Structural barriers cause deprivation.
Subject: Maoris (Health aspects)
Child health services (Management)
Pub Date: 08/01/2012
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2012 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: August, 2012 Source Volume: 18 Source Issue: 7
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Product: Product Code: 8000187 Maternal & Child Health Care; 9105264 Maternal & Child Health Programs NAICS Code: 621999 All Other Miscellaneous Ambulatory Health Care Services; 92312 Administration of Public Health Programs SIC Code: 8099 Health and allied services, not elsewhere classified
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 301648862
Full Text: All tamariki should have free access to culturally appropriate health services; greater emphasis should also be put on preventative health care, rather than health targets. These were the principle messages given by NZNO kaiwhakahaere Kerri Nuku at the Maori Affairs Select Committee oral hearing at Parliament last month on the inquiry into the determinants of well-being for Maori children.

"Rather than focusing on the vulnerable, the victims, we should focus much more attention on the structures and processes that maintain power and privilege for some, and marginalisation and deprivation for others," Nuku said.

Structural barriers that nurses saw in their everyday practice included inequalities in access to specialist appointments for rural communities and working families unable to take time off work to attend clinics.

Nuku referred to research showing Maori used nursing consultations 1.68 times more than non-Maori. (1) "Nurse-led clinics have positive outcomes because they focus on health outcomes, rather than health outputs. This approach must be extended."

Nuku acknowledged the commitment from government to extend 24-hour, seven-days-a-week free services for tamariki, but called for this to go further, eg allowing free access services for tamariki up to the age of 18, due to teenagers being a high risk population, with statistics reflecting increased suicide rates, mental health issues, teenage pregnancies, sexually transmitted infections and non-accidental incidents in this age group.

She applauded moves to have nurses working in low-decile schools, but said this could go further to include a nurse in every school.

She strongly supported mandatory bicultural training for all health professionals and said having cultural competencies available online was a good start. "However, they need to be made compulsory and part of annual practising reviews. Our tamariki deserve the right to be assessed clinically and culturally by a skilled health workforce," she said.

Speaking to the Select Committee on behalf of the Human Rights Commission, Race Relations Commissioner Joris de Bres said many Maori children were being denied their basic human rights because of poverty and inadequate public services. More than 250,000 Maori children were in New Zealand today, with a third of them living in poverty and hardship.


(1) Mills, C., Reid, P. & Vaithianathan, R. (2012) The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study. BMC Public Health; 12, pp384.
Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.

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