waka hourua national hui & fono 20 november...
TRANSCRIPT
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