waka hourua national hui & fono 20 november...

Waka Hourua National Hui & Fono20 November 2014

Mason Durie

1. Māori & Pasifika

2. Suicide

3. Prevention

Really ancient voyages

Voyages made about5000 years ago

Similar demographic trends

Similar trends for disparities in health

Similar trends for incomes

Similar aspirations to retain culture

Similar approaches to hui, fono, gatherings Karakia

Koha

Kawa

1. Māori & Pasifika

2. Suicide

3. Prevention

COMMUNITY FACTORSsuicide as a social phenomenon

MEDICAL FACTORSsuicide as a medical condition

CULTURAL FACTORSsuicide and cultural identity

INTERPERSONAL FACTORSsuicide and relationships between

people

Altruistic suicide‘sacrifice for the greater good’

e.g. suicide-bombers, ‘ready to die forthe cause’

Anomic suicide‘detachment & disengagement’

e.g. nihilistic suicide, spiritual poverty,non-participation in community, detachedfrom society and from the economy

Coercive suicide‘group pressures and

expectations’e.g. cult suicide, text messaging

Mental disorderse.g. depression

Chronic ill healthe.g. immobilisation

Terminal illnesse.g. cancer, dementia

Cultural alienationinsecure identity

Cultural confusionfragmented identity

Unconditional culturalconformity

culturally sanctionedsuicide

Termination of a lovingrelationship

loss

Response to a threateningrelationship

fear

Protection of survivor(s)sacrifice

Community Medical Cultural Inter-personal

Greater understanding of suicide anda basis for preventive strategies

1. Māori & Pasifika

2. Suicide

3. Prevention

Primary prevention – whole of populationactivities so that a problem never arises

e.g. nutritional advice to avoid diabetes

Secondary prevention – targeting at riskindividuals to avoid a problem getting worse

e.g. early diagnosis of pre-diabetes and prompt treatment

Tertiary prevention – reducing adverse impactsarising from a particular health problem

e.g. effective management of diabetes to reduce complicationssuch as renal failure

4 Making a difference

Waka Hourua should be able to demonstratethat it has made a positive difference

In order to do so there needs to be clarityabout what constitutes a’ positive difference’

And there needs to be a clear link between anaction and a result (or outcome) -

The high level aims for Waka Hourua may notbe realised in the short term.

But all Waka Hourua activities, projects, events,meetings, and publications should be able todemonstrate that they are contributing to oneor other of the three overall aims

The outcomes associated with specific projectsare more likely to be intermediary but stillcontributing to the main aims

An outcome may not necessarily be theconsequence of a planned activity – attributionis often difficult to demonstrate. The outcomemay actually be the result of some other event.

Outcomes occur over time. Some outcomes arenot achievable in the short term; the desiredoutcome may only be evident years afterwards

Measuring outcomes depends on identifyingmeasurable indicators associated with actionsthat are leading towards an outcome

The Waka Hourua aims are that:

Māori and Pasifika suicide rates will decrease

suicide attempts will reduce

and the consequences of suicide will be eased

Intermediary outcomes can be expressed asOutcome Goals

Outcome goals state the outcomes that canbe expected from a particular set of actions

The goals are stepping stones towards theultimate outcomes

Three outcome goals can be identified:

Outcome Goal 1Informed, cohesive, and resilient communities

Outcome Goal 2Strong, secure, and nurturing whānau

Outcome Goal 3Safe, confident, and engaged, Rangatahi

Waka Hourua will contribute to outcome goals by: developing programmes initiating actions Influencing policies

eg. reducing risk factors

(such as unrealistic expectations, relationship breakdown,unemployment)

building protective factors(health literacy, educational success, employment, housing, …)

informing policy makers(DHBs, PHOs, Ministry of Health)

