scholarly journals 1206Will access to Covid-19 vaccine in Aotearoa be equitable for priority populations?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Jesse Whitehead ◽  
Nina Scott ◽  
Polly Atatoa Carr ◽  
Ross Lawrenson
Keyword(s):  
Vaccine Delivery ◽  
Travel Times ◽  
Community Based ◽  
Aotearoa New Zealand ◽  
Outreach Services ◽  
If Current ◽  
Geostatistical Techniques ◽  
Potential Vaccine ◽  
Priority Populations ◽  
Statistical Area

Abstract Background This research examines the equity implications of the geographic distribution of COVID-19 vaccine delivery locations in Aotearoa New Zealand under five potential scenarios: (1) stadium mega-clinics; (2) Community Based Assessment Centres; (3) GP clinics; (4) community pharmacies; and (5) schools. Methods We mapped the distribution of Aotearoa New Zealand’s population and the location of potential vaccine delivery facilities under each scenario. Geostatistical techniques identified population clusters for Māori, Pacific and people aged 65 years and over. We calculated travel times between all potential facilities and each Statistical Area 1 in the country. Descriptive statistics indicate the size and proportion of populations that could face significant travel barriers when accessing COVID-19 vaccinations. Results Several areas with significant travel times to potential vaccine delivery sites were also communities identified as having an elevated risk of COVID-19 disease and severity. All potential scenarios for vaccine delivery, with the exception of schools, resulted in travel barriers for a substantial proportion of the population. Overall, these travel time barriers disproportionately burden Māori, older communities and people living in areas of high socioeconomic deprivation. Conclusions The equitable delivery of COVID-19 vaccines is key to an elimination strategy. However, if current health services and facilities are used without well-designed and supported outreach services, then access to vaccination is likely to be inequitable. Key messages Organisations need to proactively plan for equity, including the delivery of COVID-19 vaccines. A social justice approach should be prioritised, and in Aotearoa Te Tiriti o Waitangi obligations must be met.

scholarly journals Rainbow experiences of accessing mental health support in Aotearoa New Zealand: A community-based mixed methods study

2021 ◽  
Author(s):  
◽  
Gloria Fraser
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Community Members ◽  
Community Based ◽  
Aotearoa New Zealand ◽  
Mental Health Settings ◽  
Mental Health Support ◽  
Health Support

<p>While we know that rainbow people in Aotearoa New Zealand (that is, people of diverse sexualities, genders, and sex characteristics) experience high rates of adverse mental health outcomes, we know much less about the extent to which Aotearoa’s rainbow community members are receiving the mental health support they need. To address this gap I used mixed methods and a reflexive community-based approach to extend current understandings of rainbow mental health support experiences, and to explore how the provision of mental health care can be improved for rainbow people in New Zealand.  I first conducted interviews with 34 rainbow community young adults about their experiences of accessing mental health support. My thematic analysis showed that rainbow people across New Zealand faced significant structural barriers to accessing mental health support. Participants understood mental health settings as embedded within a heteronormative and cisnormative societal context, rather than as a safe place outside this context. This, together with a widespread silence from mental health professionals around rainbow identity, meant that participants actively negotiated coming out in mental health settings. Participants shared a variety of perspectives as to whether it should be standard practice for mental health professionals to ask about rainbow identities, but agreed on a number of subtle acts that could communicate a professional or service is rainbow-friendly. Knowledge about sexuality, gender, and sex characteristic diversity, together with clinical skills of empathy, validation, and affirmation, were described as key components for the provision of effective mental health support.  I conducted a second thematic analysis of data from a subset of the initial interviews, in which 13 participants discussed their experiences of accessing gender-affirming healthcare. Participants reported a lack of funding for gender-affirming healthcare in New Zealand, and described its provision a “postcode lottery”; the care available was largely dependent on the region participants were living in. Mental health assessments for accessing gender-affirming care were often described as tests of whether participants were “really” transgender, and participants discussed the need to express their gender in a particular way in order to access the healthcare they needed.  Thematic analyses of interview data informed the development of an online survey about rainbow peoples’ experiences of accessing mental health support and gender-affirming healthcare in New Zealand (n = 1575). Survey results closely reflected interview findings, indicating that rainbow people have mixed experiences in New Zealand’s mental health settings, and that accessing gender-affirming healthcare is a lengthy and convoluted process.   Finally, interview and survey data were used to develop a resource for mental health professionals, to guide their work with rainbow clients. I sought and incorporated feedback from key stakeholders (n = 108) during resource development. I then distributed the resource to mental health professionals around New Zealand, both in print and online.  Overall, my research shows that widespread knowledge gaps compromise the ability of New Zealand’s mental health professionals to provide culturally competent support to rainbow clients. Knowledge from this thesis can be used to increase awareness of rainbow community members’ mental health support needs, and to inform mental health professionals’ training and self-reflection around sexuality, gender, and sex characteristic diversity.</p>

