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D E T E R M I N I N G T H E P A T H

Guidelines for Developing

Mäori Health Education Resources

He Tatai i te Ara

03. Code 0005

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M A O R I F O C U S G R O U P

Name Employer/Group RegionAngela Barnes Health Promotion, St. Lukes AucklandHuia Beattie Health Promotion NapierTerryanne Clarke Sexual Health Services AucklandPeter Curry Kaumätua WhangareiRongo Curry Whäia te Hauora WhangareiMarewa Glover He Tohu Consultants Tämaki-makaurauRamari Maipi Raukura Hauora o Tainui HamiltonHiki Pihema Te Tari o te Ora TairäwhitiDonna Richards Health Promotion Manukau City

Focus group hui venue: The chief executive and staff of the Tainui Mäori Co-purchasing Organisation (MAPO),Manukau City, for the use of their facilities and boardroom.

P E E R R E V I E W G R O U P

Name Employer/Group RegionElizabeth Cunningham Southern RHA ÖtepotiLinda Grenell Mäori Women’s Welfare League Area Representative Te WaipounamuTe Miringa Huriwai Hauora Hokianga Hokianga

P R E T E S T I N G C O N T R I B U T O R S : G R O U P 1

Name Employer/Group RegionBarbara Cameron Manawatu Polytechnic Palmerston NorthPuti Fielding Te Whare Rapuora Mäori Health Unit, MidCentral Limited Palmerston NorthLorene Hine Ataarangi Fitzgerald Public Health Services, MidCentral Limited Palmerston NorthCarol Kimberley Whänau Ora Programme with Te Rünanga o Raukawa Palmerston NorthDes Martin Te Whare Rapuora Mäori Health Unit, MidCentral Limited Palmerston NorthMichael Matenga Oranga Hinengaro, MidCentral Limited Palmerston NorthWikitoria Osborne Manawatu Polytechnic Palmerston NorthRei Rawlinson Whänau Ora Programme with Te Rünanga o Raukawa Palmerston NorthFay Selby-Law Whänau Ora Programme with Te Rünanga o Raukawa Palmerston NorthRosie Searanke Te Whare Rapuora Mäori Health Unit, MidCentral Limited Palmerston NorthVanessa Sydney Oranga Hinengaro, MidCentral Limited Palmerston North

P R E T E S T I N G C O N T R I B U T O R S : G R O U P 2

Name Employer/Group RegionKate Cherrington Te Wänanga o Aotearoa Te AwamutuMereaina Eltringham Whaiora Unit, Tokanui Hospital Te AwamutuAmiria Harvey Te Whare o te Ata Fairfield / Chartwell Community House HamiltonRaewyn Hawera Waikato Mäori Asthma Services HamiltonRon McKay Whaiora Unit, Tokanui Hospital Te AwamutuTe Miringa Paerata Ngä Maunga Hei Käkahu Mäori Women’s Refuge Te AwamutuGeraldine Raukawa Ngä Maunga Hei Käkahu Mäori Women’s Refuge Te AwamutuJude Roberts Consultant CambridgeKathy Rush Te Whare o te Ata Fairfield / Chartwell Community House HamiltonGeorge Searanke Tokanui Hospital Te AwamutuAda Te Huia Whaiora Unit, Tokanui Hospital Te AwamutuDan Te Huia Tokanui Hospital Te AwamutuSue Wetere-Bryant Te Karere Mätauranga Mäori Consultancy Te Awamutu

A C K N O W L E D G E M E N T S

Nga MihiHe mäwetö, he mäwatö, he märeikura

He märere whai tënä, i te whai kau i ua

He tü kë, he ta kë

Tuia te rangi e tü nei, tuia te papa e takoto nei

Tuia rätou kua wehe atu ki te pöuriuri ki te pötangotango

He maimai aroha

Tënä koutou, tënä koutou

Tënei te mihi ki a koutou i raro i ngä manaakitanga

a te Runga Rawa. E mïharo ana ki a koutou mö tö

koutou kaha ki te häpai i tënei kaupapa. Nö reira

tënä koutou katoa. The author and the Ministry of

Health gratefully acknowledge the contributions

of the following people. Their awhi, ideas and

comments reflect the dedication of people working

in Mäori health promotion in Aotearoa today.

