NZ Health System Flashcards
What are the principles of Te Tiriti O Waitangi?
- Tino Rangatiratanga - in the design, delivery, and monitoring of health and disability services (HDS)
- Equity - committing to achieving equitable health outcomes
- Protection - act to their fullest extent to achieve equity, including being aware that it exists and what is being done
- Options - service a properly resourced Kaupapa Maori HDS’s + that current services are culturally appropriate and support expression of hauora Māori models of care
- Partnership - in governance, design, delivery, and monitoring of HDS’s
What are the six pillars of the RACS Maori Health Strategy + Health Plan?
- Healthy futures, create a healthy platform
- Maori knowledge and capability, increasing knowledge for informed decisions
- Workforce development, safe environment + increased workforce
- Research and development, Using Maori methodology
- Stronger policy and development, to help better Maori and reflect needs better
- Partnership, to be developed and maintained to support the progression of Te Rautaki Maori
Why is it important to address Maori health and inequity?
- Needs-based, Maori have worse health outcomes compared to non-Maori and are more likely to be affected negatively by the determinants of health (deprivation, unemployment, low income, and over-crowding).
- Rights-based, ToW establishes Maori having rights to health equity by granting the Crown responsibility to protect Maori, to have equal rights + citizenship which includes the right to parity of outcomes
What is cultural safety?
Commitment to:
1. acknowledge and address my biases, attitudes, assumptions, and prejudices that may affect QOC provided.
2. Identify and mitigate structures, and systems that may affect QOC provided.
Engaging in self-reflection and holding oneself accountable to delivering culturally safe care.
Why does health inequity for Maori exist?
(1) the historical and persistent consequences of colonization, whereby Māori were subjected to:
- dispossession of their land;
- appropriation of resources;
- alienation from their culture;
- disruption of their traditional relationships, responsibilities and practices.
(2) unequal access to the determinants of good health such as:
- economic security
- good-quality housing
- safe and secure employment
- good-quality education
- freedom from racial discrimination
(3) unequal access to health and disability services.
(4) differences in the quality of care Māori receive compared to other groups.
The persistent and significant health inequity Maori is longstanding and in breach of the Treaty of Waitangi. They are also avoidable, unethical, and unjust.
What is institutionalized racism?
differential access to the goods, services and opportunities of society by race
What is te whare tapa whā?
Māori model of health where health and well-being is made up of a wharenui with four walls that represents the dimensions that contribute to health and well-being demonstrating that is any one is damaged can lead to imbalance and lead to them being unwell. The four walls are: tinana, wairua, hinengaro, and whānau
What are the 5 key elements in Māori health promotion?
1) Consistent with Māori world views
2) Māori holistic views of hauora
3) Increased control of health promotion by Māōri
4) Foster Māori identity
5) Interventions are culturally competent
What are the 5 key areas of change in the health system restructure?
- Māori input
- Healthcare closer to home
- More readily available emergency and specialist care
- Digital health
- Workforce requirements
What 5 things will the health system restructure focus on delivering?
- Equity
- Partnership with Māori
- Sustainability of services
- Person and whānau centered care
- Excellence
What is Te Aka Whai Ora (Māori Health Authority)?
Statutory entity that ensures our health system has a strong focus on health outcomes and care for Māori.
Has a dual responsibility to:
1. Support the ministry with policy and strategy
2. Work in partnership with Te Whatu Ora
What is the CDH1 gene?
CHD1 is a tumor suppressor gene responsible for E-cadherin, a cell adhesion protein. A CDH1 mutation leads to poorly regulated cell growth. It has autosomal dominant inheritance.
What risks does a positive CDH1 mutation have?
70% lifetime risk of developing familial gastric cancer, and 40% lifetime risk of lobular breast cancer in women.
What is the hui process?
An example of a communication framework that enhances the therapeutic relation between clinicians and Māori. It’s has four elements:
(1) Mihi, introductions (name and role)
(2) Whakawhānaungatanga, making a connection (goes beyond building rapport)
(3) Kaupapa, the business end of discussions (history/exam/medical discussions)
(4) Poroporoaki, concluding the consultation (by summarizing, seeking clarification, answering questions)
