New Zealand Health Strategy 2023

New Zealand Health Strategy 2023 Study Notes

Introduction to the New Zealand Health Strategy 2023

  • Author: Lisa Andrew

  • Document Number: 722.556

Karakia (Prayer)

  • Karakia: A traditional Māori incantation recited to invoke peace and respect for each other.

    • Translation and Meaning:

    • "May peace be widespread"

    • "May the sea be like greenstone — a pathway for us all this day"

    • "Let us show respect for each other, Bind us all together"

Presentation Details

  • Interactive Engagement: Go to Menti.com, follow on-screen instructions, and click the icon to add pictures.

Learning Outcomes

  • Define & describe the New Zealand Health Strategy 2023

  • Identify the strategy commitments

  • Identify the associated strategies

  • Identify & describe the 2 long-term goals

  • Identify & describe the 6 priority areas for change

  • Identify the process for turning the strategy into action

Importance of Understanding Policy

  • Health Influences

    • Health is significantly shaped by government policy and public health strategy.

  • Evidence-based Decisions

    • Policy decisions dictate the distribution and prioritization of funding.

  • Directional Guidance

    • Health policies provide direction and facilitate the establishment of goals to enhance the quality and length of life.

Historical Context and Current Health Landscape

  • Existing Life Expectancy Gaps

    • Gaps in life expectancy exist but are closing due to targeted policies over the past 30 years aimed at reducing health inequalities.

  • Health Status Indicators

    • Life expectancy and mortality trends remain key measures of health in the 21st century, with an increasing focus on quality of life and social determinants of health.

Health Disparities in Aotearoa

  • Māori and Pacific Peoples

    • These groups experience significantly poorer health outcomes compared to non-Māori populations. Notable disparities include:

    • Higher rates of diabetes

    • Higher prevalence of cardiovascular disease

    • Increased mental health issues

    • Lower life expectancy

  • Other Affected Groups

    • Disabled individuals, rural communities, and low-income populations confront systemic barriers to healthcare access; disparities stem from colonization, systemic racism, and social determinants of health.

Key Health Sector Principles of Te Tiriti o Waitangi (Treaty of Waitangi)

  • Principles Include:

    • Tino rangatiratanga (self-determination)

    • Equity

    • Active protection

    • Options

    • Partnership

Commitment to Te Tiriti o Waitangi

  • Historical Context:

    • Colonization and the signing of Te Tiriti o Waitangi have led to land confiscations and economic disabilities, adversely impacting social determinants of health.

  • Bicultural Healthcare Evolution:

    • In the 1980s, healthcare transformed to be more bicultural, improving Māori healthcare access and incorporating Te Ao Māori (Māori worldview).

  • NZ Health Strategy's Foundation:

    • The New Zealand Health Strategy is built on a commitment to Te Tiriti o Waitangi and the health system’s obligations to Māori health improvements.

    • Key concepts of Oritetanga (equity) and Tino Rangatiratanga (self-determination and autonomy) emphasized.

  • Collaborative Efforts:

    • Works in partnership with the Pae Tū: Hauora Māori Strategy to enhance overall population health and set long-term health directions.

Understanding Health Equity

  • Definition:

    • Health equity is the fair and just opportunity for all individuals to attain optimal health.

  • Obstacles to Health:

    • Removal of barriers such as poverty and discrimination is crucial, including lack of access to good jobs, education, housing, safe environments, and healthcare.

  • Equity vs. Equality:

    • Equity seeks to provide what is necessary for similar outcomes, while equality focuses on providing the same resources.

Equity in Action – Nursing Practice

  • Key Actions for Nursing Practitioners:

    • Understand patients' cultural, social, and economic contexts.

    • Advocate for patients facing barriers to care access.

    • Utilize culturally safe practices and adhere to Te Tiriti o Waitangi principles.

    • Recognize and address unconscious biases in clinical settings.

Pae Ora – Healthy Futures

  • Pae Ora Act Context:

    • Enacted by the Ministry of Health to restructure the health system.

    • Health New Zealand (Te Whatu Ora) replaced the District Health Board (DHB) system.

    • Established a Māori Health Authority (Te Aka Whai Ora), which was disestablished in June 2024.

  • Public Health Agency:

    • Te Pou Hauora Tūmatanui, responsible for advising on public health matters and leading improvements in population health.

Vision of Pae Ora (Healthy Futures)

  • Future Goals:

    • Achieving a state where all New Zealanders from diverse communities can live well and maintain good health supported by their environments and communities.

  • Focus Areas:

    • Mauri ora (healthy individuals)

    • Whānau ora (healthy families)

    • Wai ora (healthy environments)

Strategies under the Pae Ora Act 2022

  • Key Strategies:

    • New Zealand Health Strategy

    • Pae Tū: Hauora Māori Strategy

    • Te Mana Ola: The Pacific Health Strategy

    • Health of Disabled People Strategy

    • Women’s Health Strategy

    • Rural Health Strategy

Disestablishment of Te Aka Whai Ora (Māori Health Authority)

  • Background:

    • Established to commission Māori health services and obtain equitable outcomes, later disbanded due to new governmental reforms in 2024.

  • Government Changes:

    • Health New Zealand now oversees Māori health initiatives, altering the functions of Iwi-Māori Partnership Boards and localities.

