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New Zealand Subgroups Waitangi Convention

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There is a worldwide concern on health status disparities and the access to health facilities and services. Health differences amongst the population have been experienced in New Zealand (NZ) and have been prioritized by the government (King, 2000). One of the primary problems in NZ is the life expectancy gap between the Maori (indigenous people of New Zealand) and non-Maori (Pacific Islanders) which is nine and a half years (Ajwani et al., 2003). Available statistics have shown that health differences among the population subgroups are on the upward trend (Howden-Chapman, & Tobias, 2000), a reason for the NZ government setting it as a goal and even other governments of the world (Strategy, 2001). The bases for the health inequalities include age, socioeconomic status, ethnicity, gender, disabilities and geographical regions (Reid, & Robson, 2000).
Socioeconomic Factors
Among the health determinants, socioeconomic inequalities play a vital role in access to health services and in determining the health of a population, hence a point of significant concern by the government (Howden-Chapman, & Tobias, 2000). Health and premature death have been found to be primarily dependent on socioeconomic factors (Hallqvist et al., 2004). The influence of socioeconomic status in the fair share of health services goes beyond just financial capabilities and purchasing power. It has been noticed that social capital is key to the health of people and their community. Individuals with better connections to resources as a result of their wealth together with their community experience high life expectancy than those in poor neighborhoods (House, Landis, & Umberson, 2008). Classifying of various communities by their income occurs all over the world, and this has negatively affected those that reside in impoverished regions or society (Musterd, 2005).  A clear distinction can be noted in the population regarding access to health facilities whereby some subgroups or class of people are disadvantaged while the other enjoys good health services (Hefford, Crampton, & Foley, 2005).
Various socioeconomic aspects have led to health inequalities in NZ. One is socioeconomic deprivation. A larger number of the Maori community resides in deprived places incapacitating their ability to access health facilities for services. Specifically, the Pacific community is the most disadvantaged of the NZ population (Salmond, Crampton, King, &Waldegrave, 2006). The Pacific and Maori communities have lesser access to health services as compared to the non-Maori people because of their poor socioeconomic status. Socioeconomic poverty further brings about school failure for the Maori and Pacific people. Consequently, leading to reduced jobs and low-income limiting them from accessing health services King, (2001). Informal education makes the community ignorant of available and better health care services. For this reason, the Maori and Pacific community going to look for the services for example dental care is difficult (Barwick, 2000). The places of residence and working conditions for the Maori and Pacific people are poor.   Their homes of stay and conditions of their jobs even expose them more to health hazards reducing their life expectancy (Anderson et al., 2006).
Income Distribution
Another determinant of health accessibility is income distribution. The degree of poverty in a country can be evidenced by the extent of inequality in earnings and wealth distribution. Research conducted in the United States of America showed that disparities in income are related to increased deaths (Wilkinson, 2002). This is a clear indication that financial inabilities lead to limited access to health services. When people get low income significantly below the poverty line their purchasing power is reduced since they strain to purchase their medications and sometimes cannot afford some medicines for they are expensive. In NZ the non-Maori people are the highest earners while the Maori and Pacific people earn lowly. Collection of prescribed medications is dependent on cost and statistics have proved that the low earning ethnic population cites cost as their reason for failure to purchase their prescribed drugs. For example, the Pacific people dismally buy the prescribed medicines chiefly for the price they cannot afford (Jatrana, Crampton, & Norris, 2010).  However, efforts have been made to reduce the income inequalities by equally distributing resources and creating more employment opportunities. Still, it’s evident that the non-Maori people have high purchasing power and can access and obtain medications in comparison with the Maori and Pacific ethnicity (Anderson et al., 2006).
Another health determinant is jobs and an individual’s occupation. Besides employment being a source of revenue, it also provides social status, self-esteem and enhances social encounter. Lack of work is detrimental to both physical and mental health (Stank?nas, & Kal?dien?, 2005). A study by Graham (2004) proved that unemployed people have poorer health status compared to employed people. This can be attributed to the lack of purchasing power due to insufficient or lack of money for seeking medical services. Low social status and self-esteem that is caused by unemployment alienate the moderate class from accessing health information and services. The Pacific community has the highest number unemployed people (17%) meaning a large percentage of its population cannot afford health services such as dental care. In fact, the Pacific community showed fewer visits to health centers compared to all other ethnic groups combined (Davis, Suaalii-Sauni, Lay-Yee, & Pearson, 2005). Maori people have got 16% unemployment while the non-Maori are at 5%, these gaps have implications on the health of these people (Strategy, 2001).
