Video shows how achieving health equity starts with collaboration

News article

10 May 2019

Health Quality and Safety Commission Kaiwhakahaere Te Whai Oranga Kiri Rikihana talks about how collaboration is helping improve health equity, in a new Ministry of Health video.

[Title: Kiri Rikihana (HQSC) on health equity]

[Slide: How can we make health more equitable?]

[Kiri Rikihana to camera]

Improving equity and understanding equity starts with understanding of self, and how you go about your business day-to-day.

So what’s your privilege?

What are your biases in the work that you do?

How does your work affect others?

You need the data and you need the information to help understand how the work that you’re doing serves some populations well and may not serve other populations.

What’s the gap between the two, and what do you, what are the steps that you need to take to address that gap?

[Health Equity Assessment Tool cover image]

[Kiri Rikihana to camera]

There’s an amazing tool that’s been around since the 2000s called the Health Equity Assessment Tool: the HEAT Tool.

It’s the sort of tool that should be used on every piece of policy, every new programme because it helps to identify the gap between those that will benefit from a policy or a programme, and those that might not, and helps you, leads you through the steps to address that.

So I can’t recommend the HEAT Tool more highly.

[Achieving Equity in Health Outcomes cover image]

[Image of the Ministry's definition of equity]

I’ve been a part of the process as they’ve been consulting on the Ministry’s new Definition of Equity with the sector.

[Kiri Rikihana to camera]

And I love to see how it, the fact that we have a Definition for Equity that the sector can use, but also that it’s got some flexibility to have a different way of working with different populations depending on what they need.

[Slide: What is the Health Equity Hub?]

[Kiri Rikihana to camera]

Four years ago when I started working at the Health Quality and Safety Commission in my role as Kaiwhakahaere Te Whai Oranga, we realised very quickly that other organisations were grappling with what equity meant for them.

And for some of them it was about the difference for their patients or the consumers of health care, and for some it was about what it meant strategically for their organisation.

And so we decided that we needed to reach out to others to assist, to help us, but also for us to help them as well.

So it was really an opportunity to coalesce around this wicked problem.

Inequities are a wicked and thorny and difficult problem, and so we put the invitation out to all likeminded health organisations and we were really, really excited with the response.

So we’ve got PHARMAC and ACC, and we have a lot of the health colleges: the colleges of surgeons, and GPs, and so on.

And so, what we, it enables us to have a conversation about what equity means structurally, strategically and for the consumers and patients that we are looking after.

[Slide: What's the Health Equity Hub achieving?]

[Kiri Rikihana to camera]

What the Health Equity Hub is achieving is it’s giving a place and visibility for the conversation around equity to occur.

It’s not ignoring the fact that it’s hard for everyone to understand what it means, that there’ll be some people within your organisation who know what it is and actually can give you examples of work, what you can do differently, and there’ll be some people within the organisation who have no idea.

And so the Hub gives support to those individuals who are doing the hard work of transforming culture, and it also does what we’ve done with the Definition of Equity, provides a place where the organisations can come together and talk about it and say ‘does this, is this fit for us?’, you know, ‘does this suit us?’, ‘this is what our experience is’, so a conversation around how equity is going to look going into the future.

In the video, Kiri says the Interagency Equity Hub is enabling Government agencies to share knowledge about making health care in Aotearoa New Zealand more equitable: a key priority across our health system.

“The Health Equity Hub is giving a place and visibility for the conversation around equity to occur. 

“Inequities are a wicked, thorny and difficult problem. We decided we needed to reach out to other agencies to help us address these, but also for us to help them. 

“So it was really an opportunity to coalesce around this wicked problem. 

“We put the invitation out to all likeminded health organisations and we were really, really excited with the response. 

“We’ve got representatives from PHARMAC and ACC, as well as a lot of the health colleges,” says Kiri.

Kiri also talks in the video about how the Ministry’s definition of equity, recently formalised by Director-General of Health Dr Ashley Bloomfield, is helping develop shared understanding of what achieving equity means in the Aotearoa New Zealand context:

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes. 

“I’ve been a part of the process as the Ministry’s consulted with the sector.

“I love the fact we have a definition for equity that the sector can use, but also that it’s got some flexibility to have a different way of working with different populations depending on what they need.

“It enables us to have a conversation about what equity means structurally, strategically and for the consumers and patients that we are looking after,” Kiri says.

The new video has been developed by the Ministry’s Achieving Equity priority work programme as part of a growing collection of resources to raise understanding about what people can do to achieve more equitable health outcomes. These other resources are available on the Achieving Equity Work Programme webpage

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