Can a participatory development approach contribute to the achievement of Sustainable Development Goal 3, target 3.8 (universal health coverage)? : lessons from the Whānau Wellness Resource Programme in Hawke's Bay : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in International Development at Massey University, Palmerston North, New Zealand
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2018
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Massey University
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Abstract
In Aotearoa, health inequities are a constant and growing concern for those in the primary health care sector. Barriers towards accessing primary health care services include the cost of treatment and prescription medication, access to a general practice and the lack of relationships with health professionals. Sustainable Development Goal 3 (ensure healthy lives and promote wellbeing for all at all ages), target 3.8 aims to address these barriers through a commitment to universal health coverage. This target seeks to ensure that everyone has access to affordable and quality health care, medications and vaccinations. Although not explicitly stated in this target, this research assumes that having people actively participate in their own health care decisions and treatment, will further enhance the impact of SDG 3, target 3.8 as participation in development has been proven to do in the Global South.
In Hawke’s Bay, the Whānau Wellness Resource Programme was established in 2015 to combat issues surrounding inequity in health and provide free primary health care and medication for one year to whānau enrolled in the programme which is a predominately Māori population. This research seeks to investigate how the Whānau Wellness Resource Programme is utilising participation to contribute to the achievement of Sustainable Development Goal 3, target 3.8 of universal health coverage.
To answer this research question, field research was undertaken during a six-week period. Alongside the field research, a literature review examined relevant information regarding the research topic. The research methods consisted of semi-structured interviews and semi-structured observations of education sessions provided by the Whānau Wellness Resource Programme. Following analysis of the fieldwork data, five research themes of inequity, valuing relationships, partnership and participation, tokenism and empowerment were discerned. In relation to the Whānau Wellness Resource Programme, positive steps are being made to utilise participation in a way that reduces inequity in Hawke’s Bay, while also providing an empowering environment for participants. The research showed Sustainable Development Goal 3, target 3.8 is relevant in Aotearoa, and the primary health care sector can learn from the Whānau Wellness Resource Programme, who have begun to embrace participation to contribute to the achievement of universal health coverage.
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Figure 1 from The Citizen's Handbook licensed for incorporation into other publications under the Creative Commons Attribution-ShareAlike 3.0 Unported License:
http://www.citizenshandbook.org/arnsteinsladder.html
Permission for use of Figures 2 & 5 obtained from the Ministry of Health / Manatū Hauora and licensed for re-use under the Creative Commons Attribution 4.0 International Licence (no changes were made):
https://www.health.govt.nz/our-work/populations/maori-health/maori-health-models/maori-health-models-te-whare-tapa-wha
https://www.health.govt.nz/publication/primary-health-care-strategy
Tables 1 & 3 removed from thesis for copyright reasons, but accessible from:
Norwegian Agency for Development Cooperation. (2013). A framework for analysing participation in development. https://www-oecd-org.ezproxy.massey.ac.nz/derec/norway/NORWAY_A_FrameworkforAnalysingParticipationDevelopment.pdf
Table 2 removed from thesis for copyright reasons, but accessible from:
White, S. (1996). Depoliticising development: The uses and abuses of participation. Development in Practice, 6(1), 6-15. https://doi-org.ezproxy.massey.ac.nz/10.1080/0961452961000157564
Appendix One: The Tohunga removed from thesis for copyright reasons, but accessible from:
http://eng.mataurangamaori.tki.org.nz/Support-materials/Te-Reo-Maori/Maori-Myths-Legends-and-Contemporary-Stories/The-tohunga
Keywords
Health services accessibility -- New Zealand -- Hawke's Bay, Public health -- New Zealand -- Hawkes Bay, Maori (New Zealand people) -- Medical care -- New Zealand -- Hawke's Bay, Medical policy -- New Zealand, Sustainable Development Goals, Whānau Wellness Resource Programme