalities in England Post 2010 (Marmot et al, 2010) [UK] Fairer decisions, better health for all: Health equity and cost-effectiveness analysis [UK] Health literacy: a necessary element for achieving health equity [US] Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary [US] WHO European Review of Social Determinants of Health & the Health Divide (Marmot et al 2012) [EU] Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care [US; 2003] Seminal report. Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. Selected Journals Diversity and Equality in Health Care Ethnicity and Health International Journal for Equity in Health see also PubMed Database Search: Health Equity last updated 12 February 2024

Contents

What is Health Equity?
New Zealand Resources
  Websites
  Toolkits and Guidelines
  Selected Reading
  Selected Journals
International Resources
  Websites
  Toolkits and Guidelines
  Selected Reading
  Selected Journals

 

What is Health Equity?

Health equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically (WHO)

 

The concept acknowledges that not only are differences in health status unfair and unjust, but they are also the result of differential access to the resources necessary for people to lead healthy lives (NZ MoH)

 

A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity | Health Quality & Safety Commission (hqsc.govt.nz)

Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. 

 

Te ao Māori framework

The Health Quality & Safety Commission has developed a te ao Māori framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards across Aotearoa New Zealand. The initial framework concept is shown below, followed by a brief description.

The aim of the framework is to improve the quality of care afforded to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. 

There are two downloadable PDFs at the bottom of this page, which include the basic framework concept plus a backgrounder on how and why it was developed. 

We are currently developing resources to support providers with implementation of the framework and will publish them here in due course.

We would like to acknowledge and thank our partner providers who gave their information freely in the hope that much-needed change could happen and be sustained over time.

Te ao Māori framework concepts

Wairuatanga

The holistic nature of Māori health, which links physical illness to emotional and spiritual wellbeing.  Hence wairuatanga is in the middle position of the framework, which makes culture a central focus in the design of services. The goal of wairuatanga is to embed tikanga Māori and cultural safety into the health system.

Pātuitanga

The growing and fostering of strong partnerships with Māori, which is fundamental to ensuring the right concepts are included in the design and delivery of services.

Whānau

Whānau need and improving health outcomes for whānau are the drivers to why services are created and designed. 

Rangatiratanga

The inclusion of Māori leadership in decision-making processes when services are designed.

Te ao Māori framework design

Each of the outer sections have two koru representing tapu and noa. The haehae lines bind each section together and connect and interact with each other.

The inside koru of each concept opens into wairuatanga, which allows wairuatanga to flow seamlessly throughout the entire framework. 

The outside koru opens into te ao Mārama. The pītau design on the edge of the outer sections represents new beginnings and is the interconnection between te ao Māori and te ao Mārama.

Downloadable attachments

 

Editorial from the NZMJ (2021): 'Closing the gaps: health equity by 2040'

The main goals of the “once in a generation” Health and Disability System Review, which has led to a major system restructuring that’s now in its early stages, included better health outcomes for all and greater health equity, despite the review accepting that most of a person’s health status is determined by factors outside the system. In July this year, the Association of Salaried Medical Specialists (ASMS) and the Christchurch Charity Hospital Trust (CCHT) co-hosted a conference of health professionals to discuss the broader range of policies that are needed to address health inequities and improve health outcomes for all. This article outlines some of the key issues and recommendations to government emanating from that conference and contain in our report, Creating Solutions Te Ara Whai Tika: a roadmap to health equity by 2040.

Māori Health Priorities Report (2022)

 

This Māori Health Priorities report draws focus to the biggest contributors to health loss and health inequity for Māori, and also represent the greatest potential for intervention.  This report was commissioned by Te Aka Whai Ora to inform our positioning on the priorities for the interim New Zealand Health Plan (iNZHP) for Māori.

 

Health Equity at CM Health

Health equity at ADHB

 

Fact and action sheets on health inequities [University of Otago and New Zealand Medical Association]

These fact and action sheets were prepared in the lead up to a visit by Sir Michael Marmot in July 2011, hosted by the New Zealand Medical Association. The purpose of these sheets includes an attempt at a brief stocktake on health inequities in New Zealand, both on what the current state of play is and what the future policy priorities might be.

 

Equity is the new black—and black lives matter (2020)

Editorial from New Zealand Medical Journal

"There is overwhelming evidence of inequities in health outcomes for Māori—you need look no further than the previous issue of NZMJ or the Wai 2575 Māori Health Trends Report. COVID-19 also presents a concern for the likely disproportionate impact on Māori.

Council encourages all doctors, employers, training and professional organisations to consider the findings in the cultural safety Report, draw on the data, and use this as a basis for achieving long-term, positive change for the benefit of all patients and whānau.

While the Report offers an insight into current practice, it is only the first step on a long journey. It sets a baseline for ourselves and our stakeholders to use when developing programmes, strategies and policies that support us to drive change."


Racism

 

Whiria te Muka Tangata: Anti-Racism Systems Change.

Ministry of Health. 2023

This publication outlines a preliminary systems change model that provides an organisational and system-level blueprint for anti-racism action in health.

 

Evolution of Racism and Anti-Racism – Lessons for the Aotearoa New Zealand Health System (Stage One Literature Review)

Minsitry of Health 2022

Evolution of Racism and Anti-Racism – Lessons for the Aotearoa New Zealand Health System.

This is the first literature review in the Ao Mai te Rā series. This review traces how understandings of racism and anti-racism have shifted over time and explores various concepts, language and definitions that have been used to date. The review considers how we might frame and think about racism and anti-racism within the Aotearoa New Zealand context and has been used to inform the Ministry’s position statement and working definitions for racism and anti-racism in health.

 

Best Practice Approaches to Addressing Racism – Lessons for the Aotearoa New Zealand Health System (Stage Two Literature Review)

Minstry of Health. 2023

This is the second literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review explores best practice approaches to addressing racism in all its forms.

 

Anti-Racism Maturity Models – Lessons for the Aotearoa New Zealand Health System (Stage Three Literature Review)

Ministry of Health. 2023

This is the third and final literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review examines the key features and characteristics of an anti-racism maturity model approach. 

 
Evolution of Racism and Anti-Racism Literature review and Summary Document (2022)

Position statement and working definitions for racism and anti-racism in the health system in Aotearoa New Zealand (2022)

 

Understanding 'white privilege?'

Racism and White Defensiveness in Aotearoa: A Pākehā Perspective (2018)

Māori health: 'We have to be talking about racism' (2018)

 

Videos

 

Māori lives matter [HQSC]
In this presentation from the Health Quality & Safety Commission's Ō tātou hiranga advance care planning hui, Hector Matthews shines the spotlight on Māori inequity and the systemic biases that perpetuate inequities.  He challenges us to confront some uncomfortable truths about inequity and explore ways we can truly place people’s cultural framework at the centre of their care and wellbeing.

 

Dr Lance O'Sullivan on a mission for health equity [Ko Awatea ]
Dr Lance O'Sullivan is at Middlemore Hospital working on a new health equity programme. In a 2016 interview on Te Karere he talks about his belief that regardless of race, age or income, people should have the same health opportunities as the next.


What is Health Equity? [Health Equity Institute]
This three-minute motion graphic video explains how social, economic, and environmental conditions can create health inequities and how these inequities can affect health disparities.

What Is Health Equity, and Why Does It Matter? [IHI]
David R. Williams, Professor of Public Health at the Harvard T.H. Chan School of Public Health, has been researching health inequities in the United States for two decades. In this video, he sits down with Don Berwick, MD, President Emeritus and Senior Fellow at IHI, to talk about health equity and why it’s important.
 
Social Media

twitter #healthequity

 

New Zealand Resources

 

Websites

Equity [Ministry of Health]

Equity Explorer [HSQC]
The Equity Explorer provides information on how health and health care varies between groups of people, and between district health board (DHB) areas of Aotearoa New Zealand (NZ).

Two types of group are compared: ethnic groups and groups based on socioeconomic status (deprivation).

The health conditions compared are diabetes, asthma and gout.

Maori Health Clearinghouse

Pacific Health Clearinghouse

Asian Health Clearinghouse

 

Health system quality dashboard
Health & Quality Safety Commission (NZ).
In partnership with Te Tumu Whakarae, HQSC has developed a new specific Māori Health Equity Report, using distinct data.

Toolkits and Guidelines

 

Hospital Ethnicity Data Audit Toolkit | Ministry of Health (2021)
A resource for assessing the quality of ethnicity data in New Zealand hospital settings, and supports quality improvement in this area.

The scope of the Toolkit (also known as HEDAT) includes four tools to assess the quality of ethnicity data and systems for data collection, recording and output within a hospital setting, and provides guidance on quality improvement activities. The Toolkit helps hospitals assess health care ethnicity data against the HISO 10001:2017 Ethnicity Data Protocols and, more broadly, against current best practice.

 

Medicine access equity monitoring and outcomes framework (NZ: 2021)
Pharmac
We’re establishing baseline measures of inequity for access to funded medicines for our priority conditions.

These reports mark the first time we have measured equity of access to funded medicines for these key long-term conditions. Our insights are drawn from dispensing data for Māori and Pacific peoples to treat:

  • asthma
  • cardiovascular conditions
  • chronic obstructive pulmonary disease (COPD)
  • gout
  • type 2 diabetes.

We are publishing our insights to raise awareness of current medicine access inequities. We hope they spark discussions on medicine access equity across the health sector. We welcome any feedback on our insights.

 

Creating Solutions Te Ara Whai Tika: A roadmap to health equity by 2040. (NZ: 2021)
Associated of Salaried Medical Specialists
The Creating Solutions Te Ara Whai Tika report by the Association of Salaried Medical Specialists Toi Mata Hauora, recommends a national goal of achieving health equity for all New Zealanders by 2040 and lays out a roadmap of policies to get there.

It follows presentations, discussions, and input from more than 200 health professionals who attended a virtual conference co-hosted by ASMS and the Canterbury Charity Hospital Trust, established by Dame Sue and Associate Professor Phil Bagshaw.



Achieving Equity in Health Outcomes: Highlights of selected papers [NZ; 2018]
Both in New Zealand and globally, our ability to address equity challenges in health has significantly improved over the past decades. In the Western world life expectancy has increased for all populations. However persistent disparities in health access, quality of services and outcomes remain. In Aotearoa New Zealand, Māori and Pacific and those in low socioeconomic groups remain the most disadvantaged.

The Government has mandated the Ministry of Health to take a bold approach that delivers tangible changes to system behaviour with measurable results in a three to five-year horizon. An approach that operates on a repeating cycle based around deepening the understanding of equity gaps, shifting thinking about where priorities for investment of time and resources lie, followed by increasing direct action to address inequalities is being developed.

This paper traces the beginnings of health equity and the philosophical and ethical foundations that sit behind it.  It looks at a selection of the international and local literature to help understand definitions of equity. It considers how framing and thinking about the concept of equity and approaches to addressing equity have evolved, and how progress to address equity can be measured.

The Health Equity Assessment Tool: a User's Guide  [NZ]
The Health Equity Assessment Tool: A User's Guide, has been developed by the University of Otago, Wellington, to help facilitate the use of the Health Equity Assessment Tool (HEAT).

The Health Equity Assessment Tool: A User's Guide gives a brief overview of inequalities in health, introduces the HEAT and its use, presents an in-depth look at each of the HEAT questions, and provides case examples of the tool's use.  This publication is an essential guide for those working in the health and disability to apply a strong equity focus to their work.

Equity of Health Care for Māori: A Framework [NZ]
This framework guides health practitioners, health organisations and the health system to achieve equitable health care for Māori through leadership, knowledge and commitment.

Quality improvement: no quality without equity? [NZ; 2017]
This ‘think piece’ from the Health Quality & Safety Commission signals our intention to tackle health inequities. 


Central Region Equity Framework

TAS, 2019

The Central RegionEquity Framework has been developed by theCentral Regionand was endorsed by the Central Region Chief Executives in April 2019.  The Central Region is a combination of MidCentral DHB, Hawke’s Bay DHB, Whanganui DHB, Wairarapa DHB, Hutt Valley DHB and Capital and Coast DHB.