Druis Barrett - Ngäti Whätua, Ngä Puhi, April 1996.

tahi one

rua

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S E C T I O N

S E C T I O N

S E C T I O N

Contents

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D E T E R M I N I N G T H E P A T H2He Tätai i te Ara

E X E C U T I V E S U M M A R Y

I N T R O D U C T I O N

E X P L A N A T I O N O F T E R M S

He Tino Whakaräpopototanga

Ngä Kupu Tïmatanga

He Whakamärama i ngä Kupu

D E V E L O P I N G A N E F F E C T I V E

R E S O U R C E F O R M A O R I7

Te Waihanga he Rauemi Tötikamö ä te Mäori

T H E P O L I C Y C O N T E X T

I D E N T I F Y A N E E D

C O N S U L T A T I O N

C O N T E N T O F T H E R E S O U R C E

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Te Horopaki o ngä Kaupapa Here

Te Huarahi Whakarite Hiahiatanga

Te Huarahi Whakawhitiwhiti Whakaaro

Te Rärangi Take mö te Rauemi

S T A G E S O F P R O D U C T I O N

- A N O V E R V I E W18

Ngä Wähanga o ngä Mahi Whakaputa - he Tirohunga Whänui

Te Whakatakoto Kaupapa mö te Rauemi

Te Whakamätautau i te Ariä Whakaaro

Te Whakaputa i te Tuhinga Tuatahi

Te Whakamätautau i te Kaupapa

Tohu Whakawätea

Te Whakahaere Mahi Whakaputa

Te Hoko me te Tohatoha i ngä Hua

Te Arotakenga

He Whakaräpopotonga

Ngä Mätäpuna

P L A N N I N G A R E S O U R C E

C O N C E P T T E S T I N G Y O U R I D E A S

P R O D U C I N G A D R A F T

P R E T E S T I N G

S I G N - O F F

P R O D U C T I O N M A N A G E M E N T

D I S T R I B U T I O N & M A R K E T I N G

E V A L U A T I O N

S U M M A R Y

R E F E R E N C E S

G L O S S A R Y

A P P E N D I C E S

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Code: 0005ISBN: 0-478-09455-8

First published June 1996

2tahi one

He Tatai i te Ara

S E C T I O N

D E T E R M I N I N G T H E P A T H

This manual was

named He Tätai i te Ara

(Determining the Path)

by the Mäori focus group

because it sets out

step-by-step the path

to take when developing

and producing an effective

health education

resource for Mäori.

3

He Tätai i te Ara (Determining the Path) is a health promotion resource

manual designed to assist the development and production of

effective health resources for Mäori.

The aim of He Tätai i te Ara (Determining the Path) is to actively

involve Mäori in producing their own health promotion resources.

Active and effective participation is a necessary part of success, for

without it Mäori desires for health improvement cannot be realised.

The key strategies for positive Mäori participation in the development of

health promotion and education resources outlined in this manual are:

• te huarahi whakawhitiwhiti whakaaro (consultation) with key Mäori during

planning and production

• application of the technical issues identified in Do We Really Need This

Resource? (PHC 1995a)

• distribution of the manual to Mäori providers and others who work closely

with Mäori communities

• provision of training on how to use He Tätai i te Ara (Determining the Path).

The content of this manual is based on a review of literature and policy, the

companion document Do We Really Need This Resource? (PHC 1995a), and

consultation with key Mäori health experts in the health promotion and edu-

cation area, including whänau, hapü and iwi puta noa (throughout) Aotearoa.

Working towards a healthy Mäori future is what He Tätai i te Ara (Determining

the Path) is about. It sets out a commitment to Te Tiriti o Waitangi and the

involvement of te iwi Mäori as active participants in the drive to improve

Mäori health status. This can be done by providing Mäori health resources

that are accessible, available, acceptable and culturally appropriate to Mäori.

E X E C U T I V E S U M M A R Y

He TinoWhakarapopototanga

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Why these guidelines have been written

He Tätai i te Ara (Determining the Path) aims to help people produce

effective health messages and resources for Mäori. It sets out the steps for

producing effective health resources that give the right messages aimed at

improving Mäori health.

He Tätai i te Ara (Determining the Path) is an important companion manual

to two documents published by the Public Health Commission (PHC): Do We

Really Need This Resource? (PHC 1995a), which looks generally at the

process of producing health education resources; and Pacific Islands Health

Education Guidelines (PHC 1995c) which looks at the process of producing

health education resources for Pacific Islands people in Aotearoa.

