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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland

The National Hauora Coalition;1 , Anneka Anderson 1 2 , Rachel Brown 1 , Jadene Wheeler 1 , Rawiri McKree Jansen 1
+ Author Affiliations
- Author Affiliations

1 PO Box 104221, Lincoln North, Auckland 0654, New Zealand

2 Corresponding author: Anneka Anderson. Email: AnnekaA@nhc.maori.nz

Journal of Primary Health Care 12(4) 384-390 https://doi.org/10.1071/HC20022
Published: 11 December 2020

Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Abstract

BACKGROUND AND CONTEXT: Rheumatic fever inequitably affects Māori and Pacific children in New Zealand. School-based throat swabbing services, such as the South Auckland Mana Kidz programme, are a key element of rheumatic fever prevention interventions.

ASSESSMENT OF THE PROBLEM: Counties Manukau has the highest national rates of rheumatic fever (4.7 per 100,000 for first recorded rates). Given these disparities, Mana Kidz undertook an exploratory, community-based initiative to improve its service delivery for Pacific Peoples.

RESULTS: Mana Kidz held a Pacific Leaders’ Fono (meeting) to discuss initiatives to improve rheumatic fever outcomes in South Auckland focused around challenges and solutions for addressing rheumatic fever, effective engagement strategies and leadership qualities needed to drive initiatives. Oral and written responses from 66 attendees were collected and thematically analysed. Four key themes were identified around challenges and solutions for rheumatic fever: social determinants of health; cultural responsiveness; health system challenges; and education, promotion and literacy. Three effective engagement strategies were identified: by Pacific for Pacific; developing a rheumatic fever campaign; improving health services. Three key leadership attributes were identified: culturally responsive leaders; having specific expertise and skills; youth-driven leadership.

STRATEGIES FOR IMPROVEMENT: Mana Kidz has now created Pacific leadership roles in rheumatic fever governance groups, promotes Pacific workforce development and endorses Pacific-led initiatives and partnerships.

LESSONS: Recognising the value of critical reflection and the importance of good governance and collaborative, right-based partnerships in health services.

KEYwords: Community health; Pacific health; rheumatic fever; school health; Treaty of Waitangi


References

[1]  Milne RJ, Lennon DR, Stewart JM, et al. Incidence of acute rheumatic fever in New Zealand children and youth. J Paediatr Child Health. 2012; 48 685–91.
Incidence of acute rheumatic fever in New Zealand children and youth.Crossref | GoogleScholarGoogle Scholar | 22494483PubMed |

[2]  Parks T, Smeester PR, Steer AC. Streptococcal skin infection and rheumatic heart disease. Curr Opin Infect Dis. 2012; 25 145–53.
Streptococcal skin infection and rheumatic heart disease.Crossref | GoogleScholarGoogle Scholar | 22327467PubMed |

[3]  Institute of Environmental Science and Research Ltd (ESR). Rheumatic fever in New Zealand: Annual Report July 2014 to June 2015. Porirua: ESR; 2017.

[4]  Ministry of Health. Public health surveillance: Annual surveillance summary. Wellington: Ministry of Health; 2018 [cited 2019 17/03. Available from: www.surv.esr.cri.nz/surveillance/annual_surveillance.php

[5]  Anderson A, Peat B, Ryland J, et al. Mismatches between health service delivery and community expectations in the provision of secondary prophylaxis for rheumatic fever in New Zealand. Aust N Z J Public Health. 2019; 43 294–9.
Mismatches between health service delivery and community expectations in the provision of secondary prophylaxis for rheumatic fever in New Zealand.Crossref | GoogleScholarGoogle Scholar | 30908804PubMed |

[6]  Webb R, Wilson N. Rheumatic fever in New Zealand. J Paediatr Child Health. 2013; 49 179–84.
Rheumatic fever in New Zealand.Crossref | GoogleScholarGoogle Scholar | 22050578PubMed |

[7]  Bryant PA, Robins-Browne R, Carapetis J, Curtis N. Some of the people, some of the time: susceptibility to acute rheumatic fever. Circulation. 2009; 119 742–53.
Some of the people, some of the time: susceptibility to acute rheumatic fever.Crossref | GoogleScholarGoogle Scholar | 19204317PubMed |