The Central Region Service Planning Forum (CRSPF) commissionshealth and disability services that aim to improve health outcomes and achieve equity for all populations living in the central region district health board areas.   This Framework1provides guidance to the CRSPF on strengthening their commissioning to achieve equity within activities identified within the Central Region’s Regional Service Plan (RSP). In the Central Region, equity in health is based on the WHO definition of equity –the absence of avoidable or remediable difference among groupsof people.  The concept acknowledges that these differences in health status are unfair and unjust. However,they are also the result of differential access to the resources necessary for people to lead healthy lives. Peoplewho are poor, have chronic conditions/diseases, live with disabilities, live rurallyand are of different ethnicities, will have poorer health, greater exposure to health risks and poorer access to health services2.These variables are unlikely to exist in isolationasthey are deeplyinterwoven.The concept of intersectionality is vital when exploring the fundamental causes of inequity.In New Zealand, inequalities between Māori and non-Māori are the most consistent and compelling inequities in health. The Central Region Chief Executives and the Central Region Māori General Managers hold the view that these differences are not random.They exist because of institutional racism3and the impact of colonisation and its continuing processes4.Achieving equity for Māoriis a priority, as the health gaps across the life-coursearesignificant for Māori.The Treaty of Waitangi was signed to protect the interests of Māori. It is not in the interest of Māorito be disadvantaged in any measure of social or economic wellbeing5.A companionTreaty of Waitangi document will be developed, with the purpose of providing direction to the Central Region DHBs on what they need to do to meet theirTreaty of Waitangi obligations.

 

HE PIKINGA WAIORA IMPLEMENTATION FRAMEWORK

University of Waikato, 2016

The Framework has indigenous self-determination at its core. All four elements have conceptual fit with Kaupapa Māori aspirations and all have demonstrated evidence of positive implementation outcomes.

A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities in Australia, Canada, New Zealand, and the United States. Cross-tabulations demonstrated that cultural centeredness (p=.008) and community engagement (p=.009) explained differences in diabetes outcomes and community engagement (p=.098) explained difference in blood pressure outcomes.

The Framework is intended as a planning tool to guide the successful development and implementation of interventions. Funders can use the Framework to assess the likely effectiveness of proposed interventions.

Community organizations can use the Framework to work with researchers or policy makers to strengthen each of the four elements.

Pitama, S., Huria, T., & Lacey, C. (2014). Improving Maori health through clinical assessment: Waikare o te Waka o Meihana. The New Zealand Medical Journal (Online)127(1393). 

Health professionals play an important role in addressing indigenous health inequalities. This paper describes the further development and a new conceptualisation of the Meihana model (2007) and the Hui process (2011), which together have formed the indigenous health framework in the University of Otago, Christchurch undergraduate medical education programme for 4th–6th year medical students over the past 5 years. The components of the framework are defined followed by description of their application to clinical assessment. The indigenous health framework has been evaluated by medical students, health practitioners, Māori patients and whanau over this time and has been rated favourably as a clinically relevant framework that supports health practitioners to work effectively with Māori patients and whānau.


Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health - Wilson - 2021 - Journal of Clinical Nursing

Conclusions

This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

 

Literature Review to Inform the Development of a Culturally Appropriate Assessment Model for Māori (2022)

Introduction

 The purpose of this literature review is to inform the development of a culturally appropriate assessment model that meets the need of Māori and whānau and will enable a holistic assessment of needs and inform the provision of care and support services. Capturing relevant findings from the literature will ensure that the processes undertaken to develop a culturally appropriate model are evidence based. The findings of the review are intended to assist the Francis Health project team and wider steering group in how best to approach this work.  The wider project is underpinned by a kaupapa Māori approach, one framework being utilised is the Te Pā Harakeke Framework. This literature review as an input contributes to Te Puawai in the framework. Te Puawai references the flower head of the harakeke plant and refers to the processes used within each function to give effect to the strategy of the kaupapa. Largely, it seeks to inform ways to weave Kaupapa Māori approaches with interRAI assessment to enable positive outcomes for Māori. The literature review is one of many information streams that is feeding into the project.

The scope of the literature review includes:

− Approaches undertaken to make established assessment tools culturally appropriate

− Approaches undertaken to develop assessment tools that are compliant with Te Ao Māori

 

− How to implement relational Māori models of health within an assessment tool

Whānau Ora Health Impact Assessment

Ministry of Health, 2007

The Whānau Ora Health Impact Assessment tool was published in April 2007 by the Ministry of Health and builds on the Public Health Advisory Committee’s, ‘A Guide to HIA: A Policy Tool for New Zealand’ (2005).

The Whānau Ora HIA tool follows the same methodology: Screening, Scoping, Appraisal and Reporting and Evaluation. It follows the same methodology: Screening, Scoping, Appraisal and Reporting and Evaluation.

 

It was developed for use by policy makers as a tool for assessing the positive and negative impact of their policies on Māori and to identify ways in which these could be enhanced or adapted. It complements other resources aimed at promoting Māori health including the Health Equity Audit Tool.

It was produced in response to the fact that the Māori population experiences significantly poorer health outcomes than the rest of New Zealand’s population and as a way to support delivery of the Ministry of Health’s strategic vision to improve health outcomes and reduce inequalities for Māori outlined in He Korowai Oranga: Māori Health Strategy 2002.

At the heart of the tool is the concept of ‘Whānau ora’, which means, ‘Māori families being supported to achieve their maximum health and well being’. Its overarching aim is to ensure equity in health for Māori.

 

Reducing Inequalities in Health

Ministry of Health, 2002

Summary

In New Zealand, ethnic identity is an important dimension of health inequalities. Maori health status is demonstrably poorer than other New Zealanders; actions to improve Maori health also recognise Treaty of Waitangi obligations of the Crown. Pacific peoples also have poorer health than Pakeha. In addition, gender and geographical inequalities are important areas for action.

Addressing these socioeconomic, ethnic, gender and geographic inequalities requires a population health approach that takes account of all the influences on health and how they can be tackled to improve health. This approach requires both intersectoral action that addresses the social and economic determinants of health and action within health and disability services themselves.

Reducing Inequalities in Health proposes principles that should be applied to whatever activities we undertake in the health sector to ensure that those activities help to overcome health inequalities. The proposed framework for intervention entails developing and implementing comprehensive strategies at four levels.

  1. Structural – tackling the root causes of health inequalities, that is, the social, economic, cultural and historical factors that fundamentally determine health.
  2. Intermediary pathways – targeting material, psychosocial and behavioural factors that mediate the impact of structural factors on health.
  3. Health and disability services – undertaking specific actions within health and disability services.
  4. Impact – minimising the impact of disability and illness on socioeconomic position.

Intervention at these four levels should be undertaken nationally, regionally and locally by policy-makers, funders and providers.

The framework can be used to review current practice and ensure that actions contribute to improving the health of individuals and populations and to reducing inequalities in health. It also highlights the importance of factors outside the direct control of the health sector in shaping the health of our population. Those outside the health sector – particularly The Treasury, the social welfare, education, housing and labour market sectors, and local government – can contribute significantly to the task of reducing inequalities in health. Success in reducing inequalities in health brings positive results for the individual, the economy and society. It enables New Zealanders to live healthier, longer lives. In turn, a healthier population will increase the country’s prosperity.

 

Te Rōpū Whakakaupapa Urutā Analysis of Health Sector Equity Tools

Te Rōpū Whakakaupapa Urutā

There is an existing suite of equity tools that clearly articulate and define the ways in which equity can be placed at the heart of the health system.

Equity resources

The following frameworks, guidelines and statements have informed the principles that underpin our recommendations and specific actions:

Te Rōpū Whakakaupapa Urutā Position Statement ​

He Pikinga Waiora Implementation Framework (Healthier Lives NSC, 2016)​

Governance for Health Equity (World Health Organisation, 2013)

He Ara Hauora Māori: A Pathway to Māori Health Equity (Medical Council of NZ, 2019)

 

Equity Tools 

 

Reducing Inequalities in Health Framework 

Health Equity Assessment Tool - A Users Guide

Whānau Ora Health Impact Assessment

Equity of Healthcare for Māori: Framework

Central Region DHB's Equity Framework

 

Analysis of Equity Tools 

In preparation for the restart of the health system and recovery from COVID-19. Te Rōpū Whakakaupapa Urutā has carried out a quick review and analysis of the existing equity tools currently available to the health sector. Our analysis provides information about each tool's development, origins, what the tool is, how long it has been in the system, examples of where the tools have been implemented and a view of their usefulness.

​As we plan for a restart of the health services and a desire to reset the system so that it achieves equity for Māori, being aware of these tools and using/adapting them might be helpful. 

​All tools to some degree use an intervention logic: problem definition, engagement with stakeholders, intervention planning, monitoring and evaluation.  

Additionally they are likely to be more useful in specific contexts. ​

For example:

The Equity of Health Care for Māori, the Central Region DHBs Equity Framework and the Health Equity Assessment Tool and its’ users guide are health services focused.  

The Whānau Ora Health Impact Assessment can be used at both a policy and project level with its strength being on the health impacts resulting from other sector activities.   

The Reducing Health Inequalities Framework is a useful background document which identifies that actions needs to be in four areas: system, intermediary environments, health services and impact of ill health and disability it is best used with another tool that is more intervention focused.​

Our quick review and analysis is available here  (doc attached)



Selected Reading

Is racism in energency care contributing to higher Māori mortality rates?
Emergency Medicine Australasia (2022)
"If we want to see health equity for Māori, we cannot continue to ignore the reasons these inequities persist. We need to talk maturely about racism. The opposite of racist is not ‘not racist’ but anti-racist. Being ‘not racist’ is not a neutral place to stand but perpetuates the status quo. The skills to be anti-racist and to embed anti-racist practice and policies are learnable.  It is a journey we can walk together as a profession and as a college."
see also: Curtis E, Paine SJ, Jiang Y et al. Examining emergency department inequities in Aotearoa New Zealand: findings from a national retrospective observational study examining Indigenous emergency care outcomes. Emerg. Med. Australas. 2022; 34: 1623.

 

The whitewashing of contracts: Unpacking the discourse within Māori health provider contracts in Aotearoa/New Zealand
Health and Social Care in the Community (2021)
Success of the proposed health reforms and the Māori Health Authority should require dismantling of non-Māori ways of commissioning and contracting, otherwise there is the continued risk of discriminatory contracting practices limiting the expression of self-determination for Māori health providers.

The Choosing Wisely campaign and shared decision-making with Māori
New Zealand Medical Journal (2021)
This work identified some structural issues in Choosing Wisely New Zealand that have limited the campaign’s ability to mitigate health inequities for Māori and helped to define a potentially transformative way forward. There was wide agreement among our participants that shared decision-making is not just a quality practice, but that it also has the potential to address health inequity among Māori by facilitating participation in healthcare that better meets self-identified need. “Practitioner dependent” factors like consumer trust, autonomy, good relationships and rapport with health providers and culturally appropriate resources are important and are as demanding of attention as systemic causes of health inequity, such as inadequate access to services, the social determinants of health and the structural determinants of health, including racism.

 

Barriers and facilitators for Māori in accessing hospital services in Aotearoa New Zealand
New Zealand Medical Journal (2021)
Māori health inequities result from systematic failures in the provision of healthcare by the public health system and historical structural failures that have led to the inequitable distribution of the social determinants of wellbeing for Māori compared to non-Māori.

He Tamariki Kokoti Tau: Tackling preterm incidence and outcomes of preterm births by ethnicity in Aotearoa New Zealand 2010‐2014.
International Journal of Gynecology & Obstetrics.(2021)
Conclusion
This study demonstrates that the Aotearoa New Zealand maternity system privileges whiteness, suggesting that clinical pathways for evidence-based medical care are not delivered systemically and equitably for all. Health pathways that focus on equity as a fundamental right will enhance health outcomes for Māori women and their infants.

The human and health costs of failure to implement pro-Tiriti and pro-equity health policies: let’s act as if we know this
New Zealand Medical Journal.  Vol 134 No 1542: 17 September 2021
After a twenty-year period of relative stability in the health system, we are entering a period of very considerable change. These changes are driven, in part, by a clearly stated desire on the part of government for fairer health outcomes for Māori. 

Inequities in people with gout: a focus on Māori (Indigenous People) of Aotearoa New Zealand / Te Karu, L., Dalbeth, N., & Stamp, L. K.
Therapeutic Advances in Musculoskeletal Disease (2021)
Health equity can be defined as the absence of systematic disparities in health between more and less advantaged social groups. Gout is one of the most common forms of arthritis and disproportionally affects Indigenous peoples, including Māori in Aotearoa New Zealand. Inequities in gout management are well documented and clearly evidenced in Indigenous populations. For example, while gout occurs at a younger age and is more severe in Māori, there is less regular dispensing of urate-lowering therapies. Indigenous peoples are also under-represented in clinical trials. Herein, we will review inequities in gout using Aoteoaroa New Zealand as an example. We will explore reasons for health inequities and challenges that need to be faced to achieve health equity.

Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health (2021)
This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

 

My role in tackling health inequalities: a frameworkl for allied health professionals
KingdFund (2021)

The King’s Fund has worked with AHPs from across the UK to develop a framework to support any AHP to think through and understand their contribution to tackling health inequalities, whatever their role. The framework details how AHPs can raise awareness, take action and optimise advocacy through six lenses: self; patients; clinical teams, pathway and service groups; communities and networks; systems; and nurturing the future. 

