Improving integrated health services for Pacific families

A Victoria University of Wellington-led project has been awarded almost $1.2 million to investigate how New Zealand's health and social services systems could better support Pacific families.

 Ausaga Fa’asalele Tanuvasa, Jacqueline Cumming, Debbie Ryan
L-R: Victoria University’s Dr Ausaga Fa’asalele Tanuvasa and Professor Jacqueline Cumming, and Pasifika Perspectives Dr Debbie Ryan.

The project, funded by the Health Research Council of New Zealand (HRC), calls into question the one-size-fits-all approach to health and social services delivery.

“Life expectancy for Pacific people is five years lower than for non-Māori or non-Pacific people in New Zealand,” says project lead Professor Jacqueline Cumming, director of Victoria's Health Services Research Centre, which sits within the new Faculty of Health.

“Pacific people have high rates of chronic conditions, and experience many barriers to obtaining the services they require to meet their needs.

“If the country is to better meet their health and social services needs, it’s essential that we don’t rely on implementing strategies that are not well researched from the perspectives of Pacific people.”

Professor Cumming says the project will involve focus groups of up to 30 families and in-depth case studies with 15 families.

“We’ll examine the healthcare experiences of Pacific families that have multifaceted needs or which are managing multiple issues simultaneously,” says co-investigator Dr Debbie Ryan from Pacific Perspectives Ltd.

“Health and social services are usually delivered by a large range of professionals working across many different organisations—a fragmented delivery that can lead to major inconvenience, wasted resources, and very poor health and social outcomes.

“Key issues in the health system include people being seen by multiple providers for the same condition, people receiving different advice from different health providers, duplicated tests, information not being shared or going missing, people slipping through gaps in the system, and harm arising from the use of incompatible medications.

“Families may also be involved with social service providers such as housing, employment and immigration, and those services may also not be working well together nor alongside health services to deliver the services that families need.

“More integrated service delivery is seen as key to improving the quality of care and health outcomes for New Zealanders, and to ensuring a much more efficient use of resources. We want to identify what this will mean for Pacific families and identify ways of delivering services that will work best for those families.”

More than 15 years on from the implementation of the 2001 Primary Health Care Strategy and the Government’s concerted attempts to deliver more integrated services, Professor Cumming says much more needs to be done.

“New Zealand health policy continues to stress the need to develop more integrated care to better meet the needs of people and families with individual, complex needs, and taking into account social and cultural practices that underpin these needs,” says Professor Cumming.

“We know very little about how individuals and families actually experience fragmentation, nor about the best ways to reduce fragmentation for families. This is the gap in knowledge that this research is aiming to fill. Our methodology emphasises identifying what works, for whom and in what circumstances or contexts.”

Professor Cumming and Dr Ryan will work with Victoria University’s Drs Marianna Churchward, Ausaga Fa’asalele Tanuvasa and Megan Pledger.

This is the tenth HRC-funded project that Professor Cumming has led since 2001, and the 24th she has been involved with. She is currently leading an HRC-funded project awarded $1.2 million in July last year examining the impact of reforms to community pharmacy services, and is also an investigator on Ageing Well National Science Challenge’s Life When Renting project.