scholarly journals Food for People in Place: Reimagining Resilient Food Systems for Economic Recovery

2020 ◽  
Vol 12 (22) ◽  
pp. 9369
Author(s):  
Kelly Dombroski ◽  
Gradon Diprose ◽  
Emma Sharp ◽  
Rebekah Graham ◽  
Louise Lee ◽  
...  
Keyword(s):  
New Zealand ◽  
Food Systems ◽  
Food System ◽  
Central Government ◽  
Long Term Effects ◽  
Community Based ◽  
Short Supply ◽  
Aotearoa New Zealand ◽  
Essential Services

The COVID-19 pandemic and associated response have brought food security into sharp focus for many New Zealanders. The requirement to “shelter in place” for eight weeks nationwide, with only “essential services” operating, affected all parts of the New Zealand food system. The nationwide full lockdown highlighted existing inequities and created new challenges to food access, availability, affordability, distribution, transportation, and waste management. While Aotearoa New Zealand is a food producer, there remains uncertainty surrounding the future of local food systems, particularly as the long-term effects of the pandemic emerge. In this article we draw on interviews with food rescue groups, urban farms, community organisations, supermarket management, and local and central government staff to highlight the diverse, rapid, community-based responses to the COVID-19 pandemic. Our findings reveal shifts at both the local scale, where existing relationships and short supply chains have been leveraged quickly, and national scale, where funding has been mobilised towards a different food strategy. We use these findings to re-imagine where and how responsibility might be taken up differently to enhance resilience and care in diverse food systems in New Zealand.

scholarly journals Turning The Tide on Private Profit-Focused Provision In Early Childhood Education

2020 ◽  
Vol 24 ◽  
pp. 75
Author(s):  
Linda Mitchell
Keyword(s):  
Early Childhood ◽  
New Zealand ◽  
Early Childhood Education ◽  
Best Interests ◽  
Community Based ◽  
Childhood Education ◽  
For Profit ◽  
Aotearoa New Zealand ◽  
Private Profit ◽  
Democratic System

The article analyses a market-based approach to early childhood education (ECE) provision and the growth of for-profit ECE provision, evidence about ‘quality’ and accessibility, and problems occurring when a need for private profit conflicts with the best interests of families and children. The issue of for-profit provision is set within the context of international developments and solutions in Europe, UK, US and Canada. Immediate steps that might be taken for a democratic system of community-based and public early childhood education in Aotearoa New Zealand are pinpointed. Overall, the article offers possibilities for asserting democratic values as a way towards alternatives in Aotearoa New Zealand’s early childhood education provision.

scholarly journals Community healthcare workers' experiences during and after COVID-19 lockdown: a qualitative study from Aotearoa New Zealand

2021 ◽  
Author(s):  
Eleanor HOLROYD ◽  
Nicholas J. LONG ◽  
Nayantara Sheoran APPLETON ◽  
Sharyn Graham DAVIES ◽  
Antje DECKERT ◽  
...  
Keyword(s):  
New Zealand ◽  
Qualitative Study ◽  
Support Groups ◽  
Professional Relationships ◽  
Protective Equipment ◽  
Community Based ◽  
Community Healthcare ◽  
Aotearoa New Zealand ◽  
Community Midwives ◽  
Adequate Provision