The framework is designed to support AHPs to do whatever they can – large or small – to tackle health inequalities.

 

Rapua Te Ara Matua: Equity report
Waikato DHB (2021)

WDHB endorsed the report, taking active ownership and explicitly acknowledging their DHB is:

"embedded in a healthcare system which has privileged the needs of the majority while failing to meet the needs of all"
"Waikato DHB is party to the systematic failure to adequately address and eliminate equity gaps and provide services that are culturally competent and holistic for Tangata Whenua" 


The report provides a clear view of the inequities experienced by Maori people and Pacific people and the systemic failure they continue to receive. While some of the data is undoubtedly confronting- the reality is this is what our priority populations endure on a daily basis.

Among other actions, the report identified (and we may have heard this before..) "Maori-led structural change was needed within the DHB to address the gaps in health equity."

Telehealth as a tool for equity: pros, cons and recommendations
NZMJ. Issue: Vol 134 No 1530: 19 February 2021
In this viewpoint, we consider whether telehealth is an equity-positive tool that might help to overcome some important barriers to health care access for Māori and Pacific people. We consider the equity ramifications of a shift toward models of care that maximise the use of telehealth solutions, and our recommendations regard how we might best achieve the equity-positive potential of telehealth for Māori and Pacific people.

 

Achieving Equity in Health Outcomes: Summary of a discovery process.
Ministry of Health. 2019.
In 2018, the Ministry of Health initiated a work programme on achieving equity in health outcomes. Specifically, this programme aims to ensure that equity is at the heart of the way New Zealand’s health and disability system operates and to promote the cultural shift needed to achieve that.  This report provides a brief summary of phase one of the Achieving Equity Work Programme: The Discovery Phase. The aim of the discovery phase was to identify where practical and coordinated effort could be undertaken to achieve a measurable shift in health equity in the next three to five years. Through an examination of the literature; a review of evidence; and consideration of what people said needs to be tackled in the health and disability system, common challenges and opportunities for achieving health equity in Aotearoa/New Zealand have been explored.

 

The Waitangi Tribunal’s WAI 2575 Report: Implications for Decolonizing Health Systems
Health and Human Rights Journal (2020)
Te Tiriti o Waitangi, a treaty negotiated between Māori (the Indigenous peoples of Aotearoa) and the British Crown, affirmed Māori sovereignty and guaranteed the protection of hauora (health). The Waitangi Tribunal, established in 1975 to investigate alleged breaches of the agreement, released a major report in 2019 (registered as WAI 2575) about breaches of te Tiriti within the health sector in relation to primary care, legislation, and health policy. This article explores the implications of this report for the New Zealand health sector and the decolonial transformation of health systems. The tribunal found that the Crown has systematically contravened obligations under te Tiriti across the health sector. We complement the tribunal’s findings, through critical analysis, to make five substantive recommendations: (1) the adoption of Tiriti-compliant legislation and policy; (2) recognition of extant Māori political authority (tino rangatiratanga); (3) strengthening of accountability mechanisms; (4) investment in Māori health; and (5) embedding equity and anti-racism within the health sector. These recommendations are critical for upholding te Tiriti obligations. We see these requirements as making significant contributions to decolonizing health systems and policy in Aotearoa and thereby contributing to aspirations for health equity as a transformative concept.

Baseline Data Capture: Cultural Safety, Partnership and Health Equity Initiatives FINAL REPORT (2020)
The Medical Council of New Zealand, in partnership with Te Ohu Rata O Aotearoa (Te ORA), is pleased to release an independent report outlining findings of the current state of cultural safety and health equity delivered by doctors practicing in Aotearoa New Zealand and experienced by patients and whānau. Māori patients’ experiences are the focus of the report, however many of the challenges and solutions will be applicable to other ethnic groups and populations who experience inequitable healthcare.

Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health. Journal of Clinical Nursing. (2021)
This study highlights the importance and relevance of relational ap-proaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust- based relation-ships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empa-thy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (impor-tance of spiritual wellbeing).

Racism and health in Aotearoa New Zealand: a systematic review of quantitative studies (2020)
Quantitative racism and health research in New Zealand consistently finds that self-reported racial discrimination is associated with a range of poorer health outcomes and reduced access to and quality of healthcare. This review confirms that experience of racial discrimination is an important determinant of health in New Zealand, as it is internationally. There is a pressing need for effectively designed interventions to address the impacts of racism on health.

Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research (2020)
Australia and New Zealand Journal of Public Health
This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’

Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition [NZ]
International Journal for Equity in Health
There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care...A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development.

Tofa Saili: A review of evidence about health equity for Pacific Peoples in New Zealand'
Pacific Perspectives (2019)
This report describes the health equity issues faced by Pacific families and communities. The report highlights approaches based on Pacific values and the strengths of Pacific communities. It is informed by the Pacific Aotearoa vision (Ministry of Pacific Peoples, 2019).

A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity
HQSC, 2019
Every year the Commission publishes a document we call A window on the quality of Aotearoa New Zealand’s health care. The Window provides a snapshot of the quality of health care in the country. While equity has always been a component of the report’s analysis over its four-year history, this year’s report focuses solely on equity. 

A window on the quality of Aotearoa New Zealand’s health care 2019 – a view on Māori health equity (Window 2019) highlights a number of areas where change is needed in the health system. The report is divided into three chapters. The first analyses inequity between how Māori and non-Māori access and receive health services, and the effects on equity of improvement activities in our system. The second chapter asks why these inequities exist, and the third chapter addresses opportunities for improvement.

Addressing equity in intergenerational wellbeing: Valuing community perspectives
Deloitte and Victoria University of Wellington, 2019.
Our partners at Victoria University of Wellington’s School of Government look at New Zealand’s wellbeing frontier and the importance of bringing in community perspectives to build effective policy.

Understanding inequalities: summary report. The impact of inequalities in the early
years on outcomes over the life course: Using international evidence to identify creative policy solutions.
Growing up in New Zealand, 2019.
The findings from the Growing Up in New Zealand study demonstrate that Maori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course. By the time they start school (at age 5 years) many are already falling behind their peers in terms of preparedness for formal education and readiness to engage in learning.

The study has shown that inequalities in developmental opportunities and outcomes have their origins in early in life. Risk factors for early vulnerability cluster and there is no one single proxy marker of disadvantage. Additionally, morbidity and poor outcomes cluster. Persistent adversity is associated with a graded likelihood of poor outcomes (across the population). Further service use is not meeting measured need. Currently, access to early life universal services may be widening inequalities. A proportional-universalism approach to services is required if they are to meet real need and reduce inequalities.

'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry'
Waitangi Tribunal. 

Our stage one report addresses claims concerning the way the primary health care system in New Zealand has been legislated, administered, funded, and monitored by the Crown since the passing of the New Zealand Public Health and Disability Act 2000 (‘the Act’) Statistics.  In our report we explore whether the persistent inequitable health outcomes suffered by Māori are indicators of Treaty breach. In doing so, we ask whether a cause of the inequitable health statistics suffered by Māori is the legislative and policy framework of the primary health care system itself.  n approaching our task, we identified four main thematic issues to focus on for this stage of the inquiry : the Treaty-compliance of the Act and framework ; funding arrangements for primary health care ; accountability arrangements for primary health care ; and the nature of Treaty partnership arrangements in the primary health care sector.

He oranga mo Aotearoa: Māori wellbeing for all
Deloitte
We consider various Māori wellbeing frameworks and measurements, the barriers to Māori wellbeing and the drivers and changes that could improve it.

Delivering better outcomes together: Policies that reflect our diverse cultures
Deloitte
The cultural and ethnic face of Aotearoa New Zealand is changing. We explore why and how our institutions and policies need to move closer toward multi-culturalism to achieve better outcomes for all.

The health equity measurement framework: a comprehensive model to measure social inequities in health
International Journal for Equity in Health201918:36

Clinical research trials achieving equitable health outcomes for Māori.  ACTA International Clinical Trials Conference 2019. Assoc Prof Matire Harwood.Dept General Practice, FMHS, University of Auckland
Includes discussion of the model for 'Explaining Ethnic Determinants of Health'.

Ethnic bias and clinical decision-making among New Zealand medical students: an observational study [NZ]
BMC Medical EducationBMC series – 201818:18 (2018)

Lessons for Achieving Health Equity Comparing Aotearoa/New Zealand and the United States [NZ]
Health Policy 2019
To authentically commit to achieving health equity, nations should: 1) Explicitly design quality of care and payment policies to achieve equity, holding the healthcare system accountable through public monitoring and evaluation, and supporting with adequate resources; 2) Address all determinants of health for individuals and communities with coordinated approaches, integrated funding streams, and shared accountability metrics across health and social sectors; 3) Share power authentically with racial/ethnic minorities and promote indigenous peoples’ self-determination; 4) Have free, frank, and fearless discussions about impacts of structural racism, colonialism, and white privilege, ensuring that policies and programmes explicitly address root causes.

Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research (2017). 
N Z Med J. 2017 Nov 10;130(1465):96-103.
Excellent health research is essential for good health outcomes, services and systems. Health research should also build towards equity and in doing so ensure that no one is left behind. As recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisational approach to this endeavour. However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work. In this viewpoint paper we provide an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori. We also describe an equity-based approach to responsiveness to Māori and highlight four key areas that require careful consideration, namely: (1) relevance to Māori; (2) Māori as participants; (3) promoting the Māori voice, and; (4) human tissue. Finally, we argue for greater engagement with responsiveness to Māori activities as part of our commitment to achieving equitable health outcomes.

The Determinants of Health for Pacific Children and Young People in New Zealand (2014) (Determinants of Health for Children and Young People). New Zealand Child and Youth Epidemiology Service (2016)

Te Ohonga Ake The Determinants of Health for Māori Children and Young People in New Zealand Series Two (2016) New Zealand Child and Youth Epidemiology Service (2016)

The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study[NZ]
BMC Public Health 12.1 (2012): 1.

Geography matters: the prevalence of diabetes in the Auckland Region by age, gender and ethnicity [NZ]
New Zealand Medical Journal 2016; 129 (1436): 25-37

Health equity in the New Zealand health care system: a national survey. [NZ]
International Journal for Equity in Health 10.1 (2011): 1.

Health equity: what does it mean for child health [NZ]
New Zealand Medical Journal 2011; 124 (1347)

Health inequalities: unfair, measurable and remediable? The case of New Zealand. [NZ]
Paper prepared for the WHO Commission on Social Determinants of Health.

Policy implementation for health equity in Aotearoa: examining healthy eating and physical activity programmes in Maaori and Pasifika communities [NZ]
Paper prepared by Arnell Hinkle (2010)

Solutions to child poverty in New Zealand [NZ]
Report prepared for the Office of the Children;s Commissioner (2012)

The politics of Māori health (2016)

The Social, Cultural and Economic Determinants of Health in New Zealand: Action to Improve Health
A Report from the National Advisory Committee on Health and Disability (National Health Committee) (1998)
The principal findings of this report are:
 social, cultural and economic factors are the main determinants of health
 there are persisting health inequalities as a result of socioeconomic factors in New
Zealand and some evidence that these may be worsening
 current trends in many socioeconomic factors in New Zealand are likely to widen
health inequalities further
 there are good reasons for intervening to reduce socioeconomic inequalities in health
 there are evidence-based interventions for reducing these inequalities

 

Selected Journals


Australia and New Zealand Journal of Public Health

Maori Health Review [NZ]

Pacific Health Review [NZ]

Asian Health Review [NZ]

 

International Resources

Websites

Equity [World Health Organisation]

Health Equity Initiative [HEI]


Toolkits and Guidelines



What are health inequalities?
The Kings Fund, 2020
Interventions to tackle health inequalities need to reflect the complexity of how health inequalities are created and perpetuated, otherwise they could be ineffective or even counterproductive. For example, efforts to tackle inequalities of health status associated with behavioural risks (such as poor diets) should address the wider network of factors that influence these behaviours (such as access to affordable healthy food, marketing and advertising regulations) and the impact that these behaviours have on health outcomes (such as access to clinical services). 

Health inequalities are not inevitable and the gaps are not fixed. 

Evidence shows that a comprehensive approach to tackling them can make a difference. Concerted, systematic action is needed across multiple fronts to address the causes of health inequalities. This includes, but goes well beyond, the health and care system.

This explainer provides an overview of how health inequalities are experienced in England’s population

Health inequalities: place-based approaches to reduce inequalities: Guidelines to support local action on health inequalities.
Public Health England, 2019
This guidance aims to reinforce a common understanding of the complex causes and costs of health inequalities and provide a practical framework and tools for places to reduce health inequalities. The accompanying documents include a slide set providing a summary and examples of how to use a place-based approach to reduce health inequalities.

Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity
National Academy of Sciences. 2019
This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.

Incorporating concerns for equity into health resource allocation. A guide for practitioners [UK]
 “Unfair differences in health care access, quality or health outcomes exist between and within countries around the world, and improving health equity is an important social objective for many governments and international organizations. This paper summaries the methods for analysing health equity available to policymakers regarding the allocation of health sector resources.”

100 Million Healthier Lives [US]
100 Million Healthier Lives is an unprecedented collaboration of change agents across sectors who are pursuing an unprecedented result.

Mission: 100 million people living healthier lives by 2020.
Vision: to fundamentally transform the way the world thinks and acts to improve health, wellbeing, and equity to get to breakthrough results.

Together, we are systematically creating a community of solutions to the most intractable challenges that stand in the way of achieving health, wellbeing and equity across the globe.  Includes guidelines and resources.

Achieving Health Equity: A Guide for Health Care Organisations [US]
This white paper provides guidance on how health care organizations can reduce health disparities related to racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.

The IHI White Paper includes:

A framework, with five key components, for health care organizations to improve health equity in the communities they serve:

Make health equity a strategic priority
Develop structure and processes to support health equity work
Deploy specific strategies to address the multiple determinants of health on which health care organizations can have a direct impact
Decrease institutional racism within the organization
Develop partnerships with community organizations to improve health and equity
Guidance for measuring health equity
A case study of one health care organization that has strategically integrated work to improve health equity throughout their system
A self-assessment tool for health care organizations to gauge their current focus on and efforts to improve health equity

Equity of Care: a Toolkit for Eliminating Health Care Disparities [US]
This toolkit is a user-friendly “how-to” guide to help accelerate the elimination of health care disparities and ensure our leadership teams and board members reflect the communities we serve.

Fair Foundations [Aus.]
Fair Foundations: The VicHealth framework for health equity is a planning tool for health promotion policy and practice. It outlines the social determinants of health inequities, suggesting entry points for action.

Health Equity and Prevention Primer [US]
Health inequities are more than disparities or differences in health and safety outcomes. Inequity describes unfairness and the systematic nature of disparities. The Health Equity and Prevention Primer (HEPP) serves as a web-based training series for public health practitioners and advocates interested in policy advocacy, community change, and multi-sector engagement to achieve health equity. The Primer helps practitioners integrate a health equity lens into their initiatives in pursuit of overall health and safety.

Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities [US]
This document was created to provide examples of strategies and surveillance data which can be used to inform obesity prevention initiatives.

Improving Health Equity Through Data Collection AND Use: a Guide for Hospital Leaders [US]
To meet the needs of their diverse populations, hospitals and health systems will need to bridge the gap between collecting meaningful patient data and reviewing the data to identify inequities in health care provision and utilization, and to implement simple yet effective interventions to improve care for patients.

Improving Quality and Achieving Equity: a Guide for Hospital Leaders [US]
This guide for hospital leaders presents the evidence for racial and ethnic disparities in health care and provides the rationale for addressing them with a focus on quality, cost, risk management, and accreditation. The guide also highlights case studies and model practices, and recommends activities and resources that can help hospitals identify and address disparities in order to achieve equity for patients.

Improving Quality and Achieving Equity: the Role of Cultural Competence in Reducing Racial and Ethnic Disparities in Health Care [US]
This report identifies aspects of cultural competence that are synergistic with current efforts to develop a system that delivers higher-quality care and discusses strategies by which the quality and cultural competence movements could be linked.

A Practitioner's Guide for Advancing Health Equity [US]
Designed to help public health practitioners advance health equity through community prevention strategies. While health disparities can be addressed at multiple levels, this guide focuses on policy, systems, and environmental improvements designed to improve the places where people live, learn, work, and play. It is designed for those who are new to the concept of health equity, as well as those who are already working to create equitable environments.

Roadmap to Reduce Disparities [US]
A US guide for health care organisations to improve minority health and foster equity, which includes a 6-step framework for incorporating disparities-reduction into quality improvement processes.


What Makes Us Healthy [UK]
A new series of infographics and accompanying blogs and commentaries to describe and explain the social determinants of health in an accessible and engaging way.These determinants include political, social, economic, environmental and cultural factors which shape the conditions in which we are born, grow, live, work and age. Creating a healthy population requires greater action on these factors, not simply on treating ill health further down stream.

 

Selected Reading

 

Five Essential Conditions for Health Equity

Public Health Wales (2023)

This report uses the WHO Five Essential Conditions, an innovative rights- and evidence based multi[1]sectoral policy action framework, aiming to address complex and persistent health gaps, accelerate action and increase opportunities to achieve healthy prosperous lives for all, leaving no one behind.

 

Health Equity Measurement: Considerations for Selecting a Benchmark 

Robert Wood Johnson Foundation (2023)

This brief summarizes the advantages and disadvantages of four common approaches to health equity benchmarking.

 

 

Health equity frameworks as a tool to support public health action: A rapid review of the literature.  National Collaborating Centre for Determinants of Health (2023)      

Much is known about the existence of health inequities across Canada, and the underlying structural drivers of these inequities. Less is known about how to advance equity across the public health system. Health equity frameworks are one tool to disrupt systems of oppression and promote health equity.  This report presents the results of a review conducted to answer the question: which health equity frameworks exist that can be used to inform public health planning, decision making and service delivery?

 

The enduring effects of racism on health: Understanding direct and indirect effects over time
SSM - Population Health (2022)
We examine the role of racism as a key driver of ethnic inequalities in health. We examine the direct and indirect effects of racism on mental and physical health. Racism severely and negatively impacts health over time and across the life course. Repeated exposure to racism leads to accumulation of disadvantage and poorer health. Policy and academic debates must focus on the fundamental role of racism on health.

Understanding Indigenous Health Inequalities through a Social Determinants Model
National Collaborating Centre for Indigenous Health (Canada) (2022)
“The authors begin by providing a brief overview of Indigenous health inequalities, followed by a description of social determinants across the life course. They then explain how root (structural), core (systemic), and stem (immediate) environments influence Indigenous health at individual, community, and population levels. Loppie and Wien highlight the importance of Indigenous self-determination and cultural resurgence as vital pathways to wellness.” 

An overview of reviews on strategies to reduce health inequalities
International Journal for Equity in Health(2020)
The strategies that facilitate the reduction of health inequalities must be intersectoral and multidisciplinary in nature, including all sectors of the health system. It is essential to continue generating interventions focused on strengthening health systems in order to achieve adequate universal health coverage, with a process of comprehensive and quality care.

Driving forward health equity – the role of accountability, policy coherence, social participation and empowerment
WHO, 2019
A scientific expert review process coordinated by the WHO European Office for Investment for Health and Development of the WHO Regional Office for Europe identified societal and institutional factors that singly and in combination offer new explanations on why progress on health equity has not been as fast as had been hoped when the association between individual determinants and inequities was first established. These four key drivers of health equity are: accountability, policy coherence, social participation and, underlying them, empowerment. Work on these drivers informs the Health Equity Status Report initiative (HESRi) and has resulted in three independent companion papers each elaborating further on one of the common goods for health equity – accountability, policy coherence and social participation – as well as this summary paper.

A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop—in Brief
National Academy of Sciences. 2019
On April 1, 2019, the National Academies of Sciences, Engineering, and Medicine held a public workshop, A Health Equity Approach to Obesity Efforts, in Washington, DC. The workshop explored the history of health equity issues in demographic groups that have above-average obesity risk, and considered principles and approaches to address these issues as part of obesity prevention and treatment efforts. Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions. This publication briefly summarizes the presentations and discussions from the workshop.

Advancing Equity in Health Systems by Addressing Racial Justice
Stanford Social Innovation review. 25 June, 2019
Lessons on racial equity underscore the need to set explicit aims, build coalitions, and flatten hierarchies in order to strengthen healthcare’s role in undoing systems of oppression.

Inclusion of equity in economic analyses of public health policies: systematic review and future directions (2017)
Twenty‐nine relevant studies were identified. The majority of studies comparing two or more interventions left interpretation of the size of the health and financial inequality differences to the reader. Newer approaches include: i) use of health inequality measures to quantify health inequalities; ii) inclusion of financial impacts, such as out‐of‐pocket expenditures; and iii) use of equity weights.

Improving Health Equity: 5 Guiding Principles for Health Care Leaders [US: IHI] (2018)
In January 2017, a team from IHI argued that health care organizations must make health equity a strategic priority. The authors identified five key steps for health care organizations: make health equity a leader-driven priority, develop structures and processes that support equity, take specific actions that address the social determinants of health, confront institutional racism within the organization, and partner with community organizations.

Insiders’ Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals [Canada] (2019)

A Framework for Educating Health Professionals to Address the Social Determinants of Health [US]

Better Health Through Equity: Case Studies in Reframing Public Health Work (2015) [US]

Closing The Gap in A Generation: Health Equity Through Action on the Social Determinants of Health (Commission on the Social Determinants of Health, CSDH 2008)

Equity and Excellence: Liberating the NHS [UK]

Evidence review: Settings for addressing the social determinants of health inequities [Aus.]

Fair Society, Healthy Lives (The Marmot Review): Strategic Review of Health Inequalities in England Post 2010 (Marmot et al, 2010) [UK]

Fairer decisions, better health for all: Health equity and cost-effectiveness analysis [UK]

Health literacy: a necessary element for achieving health equity [US]

Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary [US]

WHO European Review of Social Determinants of Health & the Health Divide (Marmot et al 2012) [EU]

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care [US; 2003]
Seminal report.  Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received.

In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed.



Selected Journals

Diversity and Equality in Health Care

Ethnicity and Health

International Journal for Equity in Health

see also

PubMed Database Search: Health Equity


 

 

