M

1
Mäori Participation in Community Health

• Mason Durie

2
One Hundred Years of Progress

• Rotorua 1903
  Mäori Health
  Inspectors
• Rotorua 1931
  Te Ropü o te Ora
• Rotorua 1994
  Hui Ara Ahu Whakamua
• Rotorua 2002
  Whänau Ora

3
Mäori Health Inspectors

• Pomare
• Department of Public Health
• Mäori Councils 1900
• Community leaders as leaders in health
• Housing,
  sanitation,
  clean
  water supplies,
  registration births, deaths,
  incidence of illness

4
Mäori Women Health Leadership

• 1931 Te Ropü o te Ora
  Nurse Cameron
• community energies
  marae based
  child care
  
  health of mothers
  Tipu Ora
• 1952 Mäori Womens Welfare League
  Whina Cooper
• regional and district branches
• urbanisation
  identification of major
  health issues (remits)
  advocacy for health
  consumer perspectives
  Rapuora

5
Dedicated Community Health Workers

• 1985
• Community knowledge
• Cultural knowledge
• Cross-sectoral
• Cross-disciplinary
• Liaison
• Health promotion
• Support

6
Mäori Community Health Workers at the Interface

• Community Health institutions
• Whänau professionals
• Health science mätauranga Mäori
• Sickness wellness
• Health sector Social Policy sector
• Mäori health Mäori development
• Treatment care and support

7
Mäori Community Health Workers in the 21st century

• Build on gains made in the previous century
  Mäori health inspectors,
  Te Ropü o te Ora,
  MWWL,
  Community health
  workers
• Maintain a broad approach to health
• Retain community base
• Gain expertise at the interface
• Advocate for Mäori health

8
The Key Tasks

• Scan the environment
• Strengthen the foundations of health
• Support the sick and infirm
• Negotiate access
• Promote healthy lifestyles

9
Key Tasks

• 1 Scan the Environment for threats to health
• a Natural environment
• water air
• waste management
• b The domestic environment
• homes
• roads, streets, cars
• c The social environment
• schools
• hotels, clubs
• workplace
• shopping malls, leisure centres

10
Key Tasks

• 2 Strengthen the Foundations of Health
• a access to Te Ao Mäori
• te reo
• marae
• whenua tipu
• whänau
• b access to society
• sound education
• employment
• technology
• c access to nuturing
• parenting
• arrangements for care
• facilitation of growth development

11
Key Tasks

• 3 Support the Sick and Infirm
• 
  a Those at risk
• elderly, children
• chronic illness
• disability
• b Care and treatment
• arrange care and treatment for individuals
  and their whänau
• c Encourage self management
• diabetes
• asthma
• dialysis

12
Key Tasks

• 4 Negotiate Access to
  
• a Health disability services
• primary health care
• secondary health care
• disability support services
• b Iwi, Mäori services
• health
• social servcies
• legal servcies
• c Community services
• social agencies e.g. CYFS
• justice
• financial servcies

13
Key Tasks

• 5 Promote Healthy Lifestyles
• 
  a nutrition
• b substance misuse
• alcohol drug
• smoking
• c exercise
• sport
• leisure
• recreation

14
Key Skills knowledge and experience in

• 1 Mäori networks
  
• 2 Health Networks
• 
  
• 3 Mätauranga Mäori
  
• 4 Community knowledge
  
• 5 Health knowledge
  

15
Key Skills knowledge and experience in

• 1 Mäori networks
  Able to access
• whänau
• hapü
• Mäori community organisations
• rongoa services
• Able to appreciate Mäori diversity
• Able to gain recognition in Mäori community

16
Key Skills knowledge and experience in

• 2 Health Networks
  able
  to provide access to health agencies
• ability to work with health agencies
• sound knowledge of the health system
• experience in shared case management

17
Key Skills knowledge and experience in

• 3 Mätauranga Mäori
  
  Competent to work in Mäori situations
• te reo
• tikanga
• local kawa
• appreciation of Mäori perspectives

18
Key Skills knowledge and experience in

• 4 Community knowledge
  
• Aware of community resources and facilities
• First hand knowledge of community dynamics
• Appreciation of cultural and ethnic
  divides
• Identification of commmunity
  decision- makers

19
Key Skills knowledge and experience in

• 5 Health knowledge
  
• Familiar with practice of health promotion
• Understanding of health and disease
• Knowledge of health policy, regulations
• Principles underlying treatment
• First aid

20
Key Outcomes

• Community health work should contribute to health
  gains for Mäori
• Health gains best measured by outcomes that
  reflect improvements in
• Wairua
• Hinengaro
• Tinana
• Whänau

21
A Framework forMäori Community Health
Key Tasks
Scan the environment
Strengthen health foundations
Support the sick infirm
Negotiate access
Promote healthy life-styles
22
A Framework forMäori Community Health
Key Skills
Mäori networks
Health networks
Mätauranga Mäori
Community knowledge
Health knowledge
Key Tasks
Scan the environment
Strengthen health foundations
Support the sick infirm
Negotiate access
Promote healthy life-styles
23
A Framework forMäori Community Health
Key Skills
Mäori networks
Health networks
Mätauranga Mäori
Community knowledge
Health knowledge
Key Tasks
Scan the environment
Wairua
Hinengaro
Strengthen health foundations
Tinana
Support the sick infirm
Whänau
Negotiate access
Best Health outcomes for Mäori
Promote healthy life-styles