Rationale Behind Health Strategy Development

  • Purpose:

    • Provide a framework to protect, promote, and improve health and wellbeing.

    • Set a long-term strategic direction (5-10 years) and identify priority areas for the health system.

    • Establish vision, goals, and necessary changes across 6 priority areas.

Overview of the NZ Health Strategy

  • Definition:

    • A ten-year strategic plan to enhance the health of all New Zealanders, part of strategies under the Pae Ora (Healthy Futures) Act 2022.

How Equity Influences the NZ Health Strategy

  • Core Principle:

    • The strategy is rooted in oritetanga (equity), focusing on under-served populations and facilitating community co-design of services.

  • Integration of Equity:

    • Equity is an integral part of each of the six priority areas.

Relationships with Pacific Realm Countries

  • Regional Acknowledgment:

    • The strategy recognizes ties with the Pacific regions, including Tokelau and the Cook Islands, ensuring inclusivity for these communities in health considerations.

The 2 Long-term Goals of the NZ Health Strategy

  • Primary Goals:

    • Achieve health equity, particularly for marginalized groups: Māori, Pacific peoples, disabled individuals.

    • Enhance health outcomes for all New Zealanders to foster longer, healthier, independent lives.

  • Interconnected Nature:

    • Achieving health equity enhances system adaptability and flexibility, benefiting everyone, thereby improving overall health outcomes.

The 6 Priority Areas for Change

  1. Voice at the heart of the system

  2. Flexible and appropriate care

  3. Valuing our workforce

  4. A learning culture

  5. A resilient and sustainable system

  6. Partnerships for health and wellbeing

Detailed Exploration of the 6 Priority Areas

Priority 1: Voice at the Heart of the System

  • Patient-Centric Focus:

    • Emphasizes recognizing and responding to community voices, facilitating greater control over service design and care decisions.

    • Cultural Responsiveness:

    • Further honor Te Tiriti and accommodate diverse cultural aspirations.

    • Community Inclusion:

    • Adapt services to meet the needs of under-served populations.

Priority 2: Flexible, Appropriate Care

  • Core Focus:

    • Create services aimed at illness prevention and provide care close to home, particularly for disadvantaged groups.

  • Primary Care Adjustments:

    • Emphasis on preventive support, early childhood focus, responsive primary services, addressing access barriers, and parity between mental and physical health.

Priority 3: Valuing Our Workforce

  • Workforce as an Asset:

    • Acknowledges health staff as essential for transformative healthcare delivery.

  • Development and Support:

    • Commitment to workforce skill enhancement, respectful treatment, and ensuring sufficient capacity for care.

Priority 4: A Learning Culture

  • Focus on Improvement:

    • Foster an environment of continuous learning and innovation leading to high-quality healthcare.

  • Key Components:

    • Identify effective practices, promote new ideas, allocate time for research involvement, ensure robust data systems, and integrate national learning roles.

Priority 5: A Resilient and Sustainable System

  • Future Preparedness:

    • Strive for a health system that’s adaptable to future challenges and efficiently utilizes resources.

  • Focus on:

    • Addressing support for an aging population, resilience improvement, and long-term service affordability.

Priority 6: Partnerships for Health & Wellbeing

  • Cross-Sector Collaborations:

    • Collaboratively work across government and local communities to address health drivers and enhance well-being.

  • Community Engagement:

    • Partnership with communities across sectors to foster healthy environments.

Turning Strategies into Action

  • Implementation Framework:

    • Ongoing evaluations every 3 years and comprehensive assessments every 5-10 years to track health strategy effectiveness and adjustments needed based on objectives and community feedback.

Associated Strategies with the NZ Health Strategy:

  • Other Relevant Strategies:

    • Kia Manawanui Aotearoa: Long-term mental wellbeing strategy

    • Oranga Hinengaro Framework: Components of contemporary mental health and addiction approach

    • Healthy Ageing Strategy: Services for older populations

    • Child and Youth Wellbeing Strategy: For the health of children and young adults

    • Te Aorerekura: Family Violence and Sexual Violence Elimination strategy

    • All-of-Government Pacific Wellbeing Strategy: Improving Pacific people's health outcomes

    • New Zealand Disability Strategy: Guiding government agencies on disability issues

    • Veteran Family Mental Health Policy Framework: Mental health focus for veterans and families.

Reflecting on Equity in Practice

  • Equity Considerations:

    • Inquiry on personal practice to assure equitable care.

    • Identification of barriers patients may face in accessing care and strategies for advocacy for systemic change.

References

  • Ministry of Health Documents:

    • Achieving Equity in Health Outcomes: Summary of a discovery process (2019)

    • New Zealand Health Strategy (2023)

    • Pae Tū: Hauora Māori Strategy 2023

    • Summary of the NZ Health Strategy: Easy Read

  • Recent Articles:

    • Stewart, E. (2024). Article on the disbandment and replacement of the Māori Health Authority.

Closing Karakia

  • Karakia Unuhia:

    • Invoking spiritual support for health and wellbeing among individuals, communities, and the health system.

    • Meaning: "Draw on the supreme sacredness of Taane to clear and free the heart, body, and spirit of mankind, unified in strength."