 last updated  12 February 2024

Childhood Obesity Clearinghouse

Childhood Obesity Childhood obesity is not just a problem for individual families and whānau; it is connected to a range of systemic and environmental drivers which shape eating and activity behaviours. The following resources will help you understand how childhood obesity relates to health equity, what is being done about it in New Zealand and overseas, how effective these approaches are, and the challenges for health professionals and communities wanting to create healthier lives for children. Contents Plans to Address Childhood Obesity Health Promotion Initiatives Research and Resource Websites Toolkits Clinical Guidance and e-Learning Selected Reading Selected Journals Social Media CM Health Library Clearinghouses Plans to Address Childhood Obesity Metro-Aukland DHB Healthy Weight Action Plan for Children 2017-2020 This plan is focused on articulating the role health services have in contributing to children maintaining a healthy weight. see also The Healthy Auckland Together Plan 2015 - 2020 and Healthy Auckland Together website Action to reduce obesity and reduce it’s impact across the life course: evidence review. [RACP, 2018] Obesity is a multifactorial problem and the causes are deeply embedded in our societal structures which means that there are no simple solutions. However, there are many opportunities to tackle obesity at individual, community and population levels. While some of the opportunities to act are within the reach of people and their families, cross-sectoral actions are needed to create a whole of society approach to reducing obesity and its related inequalities. The health sector can play many important roles in reducing the burden of obesity and, for obesity prevention, this largely involves advocating for stronger government-led policies and actions. The sector can actively support the implementation of specific policies and actions, as recommended by authoritative bodies such as WHO, to create healthier food and physical activity environments for the prevention of obesity. The sector can also advocate for action to address the deeper, underlying societal drivers of health and disease. The main areas for action are outlined [in this report]. OECD Obesity Update 2017 [OECD, 2017] In the last few years, new policy strategies devised to fight obesity have emerged. This Obesity Update focusses on a selection of those, specifically at communication policies aimed to tackle obesity, in particular by improving nutrient information displayed on food labels, using social and new media to sensitise the population, or by regulating the marketing of food products. Better communication helps empower people to make healthier choices. However, comprehensive policy packages, including not only communication but also broader regulatory and fiscal policies, are needed to tackle obesity effectively. Report of the Commission on Ending Childhood Obesity [WHO, 2016] The Commission has developed a comprehensive, integrated package of recommendations to address childhood obesity. It calls for governments to take leadership and for all stakeholders to recognize their moral responsibility in acting on behalf of the child to reduce the risk of obesity. Draft Implementation Plan for the Recommendations of the Commission on Ending Childhood Obesity [WHO, 2016] NZ Childhood Obesity Plan [launched October 2015] The plan has three focus areas, made up of 22 initiatives, which are either new or an expansion of existing initiatives: Targeted interventions for those who are obese Increased support for those at risk of becoming obese Broad approaches to make healthier choices easier for all New Zealanders. The focus is on food, the environment and being active at each life stage, starting during pregnancy and early childhood. The package brings together initiatives across government agencies, the private sector, communities, schools, families and whānau. see also : Children and Young People Living Well and Staying Well: New Zealand Childhood Obesity Programme Baseline Report 2016/17 [June 2017] The report builds on the work that these organisations did in 2016 to develop an intervention logic model for reducing childhood obesity, which includes a set of 15 performance indicators that we will use to monitor the New Zealand Childhood Obesity Programme over the next five years.The report includes a description of each of the indicators and presents a baseline view of their performance. It also provides a brief overview of the New Zealand Childhood Obesity Programme and an update on the programme’s first year of implementation (2015/16). This report will form the basis of future monitoring reports on the New Zealand Childhood Obesity Programme. The first monitoring report will be published in 2018 and will provide information on the second year of implementation (2016/17) and updated performance against the reducing childhood obesity indicators. Subscribe to the Reducing Childhood Obesity Update to keep informed of progress and activities associated with the NZ Childhood Obesity plan. UK government's Childhood Obesity Plan for Action [August 2016] The government’s plan to reduce England’s rate of childhood obesity within the next 10 years by encouraging: industry to cut the amount of sugar in food and drinks primary school children to eat more healthily and stay active. Government response to the House of Commons Health and Social Care Select Committee report, on childhood obesity: Time for action, eighth report of session 2017–19 [January 2019] This Command paper sets out the government’s response to the conclusions and recommendations in the Health and Social Care Select Committee’s report, Childhood obesity: time for action. The committee’s report covered the following areas: a whole systems approach; marketing and advertising; price promotions; early years and schools; takeaways; fiscal measures; labelling; and support for children living with obesity. The government’s response addresses each of these areas. Health Promotion Initiatives Healthy Families NZ [NZ] The Ministry of Health’s a large-scale initiative that brings together community leadership in a united effort for better health. Eat Move Live [NZ] This website supports the NZ government’s Big Change Starts Small campaign to help families make healthy choices with fast, easy and low-cost recipes, tips and fun ideas to get kids moving. Nutrition Resources for Schools [NZ] Here you can access free resources from the Health Promotion Agency to promote drinking water, eating breakfast and healthy snacks. Healthy Together Auckland [NZ] A coalition of 26 organisations representing local government, mana whenua, health agencies, NGOs, university and consumer interest groups which aims to change policy, infrastructure design and planning, so Auckland’s environments can encourage physical activity and good nutrition. INFORMAS (International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support) [NZ led] A global network of public-interest organisations and researchers that aims to monitor, benchmark and support public and private sector actions to create healthy food environments and reduce obesity and non-communicable diseases (NCDs) and their related inequalities. Project Activate [NZ] Project Activate equips young people to make lifelong healthy choices by learning about the science of good health. Research and Resource Websites Global Atlas on Childhood Obesity The atlas presents data for every country based on their current and predicted levels of obesity in children, the risk factors and the presence of government policies to tackle obesity, such as restricting marketing of foods to children, encouragement of physical activity and nation guidelines for healthy diets. Based on these factors the Atlas gives each countries a score for their childhood obesity risk. Obesity Evidence Hub [Aus.] The Obesity Evidence Hub is a joint project resulting from a partnership between the Cancer Council Victoria, the Bupa Health Foundation and the Obesity Policy Coalition. It is a foundational component to the Obesity Collective, a modern movement to drive action on important obesity initiatives in Australia. The Obesity Evidence Hub’s objective is to identify, analyse and synthesise the evidence on obesity. FAB Weight Management [NZ] A Health Improvement and Innovation Resource Centre portal for the latest published, unpublished and in progress research on nutrition, physical activity, obesity and weight management. There is also news and events information, links to NZ health promotion resources and other useful tools. You need to register to access the site, but this is open to anyone and allows you to contribute to discussions, post comments and subscribe for email alerts to new content. Partners in Information Access for the Public Health Workforce [US] Run by a collaboration of U.S. government agencies, public health organisations and health sciences libraries, this site provides a portal of news and research resources on obesity. Obesity Prevention Source [US] This Harvard School of Public Health website is an in-depth resource of science-based information for all who seek to understand the causes of obesity and to reverse the epidemic of obesity in children and adults. Obesity in the Early Childhood Years: State of the Science and Implementation of Promising Solutions [US] The Roundtable on Obesity Solutions of the Institute of Medicine workshops, including links to videos of speakers. Childhood Obesity Intervention Cost Effectiveness Study [US] The Harvard T.H. Chan School of Public Health is working to help reverse the US obesity epidemic by identifying the most cost-effective childhood obesity interventions. NZ Child and Youth Epidemiology Service [NZ] see publications that report on obesity : Craig E, Reddington A, Adams J, Dell R, Jack S, Oben G, Wicken A and Simpson J. The Health of Children and Young People with Chronic Conditions and Disabilities in New Zealand. Dunedin: New Zealand Child and Youth Epidemiology Service, University of Otago; 2013.Permanent link to OUR Archive version: http://hdl.handle.net/10523/6126 Healthier Lives The Healthier Lives National Science Challenge is a national research collaboration dedicated to achieving healthier lives for all New Zealanders. The key to this is delivering the right prevention to the right population and the right treatment to the right patient. Healthier Lives is working on the prevention and treatment of four of New Zealand’s main non-communicable diseases: Cancer Cardiovascular disease Diabetes Obesity Toolkits NICE Guidance for Delivering or Commissioning Weight Management Services for Children and their Families [UK] An evidence-based approach to designing weight management services for overweight or obese 4-12 year olds and their families. Obesity Evaluation Toolkit: Resources for Evaluating Community-Level Obesity Prevention Efforts [US] This page provides an overview of the key steps and principles in a community-level evaluation, as well as links to related resources from the Institute of Medicine, government agencies, and the Community Tool Box. Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities [US] The purpose of the Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities is to increase the capacity of state health departments and their partners to work with and through communities to implement effective responses to obesity in populations that are facing health disparities. Clinical Guidance and e-Learning Psychological Perspectives on Obesity: Addressing Policy, Practice, and Research Priorities [UK] The document seeks to guide professionals and policy makers working with individuals, groups, and populations that are impacted by obesity to take an approach that is guided by psychology. It provides a series of recommendations based around the following areas: Reducing weight-related stigma Psychologically informed policy Standards and guidelines Training and supervision Weight management services Promoting healthy weight in children, young people and families [UK] This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach. The briefing papers help to: - make the case for taking action to reduce childhood obesity - give examples of actions that can be taken - provide key documents that form the evidence base and other useful resources How We Eat – Reviews of the evidence on food and eating behaviours related to diet and body size [NZ] How We Eat is a review of the available evidence on the effect of selected eating behaviours on diet and body size. The topics reviewed are: breastfeeding, parental feeding practices and parenting style, adult role modelling, responsive eating, mealtimes and food literacy. A review of relevant New Zealand research was included. Sit Less, Move More, Sleep Well: Active play guidelines for under-fives [NZ] These Guidelines provide population health advice to support health practitioners, early childhood educators, regional sports trusts and others who provide advice to parents, caregivers and whānau or families on physical activity for children under five years of age. Clinical Guidelines for Weight Management in New Zealand Children and Young People [NZ] These updated clinical guidelines for primary health care practitioners and others who provide advice on weight management for New Zealand children and young people aged 2 to 18 years help support the government’s Raising Healthy Kids Health Target: Weight Management in 2-5 year olds. Weight Managment in 2–5 Year Olds [NZ] A practical resource to equip health providers with the most up-to-date advice to monitor, assess and manage children who are overweight and obese. Healthy Start Education Programme [NZ] This e-learning programme is offered free-of-charge to all maternity, child and whānau professionals through funding from the Ministry of Health. It gives participants a rich background knowledge and rationale to reinforce discussions with mothers and their families about why nutrition and physical activity are such critical factors during pregnancy and an infant’s early life. Guidance for Healthy Weight Gain in Pregnancy [NZ] This is a health practitioner resource that includes practice points for pre-pregnancy, during pregnancy and postpartum. It is accompanied by resources for health practitioners and information for women. Routing out childhood obesity [UK] This report outlines a range of recommendations for transforming the street environment, particularly around schools, with the ambition that all children should have access to a healthy route home. Selected Reading Public Health Concerns We can’t prevent childhood obesity by education alone: lessons from the evidence base Bristol University (2021) This briefing examines randomised control trials across a range of countries and settings. It analyses the focus of the trials through a wider determinants of health lens, and compares the focus of interventions against previously mapped causes of obesity – which show that approximately 60 per cent of the causes come from living and working conditions, such as housing or transport, or wider conditions, such as income equality or land use. Addressing the social and commercial determinants of healthy weight Sax Institute (2019) Population-level strategies to support healthy weight Sax Institute (2019) Environmental, social, and economic factors related to the intersection of food security, dietary quality, and obesity: an introduction : a special issue of the Translational Behavioral Medicine journal (2019) Every Child a healthy Weight. Ten Ambitions for London (an call to action in which we have set out ten ambitions to transform ten aspects of the daily lives of children and their parents ) London's Child Obesity taskforce (2019) Ranked Importance of Childhood Obesity Determinants: Parents’ Views across Ethnicities in New Zealand Nutrients 2019, 11(9), 2145 [NZ] (2019) Obesity prevention and the role of hospital and community-based health services: a scoping review BMC Health Services Research 19 ( 5 Jul. 2019) Role of government policy in nutrition—barriers to and opportunities for healthier eating BMJ 361 (2018) Healthy Auckland Together: Monitoring Report 2017 - the state of Auckland’s “obesogenicity” (2017) Improving food environments and tackling obesity: A realist systematic review of the policy success of regulatory interventions targeting population nutrition PLoS ONE 12.8 ( 4 Aug. 2017) Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025 Pediatric Obesity, 11: 321–325 (2016) The childhood obesity plan – brave and bold action? [UK] (2016) Government's childhood obesity plan flawed [NZ] (2016) Getting serious about protecting NZ children against unhealthy food marketing [NZ] New Zealand Medical Journal 128:1417 (2015) Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking Lancet (London, England) 385.9985 ( 13 Jun. 2015) : 2400-2409 see also Lancet Obesity Series 2015 FIZZ [NZ] This group of researchers and public health doctors have come together to advocate for ending the sale of sugar sweetened beverages (sugary drinks) from New Zealand. Equity Issues Understanding inequalities: summary report. The impact of inequalities in the early years on outcomes over the life course: Using international evidence to identify creative policy solutions. Growing up in New Zealand, 2019. The findings from the Growing Up in New Zealand study demonstrate that Maori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course. By the time they start school (at age 5 years) many are already falling behind their peers in terms of preparedness for formal education and readiness to engage in learning. The study has shown that inequalities in developmental opportunities and outcomes have their origins in early in life. Risk factors for early vulnerability cluster and there is no one single proxy marker of disadvantage. Additionally, morbidity and poor outcomes cluster. Persistent adversity is associated with a graded likelihood of poor outcomes (across the population). Further service use is not meeting measured need. Currently, access to early life universal services may be widening inequalities. A proportional-universalism approach to services is required if they are to meet real need and reduce inequalities. Child obesity prevalence across communities in New Zealand: 2010–2016 [NZ] (2019) "Implications for public health: Addressing deprivation and ethnic inequalities in obesity could substantially reduce community‐level differences in obesity in NZ." A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop—in Brief National Academy of Sciences. 2019 On April 1, 2019, the National Academies of Sciences, Engineering, and Medicine held a public workshop, A Health Equity Approach to Obesity Efforts, in Washington, DC. The workshop explored the history of health equity issues in demographic groups that have above-average obesity risk, and considered principles and approaches to address these issues as part of obesity prevention and treatment efforts. Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions. This publication briefly summarizes the presentations and discussions from the workshop. Bite Size: Breaking down the challenge of inner-city childhood obesity [UK] (2018) One of the most comprehensive explorations of the issue in disadvantaged areas, the report concludes that we need to break the link between obesity and deprivation and create environments that make the healthy thing to do, the easy thing to do. How effective are family-based and institutional nutrition interventions in improving children’s diet and health? A systematic review BMC Public Health 17:818 (2017) A novel home-based intervention for child and adolescent obesity: The results of the Whānau Pakari randomized controlled trial [NZ] Obesity (2017) Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds BMC Public Health 16:151 (2016) Reducing childhood obesity in Ontario through a health equity lens [Canada] Paper prepared by Steve Barnes (2012) Creating equal opportunities for a healthy weight [US] The summary of a workshop convened by the Institute of Medicine's Standing Committee on Childhood Obesity Prevention in June 2013 to examine income, race, and ethnicity, and how these factors intersect with childhood obesity and its prevention. *To access the free report you need to register. The impact of interventions to prevent obesity or improve obesity related behaviours in children from socioeconomically disadvantaged and/or indigenous families BMC Public Health 14:779 (2014) The Green Prescription Active Families Programme in Taranaki, New Zealand 2007–2009: Did it reach children in need? [NZ] Journal of Primary Health Care 7:3 (2015): 192–197. Ethnic differences in risk factors for obesity in NZ infants [NZ] Journal of Epidemiology and Community Health 69 (2015): 516–522. Dietary Intake and Eating Behaviours of Obese New Zealand Children and Adolescents Enrolled in a Community-Based Intervention Programme [NZ] PLoS ONE 11(11) (2016) : e0166996. doi:10.1371/journal.pone.0166996 Treatment Intervention empowerment of families in preventing and controlling overweight and obesity in children: A systematic review Journal of Public Health Research 2021; volume 10:2185 Interventions to prevent or treat childhood obesity in Māori & Pacific Islanders: a systematic review [NZ] BMC Public Health volume 20, Article number: 725 (2020 Physical activity is low in obese New Zealand children and adolescents [NZ] Scientific Reports 7, Article number: 41822 (2017) Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews (2019) Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years Cochrane Database of Systematic Reviews (2017) Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years Cochrane Database of Systematic Reviews (2017) Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years Cochrane Database of Systematic Reviews (2016) Brief primary care obesity interventions: A meta-analysis Pediatrics 138:4 (2016) Effectiveness of current interventions in obese NZ children and adolescents [NZ] New Zealand Medical Journal 128:1417 (2015) Early Childhood Education / Schools Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services (2020) School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review (2020) Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study (2019) Interventions for obesity among schoolchildren: A systematic review and meta-analyses (2019) Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis (2018) Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review (2018) Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study) (2018) [UK] Childhood obesity plan case studies (2016) [UK] Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services Cochrane Database of Systematic Reviews (2016) Proven strategies to promote students' healthy eating [US] Project Energize: Intervention development and 10 years of progress in preventing childhood obesity [NZ] BMC Research Notes 9:44 (2016) Ranui kindergarten healthy kai project [NZ] Pregnancy and Weight Management Maternal Obesity The Lancet Diabetes & Endocrinology (12 October 2016) This series of four articles examines the growing burden of maternal obesity worldwide in terms of its impact on clinical management and intergenerational health, and highlights the need for a focus on the pre-pregnancy period, along with a whole-of-society intervention approach, to reverse the cycle of ill health propagated by maternal obesity. *Register to access the articles for free or they are available through the Library in Clinical Key. Diet or exercise, or both, for preventing excessive weight gain in pregnancy Cochrane Database of Systematic Reviews (2015) Health Promotion Methodologies Practitioner insights on obesity prevention: The voice of South Australian OPAL workers [Australia] Health Promotion International (2015) Using the community-based participatory research (CBPR) approach in childhood obesity prevention Journal of Child Health and Nutrition 3:4 (2014): 170–178. Healthy together Victoria and childhood obesity—a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial Archives of Public Health 74:16 (2016) see also PubMed literature search: Childhood Obesity (last 5 years) Selected Journals Childhood Obesity Pediatric Obesity Journal of Childhood Obesity BMC Obesity Health Promotion International BMC Public Health Social Media Twitter #Childhoodobesity #Obesity #HealthyKids CM Health Library Clearinghouses Health Equity Pacific Health Māori Health last updated 6 December 2022