Actions Formulate policies that strengthen collective

community endeavours Build community leadership networks Develop a common community agenda Strengthen community resources including

cultural, economic and social resources Identify risks within communities Initiate actions that will reduce community

risks

Actions Promote Whānau centred policies and

practices (such as Whānau Ora) Build whānau capabilities to manage stress,

disadvantage, loss, risk Increase whānau access to resources and

services Facilitate whānau engagement with key

institutions (schools, services, marae,churches)

Actions National and local policies that are likely to

reduce disadvantage for young people Encourage Rangatahi leadership in key

situations (schools, sporting groups) Foster peer support groups Provide Rangatahi with access to information,

assistance, advice, including e-access Support positive initiatives for rangatahi

(culture, sport, learning, music)

For each pathway priority actions need to bedeveloped.

Priority actions may include: addressing risk factors (such as cyber-bullying,

community alcohol policies, whānau adversity) as well as building protective factors (such as enabling

policies, community cohesion, relevant educationalopportunities)

All Waka Hourua actions should lead to at least onespecific outcome goal

For each action or project, outcome indicatorsshould be developed

Outcome Goal 1 indicators could include:‘Community leaders have eliminated a known risk factor’‘Community leaders have established an academy for

innovative learning’‘Community leaders have been able to limit alcohol and

drug outlets in their community’‘Community health & social service providers have

established a common agenda for working withRangatahi

Outcome Goal 2 indicators could include:‘Whanau have attended seminars for managing

Rangatahi risks’‘Whānau have resolved the impacts of a recent suicide’‘Whānau Ora navigators have supported access to

health and educational opportunities’‘Whānau have implemented a code of ethics for e-

communication ’‘Whānau have re-established links with marae and

hapū’‘Policy makers have strengthened whānau centred polices’

Outcome Goal 3 indicators could include:‘Trade training programme for ‘at risk’ youth

established‘Marae and local secondary school enter into a

partnership to foster positive engagement withlearning’

‘Rangatahi establish a leadership network to supportpeers who are isolated or distressed ’

‘Rangatahi e-help line established’‘Rangatahi participate in health literacy courses’

Waka Hourua projectscover:

Primary prevention –whole of populationactivities

Secondary prevention –targeting at riskindividuals

Tertiary prevention –minimising the adverseimpacts arising fromsuicide

Each level of preventioncan be recognised in theoutcome goals

Outcome goal 1

Goals 1, 2, 3

Goal 1, 2

Requires: High level outcome statement Intermediary outcome goals A set of pathways or actions that will achieve

the goals Indicators that are measurable and outcome

focused A timeline Alignment of all projects with an Outcome

goal

Nga Mihi

Tena koutou katoa

The aims of Waka Hourua are to: Reduce Maori & Pasifika suicides

Reduce suicidal attempts Ease the impacts of suicide

Outcome Goal 1‘Informed, cohesive, &resilient communities’

Outcome Goal 2‘strong, secure, &nurturing whānau’

Outcome Goal 3‘safe, confident, &

engaged Rangatahi ’

The aims of Waka Hourua are to: Reduce Maori & Pasifika suicides

Reduce suicidal attempts Ease the impacts of suicide

Outcome Goal 1‘Informed, cohesive, &resilient communities’

Outcome Goal 2‘strong, secure, &nurturing whānau’

Outcome Goal 3‘safe, confident, &

engaged Rangatahi ’

Outcome Indicators for policies, actions, projects,engagements

The aims of Waka Hourua are to: Reduce Maori & Pasifika suicides

Reduce suicidal attempts Ease the impacts of suicide

Outcome Goal 1‘Informed, cohesive, &resilient communities’

Outcome Goal 2‘strong, secure, &nurturing whānau’

Outcome Goal 3‘safe, confident, &

engaged Rangatahi ’

Pathways to achieve Goals:enabling policies, actions, projects, engagements

Outcome Indicators for policies, actions, projects,engagements

The aims of Waka Hourua are to: Reduce Maori & Pasifika suicides

Reduce suicidal attempts Ease the impacts of suicide