Enhancing primary health care services to improve health in Aotearoa New Zealand

Te Herenga Waka — Victoria University of Wellington
Te Herenga Waka — Victoria University of Wellington

Research partners

University of Otago
The University of Auckland
Whakauae Research Services
pacific-perspectives
counties-manukau

What do we
want to know?

What is working, for whom, and in what contexts, to improve access to and use of primary health care services and to successfully introduce new models of care?

How are any changes improving the performance of the health system, delivering a better service user experience (including more integrated services), improving health, and reducing inequities in health?

Our programme of research, funded by the Health Research Council of New Zealand, is designed to take a systems approach and to identify key issues at all levels of the health system – macro, meso and micro; with an emphasis on service user experiences, Māori health, Pacific health, and the health of those with lower incomes who live in Aotearoa New Zealand. There are two overarching goals for this programme of work:

  1. to strengthen primary health care service delivery in Aotearoa New Zealand; and
  2. to enhance the contribution of primary health care to improving health, reducing inequities in health, and improving health system performance.

Many studies demonstrate the ongoing disparities between Māori and non-Māori health status, health outcomes, and access to health services. International evidence suggests that improved primary health care can lead to reductions in these inequities. Accordingly, the ways in which primary health care reforms are expected to improve the health of Māori, and what is happening in practice, are key aspects of our research programme.

We have five projects within the research programme. These:

  • fill key gaps in current knowledge;
  • build on our own recent and current research;
  • have a Māori lens;
  • engage with Pacific and incorporate Pacific worldviews on health;
  • focus on reducing inequities in health;
  • involve research with a range of key professional groups; and
  • will be undertaken in different parts of Aotearoa New Zealand – enabling a range of contexts to be explored.

A systems approach

Macro Level – National picture and policy Trends in primary health care
Macro/ Meso level Policy, governance, strategy and planning
Meso/ Micro Level – Service delivery Implementation and impact of new models of care
A Professional Lens Pharmacists
Māori Health Raranga Tāngata, Oranga Tāngata

Research
projects

Project 1: 
Trends in primary
health care

What will this project do?

Make use of a range of national data sources to explore trends in primary health care expenditure, enrolments, fees, use of services and barriers to primary health care.

Use national data sources to investigate equity in access to primary health care.

Investigate the relationship between enrolments, fees, use of services and barriers to primary health care and use of hospital services.

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Project 2: 
Policy, governance,
strategy and planning

What will this project do?

Identify how New Zealand’s macro/ meso level contexts are supporting reform through policy, governance, strategy, and planning processes.

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Project 3:
Implementation and
impact of new models
of care

What will this project do?

Compare the key features of some of the different new models of care being implemented around New Zealand.

Explain what supports new models of care to be successfully implemented and positive outcomes to be achieved.

Parts of this research are currently on hold because of the COVID-19 pandemic; we are currently undertaking research on patient experiences of primary health care in the COVID-19 lockdown period.

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Project 4:
Pharmacists

What will this project do?

Explore the development, implementation and impact of the practice pharmacist role, where pharmacists work directly with/in primary health care practices.

Build on an existing project exploring what works for whom, and in what contexts to successfully extend the community pharmacy role.

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Project 5: 
Raranga Tāngata,
Oranga Tāngata

What will this project do?

Raranga Tāngata, Oranga Tāngata focuses on ‘integrated care’ – a term that reflects a concern to improve patient experience and achieve greater efficiency and value from health delivery systems. Integrated care is key to improving the quality of health and wellbeing of individuals, and improving the efficiency of health services. It is, therefore, critical for Māori health, wellbeing and development because when health care service delivery is fragmented, siloed or lacks co-ordination, poor access to primary health care results.

Raranga Tāngata, Oranga Tāngata seeks Māori understandings of integrated and fragmented care, and associated whānau experiences of health and social services.

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    Te Herenga Waka — Victoria University of Wellington

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