Childhood Obesity

Childhood obesity is not just a problem for individual families and whānau; it is connected to a range of systemic and environmental drivers which shape eating and activity behaviours. The following resources will help you understand how childhood obesity relates to health equity, what is being done about it in New Zealand and overseas, how effective these approaches are, and the challenges for health professionals and communities wanting to create healthier lives for children.

 

Contents 

Plans to Address Childhood Obesity
Health Promotion Initiatives
Research and Resource Websites
Toolkits
Clinical Guidance and e-Learning
Selected Reading
Selected Journals
Social Media
CM Health Library Clearinghouses

 

Plans to Address Childhood Obesity

 

Metro-Aukland DHB Healthy Weight Action Plan for Children 2017-2020

This plan is focused on articulating the role health services have in contributing to children maintaining
a healthy weight.

see also The Healthy Auckland Together Plan 2015 - 2020 and Healthy Auckland Together website

Action to reduce obesity and reduce it’s impact across the life course: evidence review. [RACP, 2018]

Obesity is a multifactorial problem and the causes are deeply embedded in our societal structures which means that there are no simple solutions. However, there are many opportunities to tackle obesity at individual, community and population levels. While some of the opportunities to act are within the reach of people and their families, cross-sectoral actions are needed to create a whole of society approach to reducing obesity and its related inequalities. The health sector can play many important roles in reducing the burden of obesity and, for obesity prevention, this largely involves advocating for stronger government-led policies and actions. The sector can actively support the implementation of specific policies and actions, as recommended by authoritative bodies such as WHO, to create healthier food and physical activity environments for the prevention of obesity. The sector can also advocate for action to address the deeper, underlying societal drivers of health and disease. The main areas for action are outlined [in this report].

 

OECD Obesity Update 2017 [OECD, 2017]

In the last few years, new policy strategies devised to fight obesity have emerged. This Obesity Update focusses on a selection of those, specifically at communication policies aimed to tackle obesity, in particular by improving nutrient information displayed on food labels, using social and new media to sensitise the population, or by regulating the marketing of food products. Better communication helps empower people to make healthier choices. However, comprehensive policy packages, including not only communication but also broader regulatory and fiscal policies, are needed to tackle obesity effectively.

Report of the Commission on Ending Childhood Obesity [WHO, 2016]

The Commission has developed a comprehensive, integrated package of recommendations to address childhood obesity. It calls for governments to take leadership and for all stakeholders to recognize their moral responsibility in acting on behalf of the child to reduce the risk of obesity.

Draft Implementation Plan for the Recommendations of the Commission on Ending Childhood Obesity [WHO, 2016]

NZ Childhood Obesity Plan [launched October 2015]

The plan has three focus areas, made up of 22 initiatives, which are either new or an expansion of existing initiatives:

  1. Targeted interventions for those who are obese
  2. Increased support for those at risk of becoming obese
  3. Broad approaches to make healthier choices easier for all New Zealanders.

The focus is on food, the environment and being active at each life stage, starting during pregnancy and early childhood. The package brings together initiatives across government agencies, the private sector, communities, schools, families and whānau.

see also :

Children and Young People Living Well and Staying Well: New Zealand Childhood Obesity Programme Baseline Report 2016/17 [June 2017]

The report builds on the work that these organisations did in 2016 to develop an intervention logic model for reducing childhood obesity, which includes a set of 15 performance indicators that we will use to monitor the New Zealand Childhood Obesity Programme over the next five years.The report includes a description of each of the indicators and presents a baseline view of their performance. It also provides a brief overview of the New Zealand Childhood Obesity Programme and an update on the programme’s first year of implementation (2015/16).

This report will form the basis of future monitoring reports on the New Zealand Childhood Obesity Programme. The first monitoring report will be published in 2018 and will provide information on the second year of implementation (2016/17) and updated performance against the reducing childhood obesity indicators.

Subscribe to the Reducing Childhood Obesity Update to keep informed of progress and activities associated with the NZ Childhood Obesity plan.

UK government's Childhood Obesity Plan for Action [August 2016]

The government’s plan to reduce England’s rate of childhood obesity within the next 10 years by encouraging:

  • industry to cut the amount of sugar in food and drinks
  • primary school children to eat more healthily and stay active.

 

Government response to the House of Commons Health and Social Care Select Committee report, on childhood obesity: Time for action, eighth report of session 2017–19 [January 2019]
 

This Command paper sets out the government’s response to the conclusions and recommendations in the Health and Social Care Select Committee’s report, Childhood obesity: time for action. The committee’s report covered the following areas: a whole systems approach; marketing and advertising; price promotions; early years and schools; takeaways; fiscal measures; labelling; and support for children living with obesity. The government’s response addresses each of these areas.

 

Health Promotion Initiatives

 

Healthy Families NZ [NZ]

The Ministry of Health’s a large-scale initiative that brings together community leadership in a united effort for better health.

Eat Move Live [NZ]

This website supports the NZ government’s Big Change Starts Small campaign to help families make healthy choices with fast, easy and low-cost recipes, tips and fun ideas to get kids moving.

Nutrition Resources for Schools [NZ]

Here you can access free resources from the Health Promotion Agency to promote drinking water, eating breakfast and healthy snacks.

Healthy Together Auckland [NZ]

A coalition of 26 organisations representing local government, mana whenua, health agencies, NGOs, university and consumer interest groups which aims to change policy, infrastructure design and planning, so Auckland’s environments can encourage physical activity and good nutrition.

INFORMAS (International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support) [NZ led]

A global network of public-interest organisations and researchers that aims to monitor, benchmark and support public and private sector actions to create healthy food environments and reduce obesity and non-communicable diseases (NCDs) and their related inequalities.

Project Activate [NZ]
Project Activate equips young people to make lifelong healthy choices by learning about the science of good health.

 

Research and Resource Websites

 

Global Atlas on Childhood Obesity
The atlas presents data for every country based on their current and predicted levels of obesity in children, the risk factors and the presence of government policies to tackle obesity, such as restricting marketing of foods to children, encouragement of physical activity and nation guidelines for healthy diets. Based on these factors the Atlas gives each countries a score for their childhood obesity risk.

Obesity Evidence Hub [Aus.]
The Obesity Evidence Hub is a joint project resulting from a partnership between the Cancer Council Victoria, the Bupa Health Foundation and the Obesity Policy Coalition. It is a foundational component to the Obesity Collective, a modern movement to drive action on important obesity initiatives in Australia. The Obesity Evidence Hub’s objective is to identify, analyse and synthesise the evidence on obesity.  

FAB Weight Management [NZ]

A Health Improvement and Innovation Resource Centre portal for the latest published, unpublished and in progress research on nutrition, physical activity, obesity and weight management. There is also news and events information, links to NZ health promotion resources and other useful tools. You need to register to access the site, but this is open to anyone and allows you to contribute to discussions, post comments and subscribe for email alerts to new content.

Partners in Information Access for the Public Health Workforce [US]

Run by a collaboration of U.S. government agencies, public health organisations and health sciences libraries, this site provides a portal of news and research resources on obesity.

Obesity Prevention Source [US]

This Harvard School of Public Health website is an in-depth resource of science-based information for all who seek to understand the causes of obesity and to reverse the epidemic of obesity in children and adults.

Obesity in the Early Childhood Years: State of the Science and Implementation of Promising Solutions [US]

The Roundtable on Obesity Solutions of the Institute of Medicine workshops, including links to videos of speakers.

Childhood Obesity Intervention Cost Effectiveness Study [US]

The Harvard T.H. Chan School of Public Health is working to help reverse the US obesity epidemic by identifying the most cost-effective childhood obesity interventions.

NZ Child and Youth Epidemiology Service [NZ]

see publications that report on obesity : Craig E, Reddington A, Adams J, Dell R, Jack S, Oben G, Wicken A and Simpson J. The Health of Children and Young People with Chronic Conditions and Disabilities in New Zealand. Dunedin: New Zealand Child and Youth Epidemiology Service, University of Otago; 2013.Permanent link to OUR Archive version: http://hdl.handle.net/10523/6126

Healthier Lives
The Healthier Lives National Science Challenge is a national research collaboration dedicated to achieving healthier lives for all New Zealanders.  The key to this is delivering the right prevention to the right population and the right treatment to the right patient.

Healthier Lives is working on the prevention and treatment of four of New Zealand’s main non-communicable diseases:

Cancer
Cardiovascular disease
Diabetes
Obesity

 

Toolkits

NICE Guidance for Delivering or Commissioning Weight Management Services for Children and their Families [UK]
An evidence-based approach to designing weight management services for overweight or obese 4-12 year olds and their families.

Obesity Evaluation Toolkit: Resources for Evaluating Community-Level Obesity Prevention Efforts [US]

This page provides an overview of the key steps and principles in a community-level evaluation, as well as links to related resources from the Institute of Medicine, government agencies, and the Community Tool Box.

Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities [US]

The purpose of the Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities is to increase the capacity of state health departments and their partners to work with and through communities to implement effective responses to obesity in populations that are facing health disparities.

 

Clinical Guidance and e-Learning

 

Psychological Perspectives on Obesity: Addressing Policy, Practice, and Research Priorities [UK]

The document seeks to guide professionals and policy makers working with individuals, groups, and populations that are impacted by obesity to take an approach that is guided by psychology.

It provides a series of recommendations based around the following areas:

Reducing weight-related stigma
Psychologically informed policy
Standards and guidelines
Training and supervision
Weight management services 

 

Promoting healthy weight in children, young people and families [UK]

This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach. The briefing papers help to:

- make the case for taking action to reduce childhood obesity
- give examples of actions that can be taken
- provide key documents that form the evidence base and other useful resources 

 

How We Eat – Reviews of the evidence on food and eating behaviours related to diet and body size [NZ]

How We Eat is a review of the available evidence on the effect of selected eating behaviours on diet and body size. The topics reviewed are: breastfeeding, parental feeding practices and parenting style, adult role modelling, responsive eating, mealtimes and food literacy.  A review of relevant New Zealand research was included.

