Adapting an equity-focused implementation process framework with a focus on ethnic health inequities in the Aotearoa New Zealand context

Cover of the International Journal for Equity in Health

27 Jan 2024

Gustafson et al.

The adapted framework’s foundation is the principles of Te Tiriti o Waitangi (the written agreement
between Māori rangatira (chiefs) and the British Crown), and its focus is whānau (extended family)-centred implementation that meets the health and wellbeing aspirations, priorities and needs of whānau. The implementation pathway comprises four main steps: implementation planning, pathway design, monitoring, and outcomes and evaluation, all with an equity focus. The pathway is underpinned by the core constructs of equitable implementation in Aotearoa NZ: collaborative design, anti-racism, Māori and priority population expertise, cultural safety and values-based. Additionally, the contextual factors impacting implementation, i.e. the social, economic, commercial and political determinants of health, are included.

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Key issues

HEALTH SERVICES AND SYSTEMS

Covering developments in the provision, funding and organisation of health care services.

EQUITY

Exploring the impacts of the health system on minorities within the population, notably including Māori, Pacifica, Asians and LGBTQI.

DRUGS, DEVICE AND DIAGNOSTICS

Covering prescription medicines and medical devices.

PUBLIC HEALTH

Focusing on efforts to promote health and prevent disease through social and economic interventions.

DIGITAL HEALTH

Exploring the potential digital transformation to provide a more connected and accessible health system.

TE TIRITI

Monitoring how the health reforms and the performance of the health sector uphold Te Tiriti obligations.