Healing Our Spirit Worldwide, the Seventh Gathering will provide the forum to:

• Share initiatives, programmes and solutions
• Connect and learn from other each other as indigenous people
• Share strengths, hope and wisdom
• Celebrate and express cultural practices, keeping alive the cultural and spiritual foundation of indigenous people.

To find out more about this event, go to:  http://hosw.com/

Fifty-eight studies were included, which addressed a wide array of health outcomes and risk behaviors. The review examined the effects of four types of strategies or interventions: community system-level change strategies; broad health and social care system-level strategies; interventions using lay community health outreach workers or group-based health education led by professional staff; and group-based health education.

The authors found that "... interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems". However, they go on to say that "... because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects".

This article is available to read in free full text at:  http://dx.doi.org/10.1002/14651858.CD009905.pub2

Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner-Brown J, Krause LK. (2015). Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database of Systematic Reviews, 6, CD009905.

In the latest issue (attached below):

WHO presents World Health Statistics 2015 as an integral part of its ongoing efforts to provide enhanced access to comparable high-quality statistics on core measures of population health and national health systems.

To download the report, go to:  http://www.who.int/gho/publications/world_health_statistics/2015/en/

Studies in this issue (attached below):

In the latest issue (attached below):

• how the Atlas of Healthcare Variation can be used to identify areas of wide variation
• the results from the opioid domain
• potential areas for quality improvement in community and secondary care use of opioids.

To listen to the recording, go to:  http://www.open.hqsc.govt.nz/medication/publications-and-resources/publication/2059/

The key themes are: equity of access to care; timeliness, person-centredness and safety; efficiency of care; effectiveness of care.

The overview is available to read in free full text at:  http://www.health.org.uk/publications/how-does-the-nhs-compare-with-health-systems-in-other-countries/

The creation of a new document ‘Kia purea ai koe – Māori Wellbeing in MidCentral DHB’, seeks to provide health and social sector staff with a greater understanding of the strengths, resources and qualities of Māori in the district.

Developed by MidCentral DHB’s Clinical Network Programme, working with the Central PHO’s Māori Health Team, the document provides greater knowledge around Māori wellbeing. It is hoped that better informing health and social sector staff will result in a stronger appreciation of Māori and the Māori way of being, and have a flow-on effect of helping to address health equity concerns.

Chairman of Manawhenua Hauora, the Iwi consortium that works in partnership with MDHB, Richard Orzecki is glad to have this information released to the health and social sectors.

He said: “This type of information is very important to furthering the health of Māori in the MidCentral district. What ‘Kia purea ai koe’ will do is provide insights for health and social sector workers in our area, and help give them a better understanding of the Māori way of being.”

Central PHO’s Director of Māori Health Materoa Mar believes that it shines a more positive light on Māori health.

She said: “Much of what we hear in relation to Māori health is often solely focused on a deficit and issues-based approach, and it is true that these challenges exist. However, it’s good to step back and take a look at what strengths and potential the Maori culture can provide to all. Research shows that a strong cultural foundation is a big part of wellbeing, and in this document we bring together information on how culture can be used to inform health.”

The information contained within the document isn’t necessarily new, but it is having it compiled in one place that makes it a great source for health and social sector workers. It covers diverse topics, including the history of Iwi in the district, culture, demographics, education and, of course, models of health for Māori.

MDHB Project Officer, Clinical Networks Katherine Gibbs was another who helped put the document together, and recognises the importance of having a consolidated source of information.

She said: “Working with our district groups that form the Clinical Network programme, it became apparent that a resource like this one would be invaluable. The information is out there, but bringing all the information together like this makes it easier for the hard-working people who form these groups to have a chance to learn more about Māori culture. We have also created a pre and post quiz so individuals and groups will be able to assess for themselves how much they have learned in reading the document.”

A read-only electronic copy of the document will be made available on the MDHB and Central PHO websites. For a hard copy call the Central PHO on (06) 354 9107.

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1007/s11892-014-0574-1 or contact your DHB library, or organisational or local library for assistance.