The development of He Tätai i te Ara (Determining the Path)

Consultation for He Tätai i te Ara (Determining the Path) began during March

and April 1995 while Do We Really Need This Resource? (PHC 1995a) was

being pretested at nine regional workshops. A one-day focus group hui was

held in October 1995, with a röpü (group) of kaimahi Mäori, health

promoters and educators. They used their own experiences to identify the

processes needed to develop effective health education resources for Mäori.

The first draft of the manual was peer reviewed by experienced kaimahi

Mäori who had not been previously involved in its development. The peer

review process involved posting out the draft to the reviewers. Written

feedback was received.

Following editing of the first draft to incorporate the peer review comments,

pretesting was undertaken by Mäori health workers and educators in

Palmerston North and Te Awamutu.

I N T R O D U C T I O N

Nga Kupu Timatanga

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Health promotionHealth promotion is the process of enabling people to increase control over and improve their health.

Health promotion programmes do not seek to change beliefs and values, but assist people to recognise

inconsistencies between their values and their behaviour.

(MOH and PHC 1995)

Health promotion for MäoriHealth promotion for Mäori means Mäori having control over their health or tino rangatiratanga o te

hauora, or encouraging people to determine their own good health and wellbeing (Northland Health

1995). Health promotion for Mäori is the process that assists whänau to make choices to regain and

maintain tino rangatiratanga o te hauora. It includes the process of social and political action for

health development.

(PHC 1994b)

Mäori involvement in health promotion means:

• achieving potential

• making decisions

• maximising choices

• being part of the consultative process.

Health educationHealth education involves sharing knowledge, learning skills and exploring attitudes. Health messages

for Mäori should be assessed for their educational value. Does the message make a difference? Does

it provide information for the reader? Does it educate them?

The effectiveness of health messages for Mäori will also depend on whether the message is created from

a Mäori or a non-Mäori knowledge base. Health promotion materials should use the Mäori language in all

its dialects and promote Mäori society and ways of doing things.

(Ropiha 1994)

The cost of adapting resources to accommodate dialect differences will always be a problem. Regionally

designed and funded resources may be better placed to address this issue than nationally focused

resources. In order for national resources to be effective for Mäori, common principles need to be

promoted. Regional dialect differences and interpretation of concepts may be better met during the

education session by the person delivering the message. Further information about the importance of the

messenger as well as the message is discussed in the section on training-for-trainers (p 30).

Useful health education strategies for Mäori outlined in Kia Whai te Märamatanga are

summarised as follows:

• raise awareness about the kaupapa

• increase understanding of the kaupapa

• change attitudes towards given aspects of the kaupapa

• change behaviour for the given kaupapa

• maintain positive behaviour changes.

(Ropiha 1994)

E X P L A N A T I O N O F T E R M S

He Whakamaramai nga Kupu

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E L E M E N T D E F I N I T I O N

Te Taha Wairua The spiritual wellbeing of a person. It determines one’s identity. It provides

a direct link with one’s tupuna and whänau group and strengthens the

taonga and tikanga values of one’s cultural system (Durie 1994a).

Te Taha Hinengaro The mental and emotional wellbeing of a person. The concept of life -

confidence and self-esteem are important for good health (Durie 1994a).

Te Taha Tinana The physical wellbeing of a person cannot be dealt with separately from the

whänau, wairua, hinengaro, te reo rangatira and te ao türoa of Mäori (Durie

1994a).

Te Taha Whänau Involves acknowledging the importance of the whänau in providing

sustenance, support and an environment that is important to good health

(Durie 1994a).

Te Ao Türoa The environment. The relationship between Mäori and te ao türoa is one of

tiakitanga (stewardship). It is the continuous flow of life source. The

wellbeing of te ao türoa is linked with mana Mäori. It is an essential element

in the identity and integrity of the people. Without the natural environment,

the people cease to exist as Mäori (Royal Commission on Social Policy 1988).

Te Reo Rangatira The dimension that expresses the importance of language. This is an

essential part of Mäori culture. It is a taonga. It expresses the values and

beliefs of the people and a focus of identity. The root of Mäori culture is the

language, a gift from our ancestors.

A health resourceA health resource can be:

• a thing (eg, a flyer, brochure, poster, booklet, balloon, pen, cap, t-shirt)

• a person in a job (eg, Mäori health worker, Mäori Smokefree worker, cervical screening worker,

community health nurse, Mäori doctor, iwi health planner)

• financial (eg, Smokefree sponsorship that promotes Mäori activities).

By Mäori for MäoriThe most appropriate people to produce health resources for Mäori are Mäori themselves.