Literacy Levels
Literacy levels influence the ability of an individual to cope in a society effectively. According to Adams et al. (2009), the literates can quickly assimilate information about health and that it’s impossible for one to seek medical care services of which he or she does not know about. Someone has to be aware and understand the need for the services available to go for them. Therefore, low illiteracy levels negatively impact on the ability of a population to access health care (Adams et al., 2009). The capacity to evaluate health communication and put it into action hangs on health literacy. Individuals with limited health knowledge experience worse health status compared to those with adequate health information. The ability for effective communication with the health professionals becomes complicated (Adams et al., 2009) and this can discourage them from seeking medical care. The Maori people, Pacific community, and other small ethnic groups rank the highest on illiteracy levels of over 60% (Benseman, 2003). Further evidence depicts that many Pacific community members are often unaware of the government services due to lack of knowledge and limited access to information as shown in a study carried out to assess a five-year strategy of the government of NZ to improve the health and wellbeing of the Pacific people (Rush, 2014).  Some individuals, due to illiteracy, make poor health decisions as a result of their little knowledge of available health services. However, it is worth noting that lack of information about health services cannot only be attributed to illiteracy but also infective information conveyance by the health information service providers.
Cultural beliefs and practices influence the way a community participates in health-boosting behaviors and their access to health services. For example, the Pacific people have an attitude towards matters related to sexual health and education. This limits the Pacific youths’ access to reproductive health information. The teenagers do not share reproductive details with their parents for their culture forbids the exchange of information about sexual health with seniors. They fear their parents knowing that they are sexually active. This translates to fewer teenagers of the Pacific ethnicity from going to seek sexual health services for they are worried that other people may find out about their sexual maturity (Zealand, 2010). One of the cultural believes among the Maori and Pacific is that a smoker is supposed to quit smoking without any program of assistance and that nicotine treatment is more detrimental than smoking cigar has prevented many smokers from seeking healthcare services (Wilson, Blakely, & Tobias, 2006). Statistics show that the Maori lead in smoking by 45% and that of the Pacific follows closely by 31%. Mistrust of tobacco addiction interventions provided by the government by the Pacific people will hinder them from visiting health centers for advice and using the medication prescribed. To a greater extent, cultural beliefs are responsible for a significantly low number of the Pacific visiting health centers. They even don’t recognize the need and availability of the services. Smoking predisposes the population to contract respiratory diseases both in an active and passive form. A survey carried on the youths depicted that more Pacific students smoked at a rate that is twice than other European teens in schools (Helu et al., 2009). Such statics necessitate health awareness on the side effects of smoking and demands that the most affected population seek medical care about smoking-related maladies. However, it is noticed that the need for these services does hold much importance amongst the society because of their beliefs. Cultural differences bring about health care accessibility inequalities among NZ ethnic groups. A subgroup that is in dire need of some health services such as the Maori people does not go for the services in support of their cultural beliefs and practices.
The need and access to health services are determined by a wide range of social, beliefs and practices, economic and environmental aspects. People with less socio-economic resources experience poor health and are in need of health services than the group that has more resources (Jatrana, & Crampton, 2009). The poor health is as a result of a combination of reduced capital, greater predisposes to health hazards, more significant mental stress and limited access to healthcare services. The population with an urgent need of these services does not have the power to access them due to some of the factors highlighted above. Although some of these hindrances to access to health services are regarded by the population as norms, some other factors are due to poor resource distribution in the country. The first attempt to reduce health disparities should be to distribute resources among all people in an equal measure.
The Waitangi Treaty and Healthcare Promotion
In 1840 the Maori chiefs of the North Island and agents of the British Crown came to a memorandum of understanding on how New Zealand should be governed, the agreement (TeTiriti o Waitangi) was then signed by both parties.  Today the Crown is represented by the government of New Zealand and other organizations and institutions. The Waitangi treaty is regarded as the foundation document for the Aotearoa-New Zealand even though with mixed feeling (McCaffrey, 2010). The agreement obliges the crown to act in honor of the treaty. The formulation of the agreement was partly due to the complaints raised by the Maori people about their health. The agreement reached assured the well-being of the Maori and non-Maori people by recognizing the value of social and economic factors in attaining good health to all the people.