Barnard, L.S., et al. (2015). Material need support interventions for diabetes prevention and control: A systematic review. Current Diabetes Reports, 15:2.

Rural patients in southern New Zealand are much less likely to receive computed tomography (CT) scans than their city-dwelling counterparts, according to University of Otago research that is the first to compare such scanning rates.

In a study recently appearing in the international journal Health Policy, Dr Garry Nixon and colleagues show that urban patients in Otago-Southland were 1.6 times more likely to access CT services than those living in these regions’ remote rural hospital catchment areas.

Adjusted for age, the team found that the overall CT scanning rate for patients in urban areas (Dunedin, Invercargill) was 63% higher than the rate for those served by remote rural hospitals (Queenstown and Dunstan) and 14% higher than the rate for rural hospitals (Balclutha, Gore, Oamaru and Western Southland).

Overall, the researchers found scanning rates of between 19.9 and 45.6 per 1000 population per year in the two time periods studied (2007/2008 and 2010) which they indicate is low by international standards.

While scanning rates had increased since 2007/2008, in 2010 patients living in the rural hospital catchments, except Balclutha, still had statistically significant lower CT scan rates than those in urban base hospital catchments to which they normally refer patients.

The rate for the Dunedin base hospital catchment was 1.5, 1.4 and 1.1 times that of Dunstan, Oamaru and Balclutha rural hospital catchments respectively, while the rate for the Invercargill catchment was 1.8, 1.2 and 1.4 times that of the Queenstown, Gore and Western Southland catchments.

Dr Nixon and his colleagues went on to examine the extent to which the introduction of a new scanner improved access to CT scanning at Oamaru Hospital which, in 2008, became the second rural hospital in New Zealand to install a CT scanner.

Their findings indicate the scanning rate for Oamaru residents almost doubled after the local scanner was installed. By 2010, the community had the highest scanning rate in the region, 1.2 times that of Dunedin. However, the researchers point out this higher rate was not sustained and by 2011 and 2012, rates were on par with those in Dunedin.

“The sharp rise in scanning rates and then levelling off suggest that the high rates seen in the first two years were the result of pent up demand and not an indication of long-term overservicing,” says Dr Nixon.

An analysis of the scanning rates in Oamaru was recently published in The Australian Journal of Rural Health.

Any impact the rural-urban CT scan disparities may have on healthcare outcomes is unclear and requires investigating, as does the extent to which increasing local services can improve health care outcomes, according to Dr Nixon.

“The situation in Oamaru would indicate that it is possible for rural communities to overcome the disparity in utilisation rates we observed in our initial study.”

“Further research is needed to find out whether these rural urban disparities are present in other specialist services and regions and if they are, what impact they have on healthcare outcomes for rural patients.”

In the latest issue (attached below):

"Statistically significant improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, improvements in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous Queenslanders".

The authors discuss the implications of these findings.

This article can be read in free full text at:  http://dx.doi.org/10.5694/mja14.00575

Ski, C.F., et al. (2015). Improving access and equity in reducing cardiovascular risk: The Queensland Health model. Medical Journal of Australia, 202(3), 148-152.

The online Foundation Course in Cultural Competency is now available free of charge at Learn Online (www.learnonline.health.nz) – the course supports you to build your understanding of cultural competency and health literacy in New Zealand, with a focus on improving Māori health outcomes.

The multimedia, interactive course is a voluntary programme and is spread across four modules and is available for all people working in the health sector. Each training module is supported by videos, video transcripts, additional reading resources and library references.

Cultural competence training assists health workers to provide a more accessible and welcoming service and has been identified as a key skill to ensure health workers are more consistently able to provide patients and their whānau with health information in a way they can understand.

The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations.

This is an open access article and can be read in free full text at:  http://dx.doi.org/10.1093/ckj/sfu124

Garcia-Garcia, G., et al. (2015). Chronic kidney disease (CKD) in disadvantaged populations. Clinical Kidney Journal, 8 (1): 3-6

Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations.

In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.

