Grant PollardMinistry of HealthNew ZealandNovember 2014

Healthy Families NZ

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%)

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

Planning

Expert leads

Technical leadership

Knowledge transfer and translation

Meetings

Training

System networks and activation

Implementation and improvement

Communities lead

Adaptive leadership

Knowledge co-creation

‘Everyone in the room’ sessions

Networks of practice

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Prevention planning and delivery sub system

SCHOOLS

WORKPLACES

COMMUNITIES

Settings (focus of interventions) sub systems

Causative/contributing sub systems

Food System

Planning System

Alcohol System

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

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National

10 Healthy Families NZ communities

• Far North District

• Waitakere Ward

• Manukau Ward

• Manurewa-Papakura Ward

• Rotorua District

• East Cape

• Whanganui District

• Lower Hutt City

• Spreydon-Heathcote Ward

• 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 RarawaWaitakere Ward – Sport WaitakereManukau 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 AssociatesEast Cape – Horouta Whanaunga (Hauiti Hauora)Whanganui District – Te OranganuiLower Hutt City – Hutt City CouncilSpreydon-Heathcote Ward – Pacific Trust CanterburyInvercargill 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

Questions?