The Maori health model (Haori) was devised to deliver a culturally appropriate health care to the Maori and non-Maori communities. The model recognizes that Maori are not a homogenous group and therefore require the model to be adopted at all different levels of identity (Durie, 2001). All the aspects of the Haori are to be considered in providing excellent health care services to the people. The health components contained in the model encompasses the spiritual (taha wairua), physical (taha tinana), mental & emotional (hinengaro) and the family aspects. All these elements are vital in providing quality health and are to be considered wholesomely without any of it being neglected. The four factors relate to each other, and if one of them is overlooked, it brings a negative impact on an individual’s health (Kingi, 2005). For the best outcomes in health care delivery, all the four components ought to be understood and addressed.This can be referred to as the capacity for faith and communion (Durie, 2001) and it is considered an essential component in health delivery. It is believed that if a person lacks spiritual awareness, he or she is prone to illness. The health practitioners are to consider spirituality and factor it in administering health care services. Spirituality forms relationships with other factors involving the environment, the people, and their heritage. This link is to be maintained all through.
Feelings and thoughts
Durie (2001) defines the te taha hinengaro as the ability to communicate, think and to feel. The thinking of Maori people is found to be a bigger picture that is about the whole community and not as an individual. The more important picture thinking demands a holistic service delivery. Through the thoughts and emotions, the Maori communicate for example crying in a funeral instead of talking. The Maori consider the expression of feeling like part of health and therefore vital factor to consider in administering health services.
The physical component of the model as described by Durie (2001) is the ability for both physical health and development. The physical health is related to the spiritual, emotional and family well-being and it is a familiar component in the health sector. The Maori believe that there is an association between the body and things associated with the breach of tapu (sacred) (Kingi, 2002). Convictions about tapu and physical prosperity are contrasts that may exist amongst M?ori and non-M?ori. For some M?ori, certain parts of the body are additionally viewed as tapu, for instance, the head, but then by and large inside the medicinal world these convictions have been disregarded. The Te taha tinana also refer to the physical environment which encompasses the socio-economic factors such as employment and housing.
This aspect entails the well-being of the family. The family is essential in supporting healthcare delivery because it factors in the elements of spirituality, emotions, culture and physical health. Therefore, it is important to maintain family relationships to ensure the young and old are being taken care of. Family relationships also point out the roles each family member is to play in enhancing a healthy population. In typical situations, it is the family that will significantly impact on the health of an individual because it determines the type of social environment of the people (Kingi, 2005). The implication of this is that good health and health care service provision will be boosted by a conducive environment created the family member and vice versa.
The implementation of the Waitangi treaty is centered on three terms; governance, equity and the indigenous population having control and self-determination (King, 2000). These articles play a significant role in the understanding of health and sickness, delivering healthcare services and the formulation of health policies. The treaty of Waitangi promotes health at all levels for it forms the basis and the framework for service equitable service provision for the people of NZ (McCracken, &Rance, 2000). In all aspects, the three terms apply conjointly to enhance good health among the people. Therefore to understand how the treaty promotes health it is essential to consider the relationship and effectiveness of the three principles of health.
The article of management outlines the Crown’s roles and responsibilities to govern and safeguard the interests of the Maori justly. It gives freedom to the government to oversee (Came, 2013) by exercising constitutional right of enacting laws that will be geared towards providing adequate services to all citizens. These policies also govern all agencies under the Crown. In fact, the Maori gave up their lands to the government in exchange expecting to benefit from it to develop policies and services that foster their health and well-being.
The primary goal contained in the governance article in promoting health is the attainment of Maori involvement in all aspects of health promotion. These elements include decision-making, prioritizing, purchasing, planning, policy, implementing and the evaluation of the health promotion services. The treaty affirms that formulated plans their implementation should be focused on improving the health of the community as a whole. The entire process of service provision should actively involve the Maori and even give them the opportunities to research health services. At all stages of services provision, the Maori people should be included and feel part of it so that they can be new policies and implement them. Governance mandates the Maori people to participate in the making and implementation of the efforts that are aimed at providing quality and equitable healthcare in their community. The Maori people exercise governance over their society, and one aspect that they give attention to is health.
The Maori control and self-determination
This is the second article of the Waitangi treaty that focuses on the achievement and advancement of the Maori health ambitions. This is by creating and obtaining opportunities for the Maori that will enable them control and be responsible for their health. Resources such as funding, service providers, and workforce should be achieved to sustain ongoing developments in promoting Maori health. The treaty also stipulates that the Maori should be empowered by providing them with resources that enable them to fulfill their health desires. Inadequate resources owned by the Maori have always thwarted any health promotion efforts in their community. The Maori lack the power to achieve their fitness goals due to insufficient resources. It is on this basis the treaty has to be followed and empower the citizens to improve their health without being restrained. Equal distribution of resources among the citizens implies that many people will have the ability to access and obtain medical care. It is, therefore, succinct the Waitangi treaty promotes health among all citizens.