To read the report in full text, go to: http://www.commonwealthfund.org/publications/fund-reports/2015/jan/international-profiles-2014

This review article is open access and available to read in free full text at: http://dx.doi.org/10.1111/jpc.12804

Duke, T., Kado, J. H., Auto, J., Amini, J. and Gilbert, K. (2015). Closing the gaps in child health in the Pacific: An achievable goal in the next 20 years. Journal of Paediatrics and Child Health, 51: 54–60. 

Voluntary Bonding Scheme registrations are opening 2 Feb – read more at http://www.health.govt.nz/our-work/health-workforce/voluntary-bonding-scheme …

The purpose of the Atlas is to stimulate questions and debate about why there is variation. The debate may then lead to improvements in our health care services.

The Atlas displays information in easy-to-use maps, graphs and tables and is organised into ‘domains’, which cover specific clinical areas: asthma, demography, diabetes, cardiovascular disease, maternity, mental health, opoids, polypharmacy in older people, surgical procedures, trauma, Well Child/Tamariki Ora.

The Atlas is available at: http://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/

For more information on the Atlas, go to: http://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/news-and-events/news/494/

In the latest issue (attached below):

Ngā Kanohi Kitea Full Project Grant: Up to $200,000 is available over eighteen months. These grants are designed to investigate a well defined research question.

For all the details about this grant, go to:  http://www.hrc.govt.nz/funding-opportunities/maori-development#ngā-kanohi-kitea

Dr Jean Simpson, the Director of the University of Otago based NZ Child & Youth Epidemiology Service, which prepared the Technical Report for the Child Poverty Monitor, says while the reduction from 27% to 24% of children in households in income poverty is in the right direction, New Zealand still has one in four of its children aged 0—17 years living in income poverty.

"There is plenty of research that shows that living in poverty can be bad for children’s health. We know that poor health can affect a child’s ability educationally and socially, and there are also long term health consequences that will have implications for the Health budget." Dr Simpson says it is also good to see figures such as infant mortality continuing to fall, but that only gives part of the picture.

To read the full media release from the University of Otago, go to:  http://www.scoop.co.nz/stories/GE1412/S00012/health-issues-highlighted-in-child-poverty-monitor.htm

Sixty-one studies were included. "Most interventions focused on the individual level and the modification of patients' health behavior. Very few addressed the sociopolitical level. A minority of the studies acknowledged the role of socioeconomic deprivation in ethnic health inequalities. Half of the studies contained no information about the socioeconomic status of the patients. The patients receiving the interventions were socioeconomically deprived. Only 10 studies compared ethnic minority groups to majority groups ... Overall, CC interventions addressing T2DM are not congruent with the reduction of ethnic health inequalities". The authors discuss the imlications of these findings. 

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1080/13557858.2013.857763 or contact your DHB library, or organisational or local library for assistance.

Dauvrin, M. & Lorant, V. (2014). Culturally competent interventions in Type 2 diabetes mellitus management: An equity-oriented literature review. Ethnicity & Health, 19(6), 579-600.

The Health Research Council of New Zealand (HRC) has today announced more than $2.2 million in funding for Māori health researchers as part of its career development awards programme – up from $1.5 million last year.

The Māori health research career development awards for 2015 include four postdoctoral fellowships, six PhD scholarships, four masters scholarships, two Rangahau Hauora training awards, and four summer studentships. The successful projects form part of $6.25 million in total funding for the HRC’s career development awards to support the education, training and retention of those engaged in health research.

Emerging Māori biomedical researcher Dr Kimora Henare (Te Aupouri, Te Rarawa) from the University of Auckland has received a Māori Health Research Postdoctoral Fellowship to develop novel treatments for cancer by harnessing the natural abilities of immune cells to kill cancer cells.

In New Zealand the cancer burden is disproportionately greater for Māori, particularly for the most lethal cancers (i.e. lung, breast, prostate, stomach, and pancreas). Dr Henare’s research project will target macrophages, multi-functional immune cells that have been implicated in tumour growth and development – and which are also potential targets for effective treatment.