(PHC 1995a)

Priority groupThis term is used instead of ‘target group’. It refers to the grouping of people for whom your health

resource is intended. The word ‘priority’ has more positive associations than ‘target’.

Mäori model of healthMäori perceive health in a holistic way where good health is dependent on a balance of factors affecting

wellbeing. Wairua (the spiritual), hinengaro (mental), tinana (physical), te reo rangatira (language) and

whänau (family) elements interact to produce actual wellbeing. The wellbeing of te ao türoa (environment)

contributes also. This approach requires that Mäori health be understood in the context of the social,

economic and cultural position of Mäori.

(PHC 1995b)

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Te WaihangaRauemi Totikamo a te Maori

D E V E L O P I N G A N E F F E C T I V E R E S O U R C E F O R M A O R I

rua twoS E C T I O N

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When developing a health education resource it is important to be aware of

the policy context within which you may seek financial support for your

project. Government agencies have policies which determine the focus and

priorities for their budget for the year. Aligning your project with existing

Government policies will improve your chances of receiving financial support

from purchasers and providers, which include regional health authorities

(RHAs) and Crown health enterprises (CHEs).

T H E P O L I C Y C O N T E X T

8

The Government is committed to

improving Maori health by:

... the Crown seeking to improve

Mäori health status so in future

Mäori will have the same

opportunity to enjoy the same

level of health as non-Mäori.

(Minister of Health 1995)

Ka rapuhia e te Karauna

he huarahi hei whakapiki

i te ähua o te hauora Mäori, kia

noho örite ai te oranga Mäori

ki tërä o tauiwi.

It is important that the Crown objective is

considered in conjunction with the need to:

• recognise Mäori aspirations and structures

• promote positive health for Mäori

• encourage greater Mäori participation.

(Minister of Health 1995)

The emphasis is on Mäori control over Mäori

health development and a greater role for iwi

Mäori in the purchasing and provision of health

services. This prescribes a role for government

agencies of co-operation with Mäori and a

commitment to relinquishing resources to Mäori

for Mäori development.

(TPK 1994)

Te Tiriti o WaitangiTe Tiriti o Waitangi underpins health promotion

work for Mäori in Aotearoa. Recognition of Te

Tiriti o Waitangi is an essential ingredient when

developing resources for Mäori. Te Tiriti commits

to an ongoing partnership between Mäori and the

Crown (PHC 1994b). The key principles of Te Tiriti

o Waitangi are tino rangatiratanga (absolute

sovereignty) and mana motuhake (the right to

control one’s own destiny).

Te Horopaki o ngaKaupapa Here

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Empowering Mäori to havecontrol over Mäori healthTe Tiriti is neither a blueprint for good health

nor a prescription for all ills. Nonetheless, good

health is clearly an objective of te Tiriti. The

two principles of te Tiriti – partnership and

participation – have positive implications for

future Mäori health status. At a time when health

services are being developed and reorganised,

there is a need to consider the principles of

te Tiriti and to incorporate them into health

philosophies, policies and practices.

(Durie 1989).

As tangata whenua, Mäori occupy a unique place

in Aotearoa society. They have specific cultural

customs that are part of their everyday lives.

Health resources for Mäori should reflect:

• Mäori concepts and values

• tikanga (customs) and wairua (spirituality)

where appropriate.

Health resources for Mäori should be developed

with the guidance and support of kaumätua (elders).

To achieve the best results, Mäori should be

involved at every stage of developing the resource.

The Ottawa CharterKia Whai te Märamatanga links the action

strategies of the Ottawa Charter with Mäori

strategies as follows:

• building healthy public policy - making

Mäori health a priority

• creating supportive environments

- recognising Mäori concepts of health

• strengthening community action

- providing opportunities for Mäori to control

their own health care

• developing personal skills - empowering

Mäori through training and education

• re-orienting health services - encouraging

Mäori providers.

(Ropiha 1994)

Martin argues that the Ottawa Charter is

consistent with, but secondary to, Te Tiriti o

Waitangi. In applying the Ottawa Charter’s

definition of health promotion, she argues that

control over one’s health is tino rangtiratanga, and

that health promotion is the process of bringing

that about.

(Martin 1995)

Recognition & application

of the principles of te Tiriti

& acknowledgement of

tangata whenua rights

provide significant

opportunities for Mäori

to create & implement

health resources &

strategies for the benefit

of Mäori.