This is a goal that endeavors to reduce or eliminate the health differences that exist between the Maori and non-Maori people. This can only be achieved by continued improvement of the health of the Maori people to catch up with the non-Maori. Strategies are to be developed that will seek to address the leading causes of poor health. The services offered to the Maori have are to be evaluated to check for areas of improvement. In coming up with the strategies to advance the health of Maori, the communities have to be involved to come up with valid causes of health disparities. Quality assurance, assessment, and monitoring process depend on accurate information which can only be obtained by actively involving the affected group in research (Pihama, Cram, & Walker, 2002). The data collected from such study is vital to ensuring the promotion of Maori health needs and aspirations. Efficient and productive tackling of Maori health needs also depends on accurate data which is obtained from honest opinions from the people (State Services Commission, 2010). By understanding the health challenges the Maori face, it easy to avert them and ensure equity among the citizens. The less advantaged have to be empowered, for example by providing them with suitable housing and employment, to reduce the disparity gap of health.
The Maori treaty and its articles are directly related to health determinants. The principles provide for good government and safeguarding of the Maori’s self-determination and control over their affairs and for equity with other subgroups in Aotearoa. The treaty also contains three principles that govern its implementation (Kingi, 2005).  The principles of the convention are partnership, participation and active protection.
The partnership involves a continuous relationship between the British Crown, its agencies and iwi (Nightingale, 2007). In partnering to improve the health of the people, it’s important to note that it is to involve all the Maori people and not one iwi. This is because the iwi and Maori are very diverse which also translates to their needs and requirements for they have a different structure. Therefore, as the treaty advocated for partnership, it should be understood who forms the connection to facilitate equitable healthcare provision to all people. The collaborative relationship between the government and the Maori community has led to the formation of government agencies and organizations that promote the well-being of the Maori (Wise, & Signal, 2000). The bodies together with the community have developed strategies to better the health of the people at different levels. The application of the principle of partnership has led to the increase of trained and qualified medical practitioners among the Maori bettering the well-being of the community (Ellison-Loschmann, & Pearce, 2006). For example, the Maori and Pacific admission scheme have promoted health in the society by awarding academic scholarships to nursing students that has also led to the general improvement of the health of the nation. These scholarships are funded by various agencies and organization in partnership with the Maori people. Also, the Public Health service nearly screen drug adherence consistently tallying pills and monitoring the physical area of patients, especially those on directly watched treatment. Overseeing the administration and use of medications by the public health service body ensures that the health of the community is improved.
Another principle is participation, which requires the active involvement of the Maori in all social aspects of New Zealand (Nightingale, 2007). This has a significant influence on improving the health of the nation for it will ensure that every need of each citizen is taken into account. On this basis, health services are to be distributed according to the needs of the people as stated in the New Zealand Public Health and Disability Act (2000) (Anderson et al., 2006). The primary goal of participation is equity where all benefits, costs, services, and risks are distributed among every individual. Even in implementing right health policies total involvement of the citizens enhances the realization of improved health among all people and the whole country. For active participation, communication is vital. A challenge noted to undermine the principle of the involvement is the use of jargon by the medical care providers (Oh, 2005). Slang used by the healthcare professionals hinders the patients and the community at large from actively participating in coming up with appropriate strategies to improve their health. Understanding what the principle of participation entail will enhance its effective implementation and eliminate barriers such as communication that exist in the health sector.
The third principle is active protection whereby the government is under obligation to actively prioritize the interests of the Maori (Nightingale, 2007). The Maori culture, values, and beliefs have to be protected and form part of the objectives for administering health care services to the community. The study shows that many health care providers have failed to successfully incorporate cultural diversities among the Maori in healthcare service provision (Kingi, 2007). This depicts that the treaty and its founding principles have not been fully implemented and observed. However, if the policies are well understood and implemented, they will better the health of the people. The fact that the principle has not been applied efficiently hints that if fully utilized success will be realized.
All the principles are related and depend on each other for the achievement of good health. By considering the underlying health determinants, mechanisms can be developed to tackle the leading causes of poor health among the citizens. Any of such strategies will require the involvement of various sectors and agencies actually to avert causes of poor health. The easiest way to gain health is collaborating with all the related areas (Burrows, & Wright, 2004).
The key points for the formulation of the treaty of Waitangi are of improving the welfare of the citizens of New Zealand. The aspect of health also relies on the principles and articles contained in the treaty for its advancement. Determinants of health have a relationship with these laws and settlement terms, and therefore, every part of the agreement needs to be implemented into achieving the desired health goals. If any success has to be realized in the health sector, then healthcare givers and the people of New Zealand need to be guided on how to apply the Waitangi treaty service provision.
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According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
Australia Ryde Management Information system strategy University of New South Wales (UNSW) Masters in Business Administration 


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11174 Introduction To Management

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