Ms Kelly Tikao (Waitaha, Kāti Māmoe, Kāi Tahu) from the University of Otago will use her Māori Health Research PhD Scholarship to explore the rituals associated with traditional Māori birthing practices and their application to birthing plans today. Ms Tikao explored this topic for her Masters in Science Communication, producing a film (Iho – a cord between two worlds) on Māori birthing rituals, practices, and tribal and hapū variations. She hopes her PhD research will help Māori communities to “reclaim and rebuild this area of knowledge that has been forgotten by some hapū, remembered but not practiced by others, and to support whānau Māori who still incorporate some tikanga into their birthing experience”.

In 2013, Nicola Grace from Victoria University of Wellington and Hiria McRae developed a whānau-led weight loss and lifestyle change model named ‘Hauroa Homies’ to support whānau to reduce obesity long term by participating in a ‘challenge’. Now Miss Grace has been awarded a HRC Māori Health Research Masters Scholarship to evaluate this model.

“Having faced long-term health challenges personally, my passion is to support the physical health and fitness of whānau. This evaluation will deepen an understanding of how kaupapa Māori models are reducing obesity, increasing fitness, improving healthy eating, and strengthening whānau self-sufficiency to maintain these changes,” says Miss Grace.

HRC Board Chair Sir Robert Stewart, KNZM, says these awards contribute to improving health equity by investing in promising Māori health researchers who are best placed to identify and resolve health issues in their communities.

“Māori health research graduates are in great demand across a number of sectors. We’re pleased to be able to support this talented pool of researchers as they seek to address the health needs and aspirations of Māori.”

See below for a list of all the HRC career development award recipients (Māori health research category), or go to our funding recipients page.

2015 HRC career development awards  (Māori health research category)

Māori Health Research Postdoctoral Fellowships

Dr Meihana Durie, Te Wānanga o Raukawa
The Hohua Tutengaehe Postdoctoral Fellowship
Te papa o te ora
36 months, $421,600

Dr Kimiora Henare, The University of Auckland
The Eru Pōmare Postdoctoral Fellowship
Teaching immune cells old tricks: An innovative strategy for treating cancer
48 months, $388,172

Dr Huhana Hickey, AUT University
Māori Health Research Postdoctoral Fellowship
The health and disability experiences of whānau haua
36 months, $376,365

Dr Jennifer Reid, The University of Auckland
Māori Health Research Postdoctoral Fellowship
A kaupapa Māori feasibility study to improve type 2 diabetes in Whangaroa
36 months, $340,520

Māori Health Research PhD Scholarships

Mr Paul Davis, AUT University
Paramedic systems of care for ST-elevation myocardial infarction patients
36 months, $111,835

Ms Anna Fay, The University of Auckland
Towards medical education that addresses Indigenous rights to health
36 months, $59,777

Ms Tania Huria, University of Otago, Christchurch
‘Created equal’: Investigating health system perspectives of disparities
39 months, $74,616

Ms Christina McKerchar, University of Otago, Wellington
Food availability for Māori children: A rights based approach
48 months, $120,750

Ms Kelly Tikao, University of Otago, Dunedin
Iho – a cord between two worlds. Traditional Māori birthing practices
36 months, $106,750

Ms Erena Wikaire, The University of Auckland
Māori participation in traditional Māori health practices
36 months, $109,309

Māori Health Research Masters Scholarships

Ms Margaret Cheung, Te Whare Wānanga o Awanuiārangi
The Korimako practice-led Māori social work model of theory and praxis
12 months, $17,797

Miss Nicola Grace, Victoria University of Wellington
An evaluation of a Māori health weight loss and lifestyle change model
12 months, $18,734

Mr Mahonri Owen, University of Waikato

Development of a brain controlled prosthetic
12 months, $18,600

Miss Jordan Pearse, The University of Auckland
Micro-aggressions and Māori
12 months, $20,600

Māori Health Research Summer Studentships

Miss Christina Gordon, University of Otago
Changes in neural control of the heart following a heart attack
$5,000

Miss Kennedy Sarich, Independent
Burden of MRSA on Far North communities
$5,000

Ms Moerangi Tamati, Te Pou Tiringa Incoporated
A life-course approach to health and wellbeing
$5,000

Ms Te Kahui Tapsell, University of Otago, Wellington
Analysis of 20 cases of severe acute maternal morbidity in Aotearoa
$5,000

Māori Health Research Rangahau Hauora Training Award

Ms Lisa Kelly, Independent
Te ha ora: Exploring the effectiveness of kaupapa Māori antenatal education
$12,000

Reverend Bettina Maxwell, Independent
Te puna roimata te oranga whānau
$12,000

They reviewed the literature to explore whether CHWs are also effective in improving the health and the delivery of health care services to ethnic minority older adults in Western countries.

