He Korowai Oranga - Māori Health Strategy

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Date of Publication: November 2002 It is also available as a PDF file to download or print.
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Implementing He Korowai Oranga

Implementing He Korowai Oranga is the responsibility of the whole of the health and disability sector. It also has implications for other sectors as well. DHBs in particular are required to take He Korowai Oranga into account in their planning and in meeting their statutory objectives and functions for Māori health. The strategy will also assist Māori providers and communities, and other providers when planning for their own strategic development.

The following diagram shows how He Korowai Oranga fits into the overall planning, service delivery and monitoring cycle for the health sector.



Roles and Responsibilities


He Korowai Oranga and the Ministry of Health

The Ministry of Health will continue to develop, in collaboration with the sector and Māori health organisations:

• measures for assessing progress towards improved whanau ora

• specific performance expectations and national standards to ensure a consistent approach across DHBs

• frameworks for monitoring and analysing DHB performance and outcomes at a national and regional level

• ways to improve the collection and accuracy of Māori health data.

In consultation with DHBs and Māori health organisations, the Ministry will select aspects of the strategy implementation and service delivery to formally evaluate how well they are being implemented and their impact on Māori health.

The information from the DHB monitoring and service evaluation, along with international evidence on effective indigenous health strategies, will be made available to Māori communities, and will inform the Ministry’s policy advice to the Government on further development of the strategy.

The Ministry will also continue to have a role in facilitating relationships between iwi and Māori and DHBs and providing leadership to the sector.

Finally, the Ministry of Health will continue to fund some services at the national level (for example, some public health services, some disability support services and some high-cost, low-volume surgical and medical services) in the short term until DHBs have the capacity to do so. These services will also be expected to help implement He Korowai Oranga.

The Ministry of Health is developing internal policies for increasing its own organisational capability and capacity for delivering these functions effectively. All Ministry directorates have responsibility for progressing Māori health objectives.


The role of DHBs

DHBs will indicate how they will achieve their Māori health objectives and implement He Korowai Oranga in their strategic and annual plans, and will report on progress annually. Their planning documents will be based on a realistic assessment of how much each DHB can contribute to the Government’s goals.

DHBs are expected to direct resources to areas of greatest need. They will be monitored on the processes they adopt and the way they prioritise resources and allocate funding, and the effectiveness of the services they fund or provide for Māori. DHBs will be assessed on how they:

• work with iwi and Māori communities to develop and implement effective strategies for whanau ora improvement and Māori provider and workforce development

• prioritise and allocate resources (their processes should continue to reflect a shift and/or augmentation of resources into the areas that will best achieve the objectives in this strategy, and clearly identify the resources allocated to whanau health gain)

• work with providers – both Māori and mainstream – to improve their capacity and effectiveness with regard to Māori health; this will include specific performance expectations in service agreements and systems to effectively monitor providers’ performance against those expectations

• ensure they have the necessary information and ethnicity data to effectively plan for and monitor improved Māori health outcomes

• evaluate service effectiveness for whanau and use that evidence to continually improve services available to whanau and to reduce access barriers.

DHBs will be monitored over time on their investment in Māori health and Māori provider development. This information will be benchmarked for each DHB and against original baseline data.

It is expected that information on Māori and whanau utilisation of services, Māori health gain in the priority areas and the types of services delivered will improve over time.


The role of providers – Māori and mainstream

As the organisations closest to whanau and Māori communities, providers – both Māori and mainstream – have a critical role in implementing He Korowai Oranga.

Providers need to:

• develop effective relationships with whanau, hapu, iwi and Māori communities

• work collaboratively with other providers to reduce access barriers and ensure whanau receive the services they need

• increase their own capacity and capability to provide appropriate and effective services for Māori

• improve their collection of ethnicity data

• collect and report information on clinical outcomes for Māori, how well their services are reaching Māori and whanau health status.

• assess the appropriateness and competency of their services.

Monitoring and evaluation procedures must reflect the realities of the providers concerned. For example, most providers have set up in the past 10 years, whereas others are relatively new. The expectations as to what each provider should be expected to achieve must be realistic.


Role of other government sectors

The government expects other government sectors to work with the health and disability sectors to identify common goals and initiatives that reduce Māori inequalities.



Putting the strategy into action

Whakatataka outlines the actions that will be taken to implement He Korowai Oranga. Whakatataka includes a detailed set of actions for DHBs and others in the health and disability sector. The plan will be regularly updated as progress is made on particular areas.

The Ministry of Health will evaluate the implementation of He Korowai Oranga and use this evaluative information to improve performance.

As well as Whakatataka, some service areas have their own specific action plans or frameworks for Māori, including the:

• Māori Mental Health Strategic Framework

• Māori Disability Action Plan (due end of 2002)

• Māori Public Health Action Plan (due end of 2002).

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