 

Sit Less, Move More, Sleep Well: Active play guidelines for under-fives [NZ]

These Guidelines provide population health advice to support health practitioners, early childhood educators, regional sports trusts and others who provide advice to parents, caregivers and whānau or families on physical activity for children under five years of age.

Clinical Guidelines for Weight Management in New Zealand Children and Young People [NZ]

These updated clinical guidelines for primary health care practitioners and others who provide advice on weight management for New Zealand children and young people aged 2 to 18 years help support the government’s Raising Healthy Kids Health Target: Weight Management in 2-5 year olds. 

Weight Managment in 2–5 Year Olds [NZ]

A practical resource to equip health providers with the most up-to-date advice to monitor, assess and manage children who are overweight and obese.

Healthy Start Education Programme [NZ]

This e-learning programme is offered free-of-charge to all maternity, child and whānau professionals through funding from the Ministry of Health. It gives participants a rich background knowledge and rationale to reinforce discussions with mothers and their families about why nutrition and physical activity are such critical factors during pregnancy and an infant’s early life.  

Guidance for Healthy Weight Gain in Pregnancy [NZ]

This is a health practitioner resource that includes practice points for pre-pregnancy, during pregnancy and postpartum. It is accompanied by resources for health practitioners and information for women.

Routing out childhood obesity [UK] 

This report outlines a range of recommendations for transforming the street environment, particularly around schools, with the ambition that all children should have access to a healthy route home.

 

Selected Reading


Public Health Concerns

We can’t prevent childhood obesity by education alone: lessons from the evidence base

Bristol University (2021)

This briefing examines randomised control trials across a range of countries and settings. It analyses the focus of the trials through a wider determinants of health lens, and compares the focus of interventions against previously mapped causes of obesity – which show that approximately 60 per cent of the causes come from living and working conditions, such as housing or transport, or wider conditions, such as income equality or land use.

 

Addressing the social and commercial determinants of healthy weight
Sax Institute (2019)

Population-level strategies to support healthy weight
Sax Institute (2019)

Environmental, social, and economic factors related to the intersection of food security, dietary quality, and obesity: an introduction : a special issue of the Translational Behavioral Medicine journal (2019)                                  

Every Child a healthy Weight. Ten Ambitions for London (an call to action in which we have set out ten ambitions to transform ten aspects of the daily lives of children and their parents )
London's Child Obesity taskforce (2019)

Ranked Importance of Childhood Obesity Determinants: Parents’ Views across Ethnicities in New Zealand
Nutrients 2019, 11(9), 2145 [NZ] (2019)

Obesity prevention and the role of hospital and community-based health services: a scoping review
BMC Health Services Research   19   ( 5 Jul. 2019) 

Role of government policy in nutrition—barriers to and opportunities for healthier eating
BMJ   361   (2018) 

Healthy Auckland Together: Monitoring Report 2017 - the state of Auckland’s “obesogenicity” (2017)

Improving food environments and tackling obesity: A realist systematic review of the policy success of regulatory interventions targeting population nutrition
 PLoS ONE   12.8   ( 4 Aug. 2017)  

Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025
Pediatric Obesity, 11: 321–325 (2016)

The childhood obesity plan – brave and bold action? [UK] (2016)

Government's childhood obesity plan flawed [NZ] (2016)

Getting serious about protecting NZ children against unhealthy food marketing [NZ]
New Zealand Medical Journal 128:1417 (2015)

Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking
Lancet (London, England)   385.9985   ( 13 Jun. 2015)   : 2400-2409  
see also Lancet Obesity Series 2015

FIZZ [NZ]
This group of researchers and public health doctors have come together to advocate for ending the sale of sugar sweetened beverages (sugary drinks) from New Zealand.

Equity Issues

Understanding inequalities: summary report. The impact of inequalities in the early
years on outcomes over the life course: Using international evidence to identify creative policy solutions.
Growing up in New Zealand, 2019.
The findings from the Growing Up in New Zealand study demonstrate that Maori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course. By the time they start school (at age 5 years) many are already falling behind their peers in terms of preparedness for formal education and readiness to engage in learning.

The study has shown that inequalities in developmental opportunities and outcomes have their origins in early in life. Risk factors for early vulnerability cluster and there is no one single proxy marker of disadvantage. Additionally, morbidity and poor outcomes cluster. Persistent adversity is associated with a graded likelihood of poor outcomes (across the population). Further service use is not meeting measured need. Currently, access to early life universal services may be widening inequalities. A proportional-universalism approach to services is required if they are to meet real need and reduce inequalities.

Child obesity prevalence across communities in New Zealand: 2010–2016 [NZ] (2019)
"Implications for public health: Addressing deprivation and ethnic inequalities in obesity could substantially reduce community‐level differences in obesity in NZ."

A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop—in Brief
National Academy of Sciences. 2019
On April 1, 2019, the National Academies of Sciences, Engineering, and Medicine held a public workshop, A Health Equity Approach to Obesity Efforts, in Washington, DC. The workshop explored the history of health equity issues in demographic groups that have above-average obesity risk, and considered principles and approaches to address these issues as part of obesity prevention and treatment efforts. Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions. This publication briefly summarizes the presentations and discussions from the workshop.

Bite Size: Breaking down the challenge of inner-city childhood obesity [UK] (2018)
One of the most comprehensive explorations of the issue in disadvantaged areas, the report concludes that we need to break the link between obesity and deprivation and create environments that make the healthy thing to do, the easy thing to do.

How effective are family-based and institutional nutrition interventions in improving children’s diet and health? A systematic review
BMC Public Health 17:818 (2017) 

A novel home-based intervention for child and adolescent obesity: The results of the Whānau Pakari randomized controlled trial [NZ]
Obesity (2017)

Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds
BMC Public Health 16:151 (2016) 

Reducing childhood obesity in Ontario through a health equity lens [Canada]
Paper prepared by Steve Barnes (2012)

Creating equal opportunities for a healthy weight [US]
The summary of a workshop convened by the Institute of Medicine's Standing Committee on Childhood Obesity Prevention in June 2013 to examine income, race, and ethnicity, and how these factors intersect with childhood obesity and its prevention. *To access the free report you need to register.

The impact of interventions to prevent obesity or improve obesity related behaviours in children from socioeconomically disadvantaged and/or indigenous families
BMC Public Health 14:779 (2014)

The Green Prescription Active Families Programme in Taranaki, New Zealand 2007–2009: Did it reach children in need? [NZ]
Journal of Primary Health Care 7:3 (2015): 192–197.

Ethnic differences in risk factors for obesity in NZ infants [NZ]
Journal of Epidemiology and Community Health 69 (2015): 516–522.

Dietary Intake and Eating Behaviours of Obese New Zealand Children and Adolescents Enrolled in a Community-Based Intervention Programme [NZ]
PLoS ONE 11(11) (2016) : e0166996. doi:10.1371/journal.pone.0166996

 

Treatment

Intervention empowerment of families in preventing and controlling overweight and obesity in children: A systematic review
Journal of Public Health Research 2021; volume 10:2185

Interventions to prevent or treat childhood obesity in Māori & Pacific Islanders: a systematic review [NZ]
BMC Public Health volume 20, Article number: 725 (2020

Physical activity is low in obese New Zealand children and adolescents [NZ]
Scientific Reports 7, Article number: 41822 (2017)

Interventions for preventing obesity in children.
Cochrane Database of Systematic Reviews (2019)

Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years
Cochrane Database of Systematic Reviews (2017)

Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years
Cochrane Database of Systematic Reviews (2017)

Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years
Cochrane Database of Systematic Reviews (2016)

Brief primary care obesity interventions: A meta-analysis
Pediatrics 138:4 (2016)

Effectiveness of current interventions in obese NZ children and adolescents [NZ]
New Zealand Medical Journal 128:1417 (2015)

Early Childhood Education / Schools

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services  (2020)

School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review (2020)

Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study (2019)

Interventions for obesity among schoolchildren: A systematic review and meta-analyses (2019)

Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis (2018)

Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review (2018)

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study) (2018) [UK]

Childhood obesity plan case studies (2016) [UK]

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services
Cochrane Database of Systematic Reviews (2016)

Proven strategies to promote students' healthy eating [US]

Project Energize: Intervention development and 10 years of progress in preventing childhood obesity [NZ]
BMC Research Notes 9:44 (2016)

Ranui kindergarten healthy kai project [NZ]

 

Pregnancy and Weight Management

Maternal Obesity
The Lancet Diabetes & Endocrinology (12 October 2016)
This series of four articles examines the growing burden of maternal obesity worldwide in terms of its impact on clinical management and intergenerational health, and highlights the need for a focus on the pre-pregnancy period, along with a whole-of-society intervention approach, to reverse the cycle of ill health propagated by maternal obesity. *Register to access the articles for free or they are available through the Library in Clinical Key.

Diet or exercise, or both, for preventing excessive weight gain in pregnancy
Cochrane Database of Systematic Reviews (2015)


Health Promotion Methodologies

Practitioner insights on obesity prevention: The voice of South Australian OPAL workers [Australia] Health Promotion International (2015) 

Using the community-based participatory research (CBPR) approach in childhood obesity prevention
Journal of Child Health and Nutrition 3:4 (2014): 170–178. 

Healthy together Victoria and childhood obesity—a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial
Archives of Public Health 74:16 (2016)

 

see also PubMed literature search: Childhood Obesity  (last 5 years)

 

Selected Journals

Childhood Obesity

Pediatric Obesity

Journal of Childhood Obesity

BMC Obesity

Health Promotion International

BMC Public Health

 

Social Media

Twitter

#Childhoodobesity

#Obesity

#HealthyKids

 

CM Health Library Clearinghouses

Health Equity

Pacific Health

Māori Health

 

 