Seven studies were included. The effectiveness of the implementation of CHW programmes in older adults belonging to ethnic minorities is not univocal. In two studies, the authors found no significant differences. In five studies, they found some positive effects. They did not find negative effects in any of the studies.

For better interpretation of the results, effect ratios (ERs) were calculated as the number of positive findings divided by the total number of measured findings. Substantial effects on the access to care and on health behaviour were found. The mean ER for health outcomes was considerably lower.

The authors conclude that there are indications that CHWs serve as a means of improving health care use and health behaviour and, to a lesser extent, health outcomes among ethnic minority older adults. Further research is required to draw more solid conclusions on the effectiveness of CHW interventions in this target group. 

This is an open access article and can be downloaded and read in full free text at:  http://dx.doi.org/10.1186/s12913-014-0497-1

Verhagen, I., et al. (2014). Community health worker interventions to improve access to health care services for older adults from ethnic minorities: A systematic review. BMC Health Services Research, 14:497.

• Health economics related to cancer
• Drug development, including cost and regulatory issues
• Drug and lifestyle mediated prevention of cancer
• The management of cancer in low, middle and high income countries
• Inequalities in cancer care
• Priorities for cancer policy development
• Cancer systems and organisation of care, research and education
• Social determinants of cancer
• Political economy of cancer
• The role of patient advocacy groups in cancer policy

In the latest issue (attached below):

Health care use varies widely across countries but can also vary as much or more within countries. Governments should do more to improve their health systems to prevent unnecessary interventions and ensure that everyone has the same access to quality healthcare, wherever they live, according to a new OECD report. 

Geographic Variations in Health Care analyses the geographic variations across a range of high-volume and high-cost health care activities, such as heart bypass or knee replacement operations.

Some of the variations observed in the 13 OECD countries* are unwarranted, says the report, and ought to be tackled so that high-quality health systems deliver the care patients need.

The number of patients admitted to a hospital for a reason other than surgery, for example, is twice as high in Australia, Germany and Israel than in Canada, Portugal and Spain. Admission rates also vary widely within countries: in some parts of Australia, Canada, England, Finland, Italy or Portugal, a patient is two to three times more likely to be admitted to hospital than in other parts of those countries.

A patient is also three times more likely to undergo cardiac revascularisation procedures in Germany and Israel than in countries with the lowest levels of intervention. In most countries, these procedures have the highest level of variation across geographical areas. Knee replacement rates vary by more than five-fold within Canada, Portugal and Spain, and by two-to three-fold across geographic areas in most OECD countries.

Caesarean section rates are on the rise. The probability to give birth by C-section is 50% higher in Italy, Portugal, Australia, Switzerland and Germany than in the other participating countries. C-section rates vary little within countries, except in Italy where they vary by six-fold across provinces.

To tackle unwarranted variations in health care use, governments should put in place:

• Public reporting and target setting. Canada, the Netherlands, Spain, and the United Kingdom have public reporting on health care utilisation by geographic area. Italy sets regional targets to encourage more appropriate use of caesarean sections, and Belgium sets targets for reducing exposure to radiation from imaging tests.

• Policies targeting providers. Providers receive feedbackon utilisation ofcardiac care in Ontario (Canada) and caesarean sections in Belgium. Spain has a monitoring system to support compliance with clinical guidelines for C-sections and financial incentives show some promise in England, France and Korea.

• Patient centred approaches. Tools to support shared patient doctor decision-making are used in the United States and the United Kingdom. Patient outcome measurement after surgical procedures is used in Sweden and the United Kingdom to indicate to what extent patients have benefitted from the intervention or not.

