Whānau Ora – “a Concept and Outcome”

He Korowai Oranga (Māori Health Strategy) (1) defines Whānau Ora as Māori families being supported to achieve their maximum health and wellbeing.    

 

According to the World Health Organisation (WHO), "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.    The WHO definition of health is closely aligned with the Māori philosophy of health which is based on wellness.   Te Whare Tapa Wha is one example of a wellness or holistic model of health which is based on the four dimensions of life:  Taha Wairua (spiritual health), Taha Tinana (physical health), Taha Hinengaro (psychological health) and Taha Whānau (family health).   If one dimension is unbalanced the individual or collective may subsequently become unwell.   Whānau (however we choose to define it, whakapapa, kaupapa etc) is the foundation unit of Māori society a source of strength, identity, security and support.   Our health and wellbeing is influenced and affected by the Whānau as well as other factors.

External factors that protect and promote good health and wellbeing are known as the determinants of health.   The social and economic factors that have been shown to have the greatest influence on health actually lie outside the direct influence of the health and disability sector and include biological factors such as age, sex and genes, income and poverty, employment and occupation, education, housing, culture and ethnicity and social cohesion or social connectedness(2)

The Ministry of Health outcomes sought for Whānau include control over their own destinies, to experience physical, spiritual, mental and emotional health, live longer, enjoy a better quality of life and are able to participate in te ao Māori as well as the wider society(3)    The Ministry of Health has a number of tools to assist the health sector and other government departments to understand Whānau Ora and work together to achieve the outcome including the Whānau Ora Health Impact Assessment (2007), a Nationwide Service Framework called Whānau Ora etc.  

As a Māori Development Organisation mandated by Te Rūnanga o Ngāi Tahu we discharge Whānau Ora in a number of ways but primarily via our role, relationships and responsibilities which are based on both whakapapa and Māori connectivity. 

 

Whānau Ora and Integrated Health & Social Services

 

He Oranga Pounamu is charged via our constitution with integrating health and social services in the Ngāi Tahu rohe.   There are different types of organisational models for integrated services.   The type and level of integration depends on many factors such as the market, the ability of providers to cooperate, political factors, finances, legal considerations, resources available but most importantly the health and wellbeing needs of Whānau.  

 

He Oranga Pounamu currently utilises a mixture of models to achieve integration.  We operate a Māori health and social service provider network model with a mix of 30 iwi and Māori providers throughout the Ngāi Tahu takiwā.   The network is roughly broken up into 5% clinical services, 15% other health and services and 80% social services.  To enter the network as an affiliate, an organisation must be supported by Papatipu Rūnanga.  The provider network is currently working on redeveloping terms of affiliation and a collaboration framework.  We also operate a maintenance organisation model whereby we deliver community development programmes, pilot Māori service delivery initiatives for transfer to the community as well as fund Māori health and social service providers.   In July 2010 we are on target to establish a Shared Services Agency (also known as Management Organisation) which will provide a suite of administrative, management and support services to the Māori health and social service provider network with a primary purpose of reducing costs.   We also work on projects with other partners that effect Māori determinates of health and wellbeing such as wider socioeconomic; social and cultural and environmental areas.  Another important component of our work is to assist mainstream health and social service providers to support Māori Whānau achieve their maximum health and wellbeing whereby we support the provider to understand and operationalise Whānau Ora.

 

 

Has Whānau Ora been achieved?

 

A number of government sectors and agencies have Whānau Ora as an objective including health but questions have been asked as to whether the crown investment in Whānau Ora over the years has actually produced results for whānau.  In June 2009  Tariana Turia in her capacity as the Minister for the Community and Voluntary Sector established the Taskforce on whānau-centred Initiatives to develop a new approach for the design and delivery of government funded services and initiatives to whānau – one that is whānau centred and strengths based(4) and provides better value for the related investment made by the government.

The Taskforce recognised that while government funded services and initiatives are significant, whānau, hapū and iwi also have critical and distinct roles to play in facilitating Whānau Ora and government agencies should be responsive and flexible enough to align with and support whānau, hapū and iwi aspirations.  

 

The Whānau Ora: Report of the Taskforce on Whānau-Centred Initiatives was recently released. The Taskforce made six key recommendations at a structural level that will contribute to best outcomes for Whānau.    How Whānau Ora will actually work is being worked through.

 

What will Whānau Ora look like?

 

Whānau Ora is about bringing together the various agencies that help whānau and delivering support in a more efficient and effective way.  The idea is to work comprehensively with whānau (as opposed to individual members) through one agency although a number of agencies could be involved with a whānau, (such as welfare, housing, health, justice, the police and community agencies etc). The key to Whānau Ora is utilising whānau strengths and ensuring that government agencies organise their services around whānau instead of the other way around. 

 

How will Whānau Ora be implemented?

 

We will provide updates on the implementation of Whānau Ora – watch our website www.hop.org.nz.

 

To view the Whānau Ora: Report of the Taskforce on Whānau-Centred Initiatives visit www.msd.govt.nz.

 

For more information on Māori models of health and Whānau Ora visit  www.Māorihealth.govt.nz/moh.