Shortly after the COVID-19 pandemic reached Aotearoa New Zealand, a stringent lockdown lasting seven weeks was introduced to manage community spread of the virus. This paper reports the findings of a qualitative study examining how lockdown policies impacted upon the lives of those caring for community-based patients. The study involved nationwide surveys and ethnographic interviews with 15 registered nurses (RN) employed in community settings, two community midwives, and five personal care assistants (PCAs). During the strict lockdown levels 4 and 3, RNs and PCAs in the community showed considerable courage in answering their 'call to duty' by taking on heightened care responsibilities and going 'the extra mile' to help others. They faced significant risks to personal and professional relationships when they were required to take on additional and complex responsibilities for community-based patients. Despite, and sometimes due to the hypervigilant monitoring of their personal protective equipment (PPE), the need to safeguard family and community members generated considerable stress and anxiety. Many also faced personal isolation and loneliness as a result of lockdown restrictions. Although 'care' and 'kindness' became social expectations throughout Aotearoa New Zealand during the lockdown, RNs and PCAs who were already doing care work in patient homes had to do more. This article makes five core service delivery and policy recommendations for supporting community-based nurses and PCAs in respiratory disease pandemics: acknowledging the crucial role played by community-based carers and the associated stress and anxiety endured, through championing respect and compassion; demystifying the 'heroism' or 'self-sacrifice' projected onto care workers to facilitate boundary setting; the timely provision of adequate protective equipment; improving remuneration with adequate provision for time off; and regular counselling, peer support groups, and education on work-life balance delivered by support workers in recognition of stressors arising from these complex and isolated working conditions.

The potential of porous silicon particles for multi-epitopic vaccine development

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
G. Navarro-Tovar ◽  
A. Wong-Arce ◽  
M. Campos-Portillo ◽  
G. Palestino ◽  
S. Rosales-Mendoza
Keyword(s):  
Porous Silicon ◽  
Vaccine Development ◽  
Vaccine Delivery ◽  
Subunit Vaccines ◽  
Convenient Approach ◽  
Delivery Vehicles ◽  
Potential Vaccine ◽  
And Control ◽  
Vaccine Delivery Vehicle ◽  
Silicon Particles

AbstractVaccination is a crucial approach to eradicate and control amyriad of infectious and non-communicable diseases. Subunit vaccines are considered the most convenient approach for vaccine formulation; however, the development of new adjuvants and vaccine delivery vehicles to improve the immunogenicity of such formulations is needed. The authors of this review describe the recent application of porous silicon particles (PSiP) as both a potential vaccine delivery vehicle and adjuvant. PSiP are attractive for this application due to its safety, biodegradability and compatibility for functionalization. Herein, the development of multi-epitope cancer vaccines is discussed as an example on how PSiP are promising materials for the development of innovative vaccines.

scholarly journals Real-time genomics to track COVID-19 post-elimination border incursions in Aotearoa New Zealand

2021 ◽  
Author(s):  
Jordan Douglas ◽  
Jemma L Geoghegan ◽  
James Hadfield ◽  
Remco Bouckaert ◽  
Matthew Storey ◽  
...  
Keyword(s):  
New Zealand ◽  
Real Time ◽  
Public Health System ◽  
Epidemiological Data ◽  
Vital Role ◽  
Viral Transmission ◽  
Community Based ◽  
Aotearoa New Zealand ◽  
Community Outbreaks ◽  
Different Origins

There have been thirteen known COVID-19 community outbreaks in Aotearoa New Zealand since the virus was first eliminated in May 2020, two of which led to stay-at-home orders being issued by health officials. These outbreaks originated at the border; via isolating returnees, airline workers, and cargo vessels. With a public health system informed by real-time viral genomic sequencing which typically had complete genomes within 12 hours after a community-based positive COVID-19 test, every outbreak was well-contained with a total of 225 community cases, resulting in three deaths. Real-time genomics were essential for establishing links between cases when epidemiological data could not, and for identifying when concurrent outbreaks had different origins. By reconstructing the viral transmission history from genomic sequences, here we recount all thirteen community outbreaks and demonstrate how genomics played a vital role in containing them.

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