The report's main findings will be presented at a joint conference held by the OECD and the Bertelsmann Foundation on 16^thSeptember 2014 in Berlin (www.faktencheck-gesundheit.de).

For more information including detailed country notes, see: http://www.oecd.org/health/health-systems/medical-practice-variations.htm

A study investigating what has changed for sexual minority youth in New Zealand shows that they are important, vibrant and generous members of our communities.

Sexual minority youth are young people attracted to others of the same sex or both sexes and those not sure of their sexual attractions.

Key findings in the University of Auckland research also highlighted that a greater proportion of students were ‘out’ in relation to their sexuality in 2012 (i.e. 53.1 percent had told someone close to them about their sexuality in 2012 compared to 31.3 percent in 2001).

Researchers also found that sexual minority youth were more likely to work as volunteers than exclusively opposite-sex attracted students and that the majority of sexual minority youth reported good general health.

The results were drawn from the nationally representative New Zealand Adolescent Health Surveys conducted by the Adolescent Health Research Group in 2001, 2007 and 2012 of more than 25,000 young people.

About six out of every 100 students reported in the survey that they were attracted to people of the same sex, both sexes, or that they were not sure of their sexual attractions in each survey year.

The study also showed that there has been no progress between 2001 and 2012 in relation to reducing bullying, depression and suicide attempts for sexual minority youth.  

“Sexual minority youth are important, vibrant and generous members of our communities,” says study lead author, Dr Mathijs Lucassen.  “Everyone can help address the worrying health and well-being disparities experienced by sexual minority youth.  We all need to create environments that eliminate bullying and mistreatment towards sexual minority people as well as gender diverse individuals.”

The study was published by the Journal of Paediatrics and Child Health (a journal of the Royal Australasian College of Physicians).

For a PDF of the full academic paper please contact Suzi Philips 

Chair of the Alliance and Deputy-Director Funding, Auckland and Waitemata DHBs, Tim Wood says the signing of the Auckland-Waitemata Health Alliance agreement Wednesday 10 September was a significant event for all involved.

“But particularly, patients enrolled with the PHOs. We believe they will be experiencing the difference in the very near future.”

“In addition, this is a significant strengthening of the relationships between Mana Whenua, Mataawaka, Primary Health Organisations (PHOs) and the Auckland and Waitemata District Health Boards.”

“The alliance provides the opportunity to improve the health and well-being of the people within the two health districts,” Mr Wood says.

Mr Wood said members of the alliance are determined to develop a more cohesive, accessible, efficient, effective, safe, and sustainable health system for these communities. It plans to do so by:

• creating the conditions for patient and whanau-determined care through the locality approach and so empower individuals to make informed decisions about their healthcare
• increase integration of community, primary-care, secondary-care health services and social services through locality development and a whole-of-system approach for our future health system.
• building capability and capacity across the sector by increasing the scope of primary care
• supporting, where appropriate, infrastructure development within primary care 
• reducing health inequalities through a reorientation of the sector so that individuals and communities are supported to improve their own lives
• supporting clinical governance through engagement with clinicians and design of services and change processes that enable the achievement of desired outcomes
• driving performance through quality improvement, transparent reporting and effective mechanisms for public accountability from the alliance.

Mobile health services are not the hoped for silver bullet to improved disease prevention and control in the Pacific, according to researcher, Elaine Umali.

Although promising and with potential, Elaine doesn’t believe they are a substitute for improvements in the health system, especially in low-resourced settings.

The University of Auckland, Master of Public Health graduate has investigated the potential use of mobile phones as a health tool for disease prevention and control in the Pacific.

Her research was supported by a Fred Hollows Foundation NZ scholarship.

Elaine is now writing her formal paper, but warns mHealth (mobile health services) is not the hoped for silver bullet.

 “If core health infrastructures are defective or lacking, investments in mHealth can’t be used to replace actual investments to improve health services,” she says.

Philippine born and educated, Elaine took up Global Health papers in the University’s School of Population Health, as course requirements for postgraduate studies in public health, under co-ordinator Dr Judith McCool.