last updated 6 December 2022

Leadership in Healthcare: a clearinghouse of resources for health professionals

''Leadership in Healthcare' is a clearinghouse of courses, resources and learning tools freely available to support your leadership journey. Please suggest further resources to add to this collection. Contents London Leadership Academy Leadership Toolkit Accippio eLeadership Academy Businessballs Topics (selected) NHS [Leadership Learning] Academy Open Learn [UK Open University] Learning and Management Courses Prosci's Change Management Webinars LinkedIn Learning Platform [ for Auckland, NZ] Resources freely available from the Centre for Creative Leadership Resources freely available from the King's Fund More Leadership Resources Leadership Videos, Blogs and Podcasts London Leadership Academy Leadership Toolkit Managing self / Personal effectiveness Self awareness and well being Growing self awareness and developing successful strategies for maintaining well-being Communication and listening Developing two-way communication skills focusing on listening and achieving shared understanding Influencing, collaboration and networking Building the key skills of getting things done by working with others Time management and planning Planning and organising for all aspects of your work, including making time for your people responsibilities and running effective meetings Success strategies for new leaders Preparing to take on the role of managing and leading others Leading and managing others / One on one relationships Empowering others Providing clarity and support and delegating effectively Performance and capability Performance appraisals, managing capability and disciplinary processes Developing others Using different approaches such as feedback and coaching, to encourage the personal and professional development of staff Recognition and motivating others Building motivation and engagement through recognition Difficult conversations Dealing with conflict including handling emotion and egos Supporting wellness Encouraging wellness in your team members Leading teams & change / One to many relationships Leading teams Working together to create shared goals and values Leading change Providing context for change and supporting people through the stages of change Accippio eLeadership Academy The eLeadership Academy is a free resource aimed at giving you internationally recognised qualifications for leadership and management content you read online. We have converted the brilliant, yet static, content from *BusinessBalls into engaging and interactive eLearning modules with voice-overs and quizzes to enable us to accredit learning. * Businessballs is a free ethical learning and development resource for people and organisations. It includes resources to support personal development, leadership and management. eCourses Leadership Personal Effectiveness Building & Leading Teams Strategy Development & Planning Performance Management Leading & Managing Change Featured eModules 10 Leadership Behaviours Personality VAK Learning Styles Five Dysfunctions of a Team Group Formation Leading Change Businessballs Topics (selected) Leadership / management corporate responsibility and ethics david mcclelland - achievement motivation john adair's action-centred leadership adams' equity theory on job motivation adizes ten stages - corporate life cycle model benziger personality assessment model conscious competence learning model corporate governance decision-making and problem-solving change and innovation decision-making template delegation - how to employee motivation and staff motivation surveys kaizen tuckman forming storming norming performing model, situational leadership® frederick herzberg - motivation theory gung ho!® - ken blanchard's organizational development system albert humphrey's tam® business change model charles handy - motivation calculus in search of excellence model - tom peters leadership tips leadership theories love and spirituality in management and business kolb's learning styles kotter's change model motivational case study exercise motivational theory and ideas maslow's hierarchy of needs nudge theory organizational change, training and learning pareto's 80-20 rule theory people performance potential model performance management project sponsorship the psychological contract six sigma® - definitions, history, overview quality management, history, gurus, TQM, process improvement, etc training certificate template mcgregor x-y theory, william ouchi - theory z Business business plan or operational plan template business planning and marketing strategy - how to write, boston matrix, ansoff product-market matrix business process modelling business strategy implementation and realisation continuity and contingency management CRM - customer relationship management customer service - code of practice and role development environmental management and resources efficiency market development process for developing sales - new business and new markets negotiation - how to networking nudge theory project management skills and technique service contracts and supply agreements template and tips sostac® - pr smith's business marketing planning system swot analysis - free template and examples pest market analysis - free template porter's five forces of competitive position Human resources age diversity and age discrimination performance appraisals - process and appraisals form template, 360 degree appraisals tips and templates bloom's taxonomy of learning domains employment termination, dismissal, redundancy, letters templates and style, grievance procedures letters samples for employees exit interviews, questions examples, tips induction training checklist, template and tips job interviews - tips, techniques, questions, answers, group selection recruitment method job descriptions, writing templates and examples multiple intelligences - howard gardner's theory and the VAK learning styles inventory nvq's - national vocational qualifications the psychological contract resolving employment disputes team briefing process training evaluation processes training and developing people - how to training and development policy/manual template HR performance evaluation, kirkpatrick's learning evaluation model Writing / communicating body language code of practice sample responding to customer complaints writing effective job adverts writing a reference letter writing technique - general Self / personal development abstract images for feelings, challenge and change assertiveness techniques and self-confidence campling's aspects of the work psyche career/business direction planner charisma - definitions, elements, development cherie carter-scott's rules of life clean language - david grove questioning method coaching - life coaching and personal coaching cybernetics - science of communications and control within systems dating and matchmaking emergent knowledge emotional freedom techniques (EFT) emotional intelligence (EQ) empathy erikson's psychosocial theory of human development experiential learning fantasticat - ideas for developing, teaching and learning the four agreements - don miguel ruiz goal planning hard questions for an authentic life - susan piver johari window model and free diagrams life balance pay rises and salary increases personal change stages - john fisher personality theories and types - jung, myers briggs®, keirsey, belbin, etc personality tests the seven habits of highly effective people® transactional analysis - eric berne - early theory transactional analysis - eric berne - recent theory mehrabian's communication theory - verbal, non-verbal, body language personal development - modern integrated methods personal development - excellent BBC books series reflective diary template - sharon drew morgen edition (msword) or (pdf) singing - for personal and group development stress and stress management time management tips time management techniques, free tools and templates "I am" - a script for self-help and personal change workplace well-being NHS [Leadership] Learning Academy A range of tools, models, programmes and expertise to support individuals, organisations and local academies to develop leaders, celebrating and sharing where outstanding leadership makes a real difference. see also The Edward Jenner Programme The Edward Jenner programme builds a strong foundation of leadership skills that can help enhance your confidence and competence in your role. The programme will support you as you develop essential leadership skills; open to all, this programme leads to an NHS Leadership Academy award in Leadership Foundations. The first two components of the programme - Launch and Foundation are free and open to global participants. Open Learn [UK Open University] Leadership and Management Courses Understanding operations management Management: perspective and practice Discovering management Project management: the start of the project journey Prosci's Change Management Webinars An excellent, free resource for staying up to date with Best Practices and learning from change practitioners in other organisations. LinkedIn Learning Platform [ for Auckland, NZ] Auckland libraries membership now gives you free online unlimited access to video courses and tutorials from industry experts provided through LinkedIn's online training platform lynda.com. Over 5,800 courses and 256,000 tutorials on everything from business and management to IT and creative design. Topics Includes: Collaboration (56) Communication (134) Finance (48) Leadership (90) Management (115) Productivity (177) Project Management (70) Social Networks (28) Resources freely available from the Centre for Creative Leadership Collaborative Healthcare Leadership: A Six-Part Model for Adapting & Thriving during A Time of Transformative Change Developing a Leadership Strategy: A Critical Ingredient for Organizational Success Navigating Change: A Leader's Role Innovation: How Leadership Makes the Difference Understanding the Leadership Challenges of First-Time Managers Networks: How Collective Leadership Really Works Transformational Change: An Ecosystem Approach "It's Not About Me. It's Me & You.": How being Dumped can Help First-Time Managers Change-Capable Leadership: The Real Power Propelling Successful Change Resources freely available from the King's Fund Cascading Leadership: a new model to support leadership in the voluntary and community sector Leading across the health and care system: lessons from experience Caring to change: How compassionate leadership can stimulate innovation in health care | King's Fund Delivering a Collective Leadership Strategy for Healthcare Leadership and Leadership Development in Healthcare: the Evidence Base Leadership for Patient Engagement Patient-Centred Leadership: Rediscovering Our Purpose The Practice of System Leadership: Being Comfortable with Chaos More leadership resources 100 Māori Leaders This resource identifies Māori leaders of today who influence and contribute to Māori health and wellbeing. It identifies Māori at the top of health career pathways, to inspire the Māori health workforce and generate interest from others to look at careers in health. Māori and other leaders were approached to write kōrero awhi (kind words) about the leadership qualities of living Māori leader. 100 Maori leaders resource will link to other information about our leaders and about education, training and roles in health and wellbeing. New profiles will be added and older ones archived. Healthcare Leadership Model: the Nine Dimensions of Leadership Behaviour [NHS Leadership Academy] Leading Networks in Healthcare [Health Foundation] Harvard Business Review Leadership Development resources Strategy& Thought Leadership Articles on key topics in the area of people and organization strategy. Modelling Māori leadership: What makes for good leadership? Leadership in Aotearoa New Zealand: A cross-cultural study Take me to your leader: hospital collaboration in the NHS [ KPMG; 2016] "How to Be a Charismatic Leader" [UCL; 2019] Leadership videos, blogs and podcasts [selected] Flipboard: Leadership Aggregated content from social media, news feeds, photo sharing sites and other websites, presented in magazine format Ted Talks: LeadershipWhat makes a great leader? These TED Talks -- from soldiers and psychologists, athletes and entrepreneurs -- share hard-won wisdom on leadership. Harvard Business Review IdeaCast – A weekly podcast that discusses the latest business trends. This podcast discusses lessons learned from leadership successes and failures. It does not focus only on leadership, but on business as a whole. Stanford Entrepreneurial Thought Leaders Podcast Series Browsible by topic: leadership ; innovation ; culture ; entrepreneurship ; life balance ; etcetera 15 podcast episodes that will make you a better leader Best 21st Century Leadership Blogs This excellent curated collection of bloggers arranged by theme also includes link to the bloggers twitter and facebook. Leadership Freak: Empowering Leaders 300 words at a Time / Dan Rockwell last updated 12 February 2024

''Leadership in Healthcare' is a clearinghouse of courses, resources and learning tools freely available to support your leadership journey.

Please suggest further resources to add to this collection.

 

Contents

London Leadership Academy Leadership Toolkit
Accippio eLeadership Academy
Businessballs Topics (selected)
NHS [Leadership Learning] Academy
Open Learn [UK Open University] Learning and Management Courses
Prosci's Change Management Webinars
LinkedIn Learning Platform [ for Auckland, NZ]
Resources freely available from the Centre for Creative Leadership
Resources freely available from the King's Fund
More Leadership Resources
Leadership Videos, Blogs and Podcasts


London Leadership Academy Leadership Toolkit

Managing self / Personal effectiveness

Leading and managing others / One on one relationships

Leading teams & change / One to many relationships

  • Leading teams
    Working together to create shared goals and values
  • Leading change
    Providing context for change and supporting people through the stages of change

Accippio eLeadership Academy
The eLeadership Academy is a free resource aimed at giving you internationally recognised qualifications for leadership and management content you read online. We have converted the brilliant, yet static, content from *BusinessBalls into engaging and interactive eLearning modules with voice-overs and quizzes to enable us to accredit learning.  * Businessballs is a free ethical learning and development resource for people and organisations.  It includes resources to support personal development, leadership and management.

eCourses

Featured eModules

Businessballs Topics (selected)

Leadership / management

Business

Human resources

Writing / communicating

 

Self / personal development

 

NHS [Leadership] Learning Academy
A range of tools, models, programmes and expertise to support individuals, organisations and local academies to develop leaders, celebrating and sharing where outstanding leadership makes a real difference.
 see also The Edward Jenner Programme

The Edward Jenner programme builds a strong foundation of leadership skills that can help enhance your confidence and competence in your role. The programme will support you as you develop essential leadership skills; open to all, this programme leads to an NHS Leadership Academy award in Leadership Foundations.  The first two components of the programme - Launch and Foundation are free and open to global participants.

Open Learn [UK Open University] Leadership and Management Courses

Prosci's Change Management Webinars
An excellent, free resource for staying up to date with Best Practices and learning from change practitioners in other organisations.

LinkedIn Learning Platform [ for Auckland, NZ]
Auckland libraries membership now gives you free online unlimited access to video courses and tutorials from industry experts provided through LinkedIn's online training platform lynda.com. Over 5,800 courses and 256,000 tutorials on everything from business and management to IT and creative design.

Topics Includes:

 

Resources freely available from the Centre for Creative Leadership 

 

Collaborative Healthcare Leadership: A Six-Part Model for Adapting & Thriving during A Time of Transformative Change 

Developing a Leadership Strategy: A Critical Ingredient for Organizational Success 

Navigating Change: A Leader's Role 

Innovation: How Leadership Makes the Difference 

Understanding the Leadership Challenges of First-Time Managers 

Networks: How Collective Leadership Really Works 

Transformational Change: An Ecosystem Approach 

"It's Not About Me. It's Me & You.": How being Dumped can Help First-Time Managers 

Change-Capable Leadership: The Real Power Propelling Successful Change

 

Resources freely available from the King's Fund

 

Cascading Leadership: a new model to support leadership in the voluntary and community sector

Leading across the health and care system: lessons from experience

 

Caring to change: How compassionate leadership can stimulate innovation in health care | King's Fund

 

Delivering a Collective Leadership Strategy for Healthcare

Leadership and Leadership Development in Healthcare: the Evidence Base

Leadership for Patient Engagement

Patient-Centred Leadership: Rediscovering Our Purpose

The Practice of System Leadership: Being Comfortable with Chaos

 

More leadership resources

 

100 Māori Leaders
This resource identifies Māori leaders of today who influence and contribute to Māori health and wellbeing. It identifies Māori at the top of health career pathways, to inspire the Māori health workforce and generate interest from others to look at careers in health. Māori and other leaders were approached to write kōrero awhi (kind words) about the leadership qualities of living Māori leader. 100 Maori leaders resource will link to other information about our leaders and about education, training and roles in health and wellbeing. New profiles will be added and older ones archived.
 

Healthcare Leadership Model: the Nine Dimensions of Leadership Behaviour [NHS Leadership Academy]

Leading Networks in Healthcare [Health Foundation]

 

Harvard Business Review Leadership Development resources

 

Strategy& Thought Leadership
Articles on key topics in the area of people and organization strategy.


Modelling Māori leadership: What makes for good leadership?

 

Leadership in Aotearoa New Zealand: A cross-cultural study

 

Take me to your leader: hospital collaboration in the NHS [ KPMG; 2016]

 

"How to Be a Charismatic Leader" [UCL; 2019]

 

 

 

 

Leadership videos, blogs and podcasts [selected]

Flipboard: Leadership
Aggregated content from social media, news feeds, photo sharing sites and other websites, presented in magazine format

Ted Talks: LeadershipWhat makes a great leader? These TED Talks -- from soldiers and psychologists, athletes and entrepreneurs -- share hard-won wisdom on leadership.

Harvard Business Review IdeaCast – A weekly podcast that discusses the latest business trends.  This podcast discusses lessons learned from leadership successes and failures.  It does not focus only on leadership, but on business as a whole.

Stanford Entrepreneurial Thought Leaders Podcast Series
Browsible by topic: leadership ; innovation ; culture ; entrepreneurship ; life balance ; etcetera

15 podcast episodes that will make you a better leader

Best 21st Century Leadership Blogs
This excellent curated collection of bloggers arranged by theme also includes link to the bloggers twitter and facebook.

Leadership Freak: Empowering Leaders 300 words at a Time / Dan Rockwell

 

 

 

 last updated 12 February 2024

Contact Details

This page was last updated at 10:46AM on February 27, 2024. This information is reviewed and edited by Library Database and Resource Directory | Te Whatu Ora.