Browsing by Author "Came H"

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    A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill
    (New Zealand Medical Association, 2022-03-11) Rae N; Came H; Baker M; McCreanor T
    Aim The Pae Ora (Healthy Futures) Bill is the framework for a reformed health system intended to embed Te Tiriti o Waitangi and centre equity. The Bill is informed by the Wai 2575 Health Kaupapa Waitangi Tribunal Inquiry and the Health and Disability System Review, both of which established an urgent mandate to transform the health sector. This desktop review explores to what extent the proposed Bill is likely to uphold Te Tiriti. Method This paper uses Critical Tiriti Analysis to review the Pae Ora Bill. The analysis involves five phases: (i) orientation; (ii) close reading; (iii) determination; (iv) strengthening practice and (v) Māori final word. As part of that, a determination is made whether the Bill is silent, poor, fair, good or excellent in relation to the Preamble and the four articles (three written, one verbal) of te Tiriti o Waitangi (Māori text). Results The desktop analysis showed fair engagement with most of the Te Tiriti elements; but with good commitment to address equity issues. The Bill was silent in relation to wairuatanga (spirituality) and there is no evidence of Māori values informing it. Conclusion The dominant Crown narrative that interprets kāwanatanga as the right to govern over all peoples pervades this legislation. There are significant power sharing shifts within this Bill and these are welcomed, but whilst the Crown maintains ultimate power and authority only a partial fulfilment of Te Tiriti will be evident within the health system.
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    COVID-19 and Indigenous knowledge and leadership: (Re)centring public health curricula to address inequities
    (Elsevier B.V on behalf of the Public Health Association of Australia, 2021-02) Severinsen C; Ware F; Came H; Murray L
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    COVID‐19 and Indigenous knowledge and leadership: (Re)centring public health curricula to address inequities
    (Elsevier B.V, 2023-02-27) Severinsen C; Ware F; Came H; Murray L
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    Strengthening public health contracting: findings of a follow-up nationwide survey from Aotearoa
    (Informa UK Limited, trading as Taylor & Francis Group, 2022-01-01) Came H; Baker M; McKenna B; McCreanor T
    In 2010 and 2015 nationwide surveys monitored government management of public health providers. These surveys found evidence of inconsistent management which disadvantaged Māori providers, consistent with institutional racism. In Dec 2019 to March 2020 a follow-up nationwide telephone survey was completed. Public health units, primary health organisations, Māori health providers and non-governmental organisations with public health contracts responded (72%). This paper focuses on the findings about (i) contracts, and (ii) relationships. Descriptive statistical analysis was applied to quantitative responses and explanatory and combinatory analyses informed by thematic analysis were applied to qualitative data. The 2019–2020 quantitative data identified no statistically signficant variations. There was no evidence Māori provider experiences improved, but generic providers reported less favourable conditions. Qualitative data revealed providers remain dependent on individual managers and there was inconsistency across providers that could be addressed by transparent quality assurance. Māori providers were frustrated by contracting environments. They wanted to be recognised as Te Tiriti o Waitangi partners, with flexibility, certainty of investment (longer contracts), support (infrastructure investment) to be able to meet the high needs of their communities. This nationwide survey was completed prior to the current health reforms but implications are considered for the Māori Health Authority.
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    Using vignettes about racism from health practice in Aotearoa to generate anti-racism interventions
    (John Wiley & Sons Ltd on behalf of Health and Social Care in the Community, 2022-11) Kidd J; Came H; McCreanor T
    Racism is a key modifiable determinant of health that contributes to health inequities in Aotearoa and elsewhere. Experiences of racism occur within the health sector for workers, patients and their whānau (extended family) every day. This paper uses stories of racism from nurses – reworked into vignettes – to examine the dynamics of racism to generate possible micro, meso and macro anti-racism interventions. A critical qualitative design was utilised, informed by kaupapa Māori approaches. The five vignettes in this paper were sourced from a pair of caucused focus groups with nine senior Māori (Indigenous peoples of Aotearoa) and Tauiwi (non-Māori) nurses held in Auckland Aotearoa in 2019. The vignettes were lightly edited and then critically analysed by both authors to identify sites of racism and generate ideas for anti-racism interventions. The vignettes illustrate five key themes in relation to racism. These include (i) mono-cultural practice, (ii) everyday micro-aggressions; (iii) complexity and the costs of racism, (iv) Pākehā (white settler) privilege and (v) employment discrimination. From analysing these themes, a range of evidence-based micro, meso and macro-level anti-racism interventions were derived. These ranged from engaging in reflective practice, education initiatives, monitoring, through to collective advocacy. Vignettes are a novel way to reveal sites of racism to create teachable moments and spark reflective practice and more active engagement in anti-racism interventions. When systematically analysed vignettes can be utilised to inform and refine anti-racist interventions. Being able to identify racism is essential to being able to effectively counter racism.