 “I wanted to look at how mobile phones could be used in health, because they present a critical opportunity among low and middle income countries to improve and increase access to health care,” she says.

“The rapid spread of mobile technology across the globe is making the medium very attractive in the development sector,” says Elaine. “And in the Pacific, there’s been a huge leap in the number of people with access to a mobile phone, providing a way for Pacific Islanders to change how they communicate, govern and implement activities.

“Looking at how mobile phones can be used for health in the region is something timely and useful,” she says.

During her research Elaine undertook an analysis of key stakeholder perspectives on establishing mobile phone services in the Pacific region to support the prevention of trachoma by conducting interviews with key NGO and government representatives and mHealth experts across the Pacific, Asia, Africa and the United States.

She hopes the outcomes can be a useful tool to start debate around the use of mHealth in the region and enhancing local health systems. 

Before moving with her family to New Zealand five years ago, Elaine worked for a variety of internationally funded development programmes, spending more than five years in tuberculosis programmes in the Philippines as well as environmental governance projects, and hygiene and sanitation initiatives.

She retains a passion for development work and views this research as another step in advancing health care development in the Pacific.

Since 2012, the Fred Hollows Foundation NZ has funded research scholarships to support Master of Public Health students in the School of Population Health’s Global Health group. Students work in partnership with the Foundation and its Pacific Eye Institute in Suva.

For further information about these grants, and all the important 2014/2015 dates for Ngā Kanohi Kitea grants, go to: http://www.hrc.govt.nz/funding-opportunities/maori-development#ng%E2-kanohi-kitea

Presentations from the conference are available to view (where permission as been granted by presenters) at: http://www.immune.org.nz/2013-immunisation-conference

New research shows that Māori diagnosed with stomach cancer are 27% less likely to survive than non-Māori, prompting calls for recently-released national stomach cancer standards to prioritise the needs of Māori.

A just-published University of Otago, Wellington study comparing 172 Māori stomach cancer patients with 163 non-Māori patients found Māori patients were younger, more likely to have disease in the lower (distal) part of the stomach, had less access to specialised surgical services, and were less likely to survive once diagnosed.

Lead researcher Virginia Signal says Māori have five times the rate of stomach cancer compared with non-Māori, and the study’s finding about their survival is consistent with previous research.

On average around 390 people in New Zealand develop stomach cancer each year and 276 die of the disease.

The differences in the type of care that Māori stomach cancer patients receive may, at least in part, account for their poorer survival, Signal says.

“Because Māori are more likely to have distal disease, they are more likely to undergo less complex partial gastrectomy. However, they are less likely to have surgery performed by a specialist upper gastrointestinal surgeon and less likely to be treated in a main centre, regardless of where their tumour is sited,” she says.

The higher rate of distal cancer for Māori also suggests differing factors causing the disease than those for non-Māori, Ms Signal says.

Infection with H Pylori – the bacterium that causes chronic inflammation of the inner lining of the stomach (gastritis) – and smoking are two known risk factors for distal stomach cancer. H Pyloriinfection tends to be acquired in childhood, and is associated with overcrowding and deprivation, she says.

“Further research into the risk factors for Māori is needed, but these findings add weight to a continued emphasis on childhood poverty and reducing smoking among Māori, as well as investigating other risk factors for, and treatment of, H Pylori infection, particularly among Māori.”

A further concern highlighted by the study is the higher likelihood of comorbidities among Māori patients, Signal says.

The presence of one or more additional diseases is known to impact on patients’ quality of care and survival rate, she says.

“Comorbidity amplifies the complexity of, and can delay or change, the treatment pathway. These patients require well-coordinated care and services to ensure they have the best possible patient journey.”

While the recent publication of national standards for the provision of services for upper gastrointestinal cancer patients in New Zealand and the introduction of Faster Cancer Treatment times and care coordination are positive developments, Māori must be prioritised in order to address inequities, Signal says.

“The next step for our research will be to talk to key people in the cancer sector about these findings and how to ensure that prioritisation occurs.”

The study is published online in the international peer-reviewed journal Gastric Cancer.