[8]  Barker H, Oetzel JG, Scott N, et al. Enablers and barriers to secondary prophylaxis for rheumatic fever among Māori aged 14–21 in New Zealand: a framework method study. Int J Equity Health. 2017; 16 201
Enablers and barriers to secondary prophylaxis for rheumatic fever among Māori aged 14–21 in New Zealand: a framework method study.Crossref | GoogleScholarGoogle Scholar | 29149897PubMed |

[9]  Heart Foundation of New Zealand. New Zealand Guidelines for Rheumatic Fever: diagnosis, management and secondary prevention of acute rheumatic fever and rheumatic heart disease: 2014 Update. City: Publisher; Year. [cited 2020 January 21]. Available from: www.heartfoundation.org.nz

[10]  Ministry of Health. Reducing rheumatic fever: downloads 2019. City: Publisher; Year. [cited 2019 December 18]. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/rheumatic-fever/reducing-rheumatic-fever

[11]  Counties Manukau District Health Board. Counties Manukau Health Rheumatic Fever Prevention Plan 2013–2017. City: Publisher; Year. [cited 2020 December 18]. Available from: https://countiesmanukau.health.nz/assets/About-CMH/Reports-and-planning/2013-2017-Rheumatic-fever-prevention-plan.pdf

[12]  Auckland Regional Public Health Services. Acute rheumatic fever notifications update for the period of 01 January 2010 to 31 March 2019. Auckland: Auckland Regional Public Health Services; 2019a.

[13]  Auckland Regional Public Health Services. Acute rheumatic fever notifications to Auckland Regional Public Health Service for the period 1 January 2010 to 30 September 2019. Auckland: Auckland Regional Public Health Services; 2019b.

[14]  Anderson P, King J, Moss M, et al. Nurse-led school-based clinics for rheumatic fever prevention and skin infection management: evaluation of Mana Kidz programme in Counties Manukau. N Z Med J. 2016; 129 37–46.
| 27348871PubMed |

[15]  The National Hauora Coalition. Our Mahi. City: Publisher; Year. [cited 2019 September 23]. Available from: https://www.nhc.maori.nz/our-mahi

[16]  Anderson A, Leversha A, Ofanoa M, et al. Māori and Pacific whānau experiences of recurrent rheumatic fever and unexpected rheumatic heart disease in New Zealand. Auckland: The University of Auckland; 2018.

[17]  Tarr J, Gonzalez-Polledo E, Cornish F. Using arts workshops as a research method. J Qual Res. 2018; 18 36–52.
Using arts workshops as a research method.Crossref | GoogleScholarGoogle Scholar |

[18]  Knapp CN, Fernandez-Gimenez M,, Kachergis E, Rudeen A. Using participatory workshops to integrate state and transition models created with local knowledge and ecological data. J Rangel Ecol Manag. 2011; 64 158–70.
Using participatory workshops to integrate state and transition models created with local knowledge and ecological data.Crossref | GoogleScholarGoogle Scholar |

[19]  Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006; 27 237–46.
A general inductive approach for analyzing qualitative evaluation data.Crossref | GoogleScholarGoogle Scholar |

[20]  Southwick M, Kenealy T, Ryan D. Primary care for Pacific People: a Pacific and health systems approach. Wellington: Pacific Perspectives; 2013.

[21]  Reid P, Robson B. Understanding health inequities. In: Hauora: Māori Standards of Health IV, Robson B, Harris R, editors. Wellington: Te Popu Rngahau Hauora a Eru Pomare; 2007. p 3–10

[22]  Came H, Tudor K. Unravelling the whāriki of Crown Māori health infrastructure. N Z Med J. 2017; 130 42–7.
| 28694538PubMed |

[23]  Reid P Good governance: the case of health equity. In: The Treaty of Waitangi and public policy, Gray-Sharp T, Gray-Sharp K, editors. Auckland: Hui (NZ) Ltd; 2013. p. 35–48.

[24]  Reid P, Paine S-J, Curtis E, et al. Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research. N Z Med J. 2017; 130 96–103.
| 29121628PubMed |

[25]  Tipene-Leach D, Able S, Haretuku R, Everard C. The Māori SIDS Prevention Programme: challenges and implications of Maori health service development. Soc Policy J N Z. 2000; 14 65–77.