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|National Maaori Alcohol Health Needs Assessment

|Me Aromatawai te Hauora Waipiro Maaori moo te Motu.

The concept of conducting a national Maaori Alcohol Health Needs Assessment (HNA) as the first stage of a commissioning cycle was presented to Dr Ashley Bloomfield in 2018 by Raawiri David Ratuu.  


There was consensus that alcohol harm evidence for Maaori was often high-level, unreliable, hard-to-access or did not exist. Hence, there was a need to understand the more 'granular' detail at the local level. This included systematically understanding the actual needs of people in real-time from across the motu.  This was important as the needs of urban vs rural Maaori are very different, as is old vs young, those in low vs high socio-economic areas etc.  


In response to this hui, the concept was further developed that used a kaupapa Maaori methodology blended with non-clinical best practice from the UK. Unlike the UK, where HNAs are predominantly quantitative data-driven, the idea proposed prioritised moohiotanga Maaori and the people's stories, supported by quantitative data.  

This model, 'Kaupapa Maaori Tukanga moo te Panoni' or 'Process for Change', has been commissioned by Te Hiringa Hauora (formerly the Health Promotion Agency), with whom we now work in partnership. The purpose of this kaupapa is to: 

  1. Identifying priority needs for long-term and strategic planning, implementation, and monitoring of evidence-based, Tiriti compliant, and whaanau-informed solutions to prevent and eliminate alcohol harm to Maaori.  This includes breaking the intergenerational harm to Maaori caused by alcohol.
  2. Embed the Maaori HNA into the wider health and disability system as part of the transition to Health NZ and the Maaori Health Authority.
  3. Identify policy opportunities to utilise the evidence from the HNA, including but not limited to the review of the Sale and Supply of Alcohol Act (2012). 

Kaupapa Maaori Tukanga moo Panoni Tirohanga-overview.

The principal purpose of the process is to drive change at system and community levels concerning alcohol. Accordingly, the process will achieve Maaori health and social aspirations and ensure the solutions identified are Tiriti compliant. Te Tiriti underpins the approach guided by the principles as the framework for meeting Tiriti obligations at every step. At the centre of the process is also: 

  • Pae Ora - to remind us that the goal is healthy futures for Maaori.
  • Whaanau engagement - to highlight the keys to achieving equity is meaningful community engagement. The community's support to centre maatauranga Maaori is critical for preventing and eliminating alcohol harm in Maaori communities. 

Without understanding the size of the issue and the issues themselves from the whaanau perspective, it is challenging, if not impossible, to strategically plan for culturally safe, evidence-based and Tiriti compliant solutions to the harm caused by alcohol.

              Te Waahi Tuatahi - Assess needs and identify priorities.

              The needs assessment is the first critical step in a four-stage process to address avoidable inequities and social injustices. The identified priority needs and policy opportunities determined from the assessment shapes stages two to four. It is not until the needs, opportunities, and priorities are identified that the strategic planning and implementation of evidence-based, proportionate, and Tiriti compliant solutions can occur.

                          Te Waahi Tuarua - Strategically Plan.

                          This stage involves planning and designing the solutions to meet the priority needs and leverage the policy opportunities identified in stage one. This should include empowering, supporting, and building capacity in the community to drive solutions such as responding to a policy review, advocating for more robust legislation, or developing a community initiative. The solutions will be strengths-based and rights-based to achieve Māori health equity and aspirations.

                                      Te Waahi Tuatoru - Impliment Solutions.

                                      This stage involves implementing and delivering the solutions that were designed and planned for in stage two. Solutions can be defined as anything that can achieve equitable outcomes for Māori, such as a change to systems, policy, strategy, legislation, planning and funding. At a community level, it would involve building capacity and empowerment to advocate and enable Māori to control their health and wellbeing.

                                                  Te Waahi Tuawhaa - Evaluate the impact.

                                                  The impact of the implemented solutions at stage three must be evaluated to ensure they have the desired impact, analyse if the priority need is still valid, learn lessons for continual improvements, and provide accountability. This step feeds into the following alcohol needs assessment that will be repeated every three to five years in perpetuity.