Healthy Families NZ
Grant Pollard
Ministry of Health
New Zealand
November 2014
Outline
• The journey to date
• Overview of Healthy Families NZ model
• Update on where we are at in establishing
Healthy Families NZ
Overweight and obesity
31% of NZers are obese and a further 34% are overweight
11% children (12-14 years) are obese
Total of 1.2 million obese New Zealanders
2/3 Pacific adults and almost half Maori adults are obese
29% of European /Other adults are obese
Adult obesity rate has tripled since 1970s (from 10% in 1977 to
30% in 2011-13)
 Obesity strongly positively associated with deprivation –even
after adjusting for age, sex and ethnicity
 Dietary risk factors have now overtaken tobacco as the leading
cause of heath loss in NZ (11.4% vs 9.1%)
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Timeline
November 2013 – Cabinet paper commissioned & approved
March 2014 – Registration of Interest to identify lead
providers released – Healthy Together Victoria managers
delivered workshops on systems approach
July 2014 – Short-listed organisations invited to develop
detailed response to request for proposal
September 2014 – First contract with lead providers signed
November 2014 – Last contract with lead providers signed
Aims to improve people’s health where they live, learn,
work and play by taking a dynamic systems approach to
prevention
About encouraging families to live healthy lives – by
making good food choices, being physically active,
sustaining a healthy weight, being smoke-free and
moderating alcohol consumption
The Healthy Families NZ Model
Key elements of each Healthy Families Community
Lead provider as ‘backbone organisation’
Dedicated health promotion workforce (x 4 FTE min) that
works across the community to create sustainable change
Establishment of local Prevention Partnership - bringing
together a partnership of key stakeholders
Establishment of local governance arrangements
Explicit focus on engaging settings to become health
promoting environments – including schools, ECEs,
workplaces, and other community settings
Whole of system working
Traditional health promotion
Whole of systems approach
Projects
System networks and activation
Planning
Implementation and improvement
Expert leads
Communities lead
Technical leadership
Adaptive leadership
Knowledge transfer and
translation
Knowledge co-creation
Meetings
Training
‘Everyone in the room’ sessions
Networks of practice
Prevention planning and
delivery sub system
Causative/contributing
sub systems
Settings (focus of interventions)
sub systems
National
STATEWIDE
Food System
Alcohol System
REGIONAL
LOCAL
COMPLEX INTERORGANISATIONAL RELATIONS
SCHOOLS
WORKPLACES
Planning System
COMMUNITIES
Tobacco System
Transport System
Networks of communication &
influence within and between
settings
Local government: part of delivery system, a setting for change and a system in own right
Media System
10 Healthy Families NZ communities
• Far North District
• East Cape
• Waitakere Ward
• Whanganui District
• Manukau Ward
• Lower Hutt City
• Manurewa-Papakura Ward
• Spreydon-Heathcote
Ward
• Rotorua District
• Invercargill City
Procurement process to select providers that are:
•
Embedded in their community with an excellent understanding of local
needs, strengths, networks and infrastructure
•
Well placed to lead a systems approach to prevention in the community
selected
•
Perceived by the community as credible and supported as lead provider by
key stakeholders
•
Strong relationships with key stakeholders who could have a role in making
Healthy Families NZ successful
•
Demonstrated an ability to work strategically, collaboratively, and to work
across sectors and settings
•
Linked into key initiatives underway in the community (for example, Social
Sector Trials, Whānau Ora, Children’s Action Plan, and other initiatives
related to Better Public Services)
10 Healthy Families lead providers
Far North District – Te Runanga o Te Rarawa
Waitakere Ward – Sport Waitakere
Manukau Ward – (Auckland Council in partnership with Alliance
Health Plus and Ngā Manawhenua o Tāmaki Makaurau)
Manurewa-Papakura Ward – (Auckland Council in partnership
with Alliance Health Plus and Ngā Manawhenua o Tāmaki Makaurau)
Rotorua District – Te Arawa Whānau Ora & Kowhai Health Associates
East Cape – Horouta Whanaunga (Hauiti Hauora)
Whanganui District – Te Oranganui
Lower Hutt City – Hutt City Council
Spreydon-Heathcote Ward – Pacific Trust Canterbury
Invercargill City – Sport Southland
Healthy Families NZ Principles
1. Implementation at Scale
Strategies are delivered at a scale that impacts the
health and wellbeing of large number of the population
in the places where they spend their time – in schools,
workplaces and communities
Healthy Families NZ Principles
2. Collaboration for Collective Impact
Long term commitment is required by multiple partners,
from different sectors, at multiple levels, to generate
greater collective impact on the health of all New Zealanders
Knowledge is co-created and interventions co-produced,
supported by a shared measurement system, mutually
reinforcing activities, ongoing communication and a
“backbone” support organisation
Healthy Families NZ Principles
3. Adaptation
Strengthening the prevention system requires constant
reflection, learning and adaption to ensure strategies are
timely, relevant and sustainable
Healthy Families NZ Principles
4. Experimentation
Small scale experiments provide insight into the most
effective interventions to address chronic disease
These experiments are underpinned by evidence and
experience, monitored and designed to be amplified across
the system if they prove effective
Healthy Families NZ Principles
5. Leadership
Leadership is supported at all levels of the prevention effort
including senior managers, elected officials, and health
champions in our schools, businesses, workplaces, sporting
clubs and other settings in the community
Healthy Families NZ Principles
6. Equity
Health equity is the attainment of the highest level of health for
all people.
Healthy Families NZ will have an explicit focus on improving
Māori health and reducing inequalities for groups at
increased risk of chronic diseases
Māori participation at all levels of the planning and
implementation of Healthy Families NZ community is
critical
Where we are at
Supporting communities in establishment phase
• Participation in recruitment process
• Guidance and support around governance arrangements
Developing evaluation and monitoring framework
Establishing the Ministry’s Healthy Families NZ team (4 FTE)
Establishment of national networks
Where we are at
Development of national level support structures
• Working through licencing arrangements with
Victorian Department of Health
• Finalising agreement with Health Promotion Agency
to lead adaptation of Healthy Together Victoria’s
Achievement Program for NZ context
• Orientation process and ongoing workforce
development approach to support systems thinking,
leadership for prevention, evaluation capacity
building
Challenges and opportunities
• Competitive procurement process and implications for
building collaboration
• Speed of Cabinet paper development, procurement
process, and getting contracts in place
• Challenges around getting baseline measures
• New Minister – high interest in childhood obesity, also
Minister for Sport and Recreation
• Sir Peter Gluckman as co-chair of the WHO Commission on
ending Childhood Obesity – provisional report due December
Questions?