Equity in access to zero-fees and low-cost Primary Health Care in Aotearoa New Zealand: Results from repeated waves of the New Zealand Health Survey, 1996-2016

INTRODUCTION: The social work profession has a long-standing history of contributing to health care in Aotearoa New Zealand. Traditionally, hospitals have been the stronghold for the profession. However, both international and national evidence demonstrates that social workers have also been integrated in primary health care practices (PHCPs). Primary health care (PHC) provides care in the community and is recognised for its potential to achieve health equity across all population groups. This article reports on a small, qualitative research project which explored the perceptions of key stakeholders about social work integration into PHC and the experiences gained by social workers working within PHCPs regarding their contributions to the achievement of national aspirations for PHC.METHODS: Semi-structured, one-to-one interviews with 18 participants representing three groups (social workers, other PHC professionals and key informants) were undertaken in 2012. The interviews took place in various locations in Aotearoa New Zealand. A general inductive approach was used to identify key themes. FINDINGS: Three key themes were identified from the data: these are issues of context, namely social work professional factors, organisational factors in PHC and lastly, wider factors in the health care system. The integrated social workers enhanced the access of populations to coordinated care, increased engagement with communities, and strengthened the workforce, among other things. These unique contributions towards the PHC vision were well recognised by all groups, with participants calling for the establishment of integrated social work positions on a larger scale. CONCLUSION: The study evidences the successful integration of social workers into PHC practices in Aotearoa New Zealand. This viable model should be of special interest for key stakeholders regarding the design of local, holistic, PHC services which serve populations most affected by health and social inequalities. Importantly, “health for all”, as anticipated by the PHC vision needs long-term and real commitment especially by financial decision-makers.

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Introducing critical Tiriti policy analysis through a retrospective review of the New Zealand Primary Health Care Strategy

Ethnicities ◽

10.1177/1468796819896466 ◽

2020 ◽

Vol 20 (3) ◽

pp. 434-456 ◽

Cited By ~ 2

Author(s):

Heather Came ◽

D O’Sullivan ◽

T McCreanor

Keyword(s):

Health Care ◽

Health Policy ◽

Primary Health Care ◽

New Zealand ◽

Policy Analysis ◽

Policy Development ◽

Policy Makers ◽

Aotearoa New Zealand ◽

Primary Health ◽

Maori Health

Background Te Tiriti o Waitangi was negotiated between the British Crown and Indigenous Māori leaders of Aotearoa New Zealand in 1840. Māori understood the agreement as an affirmation of political authority and a guarantee of British protection of their lands and resources. The Crown understood it as a cession of sovereignty. The tension remains, though legal and political developments in the last 35 years, have established that the agreement places a mandatory obligation on the Crown to protect and promote Māori health. It also requires that Māori may exercise rangatiratanga, or responsibility and authority, in relation to health policy development and implementation. Methods Te Tiriti is, then, an instrument against which health policy is justly and efficaciously evaluated. This paper introduces critical Tiriti analysis as such an evaluative method. Critical Tiriti analysis involves reviewing policy documents against the Preamble and the Articles of te Tiriti o Waitangi. The review process has five defined phases: (i) orientation; (ii) close reading; (iii) determination; (iv) strengthening practice and (v) Māori final word. Results We present a working example of critical Tiriti analysis using the New Zealand Government’s Primary Health Care Strategy published in 2001. This policy analysis found poor alignment with te Tiriti overall and the indicators of its implementation that we propose. Conclusion This paper provides direction to policy makers wanting to improve Māori health outcomes and ensure Māori engagement, leadership and substantive authority in the policy process. It offers an approach to analysing policy that is simple to use and, inherently, a tool for advancing social justice.

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Myths, cautions, and solutions: Nurse practitioners in primary health care in Aotearoa New Zealand

10.36951/27034542.2020.001 ◽

2020 ◽

Vol 36 (1) ◽

pp. 5-7

Author(s):

Sue Adams ◽

Keyword(s):

Health Care ◽

Primary Health Care ◽

New Zealand ◽

Nurse Practitioners ◽

Aotearoa New Zealand ◽

Primary Health

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Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.511 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L F Pinto ◽

D Soranz ◽

L J Santos ◽

M S Paranhos ◽

L S Malta ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Data Collection ◽

Health Survey ◽

Household Surveys ◽

Mato Grosso ◽

Primary Health ◽

The World ◽

Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

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Understanding the general practice nursing workforce in New Zealand: an overview of characteristics 2015–19

Australian Journal of Primary Health ◽

10.1071/py20109 ◽

2021 ◽

Vol 27 (1) ◽

pp. 22

Author(s):

Sarah L. Hewitt ◽

Nicolette F. Sheridan ◽

Karen Hoare ◽

Jane E. Mills

Keyword(s):

Health Care ◽

General Practice ◽

Primary Health Care ◽

New Zealand ◽

Survey Data ◽

Nursing Workforce ◽

Roles And Responsibilities ◽

Primary Health ◽

Part Time ◽

Role Confusion

Limited knowledge about the nursing workforce in New Zealand general practice inhibits the optimal use of nurses in this increasingly complex setting. Using workforce survey data published biennially by the Nursing Council of New Zealand, this study describes the characteristics of nurses in general practice and contrasts them with the greater nursing workforce, including consideration of changes in the profiles between 2015 and 2019. The findings suggest the general practice nursing workforce is older, less diverse, more predominately New Zealand trained and very much more likely to work part-time than other nurses. There is evidence that nurses in general practice are increasingly primary health care focused, as they take on expanded roles and responsibilities. However, ambiguity about terminology and the inability to track individuals in the data are limitations of this study. Therefore, it was not possible to identify and describe cohorts of nurses in general practice by important characteristics, such as prescribing authority, regionality and rurality. A greater national focus on defining and tracking this pivotal workforce is called for to overcome role confusion and better facilitate the use of nursing scopes of practice.

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Using population health surveys to provide information on access to and use of quality primary health care

Australian Health Review ◽

10.1071/ah060485 ◽

2006 ◽

Vol 30 (4) ◽

pp. 485 ◽

Cited By ~ 5

Author(s):

Elizabeth J Comino ◽

Oshana Hermiz ◽

Jeff Flack ◽

Elizabeth Harris ◽

Gawaine Powell Davies ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Population Health ◽

Health Survey ◽

Health Surveys ◽

Diabetes Management ◽

Relevant Information ◽

Population Based ◽

Primary Health ◽

Data Collections

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.

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