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I D E N T I F Y A N E E D

Te Huarahi WhakariteHiahiatanga

How is a need identified?A resource needs to be developed for

Mäori when:

• health workers or the Mäori community

identify a need

• existing health resources need to be adapted

to meet Mäori needs (eg, a resource in English

may not be appropriate for use with Te

Köhanga Reo tamariki)

• it is part of a Mäori health strategy being

developed by a provider (examples of

purchaser and provider organisations that

develop resources are included in Appendix 1).

How do you know ifthe resource will be effectivefor Mäori?It will be a good, effective health resource for

Mäori if:

• it is designed with input from the Mäori

community, right from the start

• the language and images fit the expectations

and learning level of the group (eg, use of te

reo Mäori)

• accurate information and clear messages are

presented and promoted

• funding is available to produce the resource

• there is a way of measuring the

resource’s effectiveness.

(PHC 1995a)

If you are asked to produce a resource it is

important to check what information is already

available about the issue. Another region or

agency may have already developed something

suitable. It is also important to consider whether

you have the expertise available to produce

the resource, or if you need to employ skilled

people to help.

F O R E X A M P L E

A survey of the local marae shows that

alcohol is not being served responsibly at

its social functions. Kaimahi are concerned

about the high numbers of car crashes

involving rangatahi.

• The marae has no policy on alcohol.

• Kaimahi ask a Mäori community health

worker to develop a health promotion

programme with the marae.

• The community health worker uses the

Manaaki Tangata/Host Responsibility

programme that was developed by the

Alcohol Advisory Council of New Zealand

(ALAC). Posters, brochures and guidelines

are used to promote the safer use of

alcohol by rangatahi.

Needs analysisBefore deciding what type of resource needs to be

developed, it is important to know as much as you

can about the health issue. While gathering data

about the health issue may seem höhä or

unnecessary, it does help you to understand the

topic more fully so you can accurately direct the

messages where you need them to go. It is also

important to know as much as possible about the

priority group for whom you are producing the

resource and with whom you will be working.

This process is called a ‘needs analysis’ or ‘needs

assessment’. The needs analysis increases the

chance of identifying important issues outside the

immediate health issue.

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F O R E X A M P L E

A need has been identified by a rural-based

community for a resource on diabetes.

• There is a group of kaumätua with this

problem in their area.

• The nearest doctor is 400 km away.

• Many factors contribute to diabetes like

family history, diet, medication.

• However, access to medical care

may be considered more important

by the kaumätua than a new health

education resource.

In this example, helping the kaumätua to

deal with their access concerns would be

essential before developing the resource.

Part of the needs analysis involves finding out

what is already known on the topic. Read articles,

books or similar resources that could provide

useful information on the topic. Librarians will

help you to do a literature search to find articles

and information.

Information gatheringInformation about the priority group and the

effect of the health issue can be obtained from a

range of sources. The main source involves

consultation with Mäori as discussed in the

consultation section of this publication (p 14).

Written material is another key source. There are

also Mäori within the community with technical

and specialist knowledge who can assist.

Needs analysis

In some instances information may need

to be gathered about the priority group

and the health issue. Find out things like:

• health facts and figures about the

community on which you want the

resource to be focused

(eg, kaumätua, pakeke, wähine, täne,

rangatahi and tamariki)

• the type of area in which the resource

is to be used (eg, rural, urban)

• whether there are important social

aspects of which to be aware (eg,

employment status, housing, education

levels, experience of violence)

• whether there are important lifestyle

issues of which to be aware (eg,

smoking, diet, drinking, disabilities)

• access to and use of existing health

services (eg, cervical screening, breast

cancer screening)

• use of existing health resources

(eg, glue ear resource).

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Written materials

Reading about similar projects can give you

valuable information about the pros and cons of

different strategies, costs and any conclusions the

project team reached.

It is useful to find out:

• what worked and what did not

• what could be improved and adapted

to your project

• how the resource may be affected by existing

health resources

• how other projects may be affected

by your resource.

Reports are usually available from the

organisation that produced them and from

libraries. If the content is too technical, ask the

organisation to explain it to you so you are able

to communicate the information to others (PHC

1995a). An example of an evaluation report on

a Mäori strategy is The Evaluation of the Public

Health Commission Education Hui to Promote

Immunisation Among Mäori.

(Stuart 1994)

Tikanga (Policies)

If you are developing a national resource, you will

need to be aware of any national or regional

tikanga in areas where your resource will be

distributed. It is important that you find out about

these tikanga before developing the resource.

Consultation with iwi and marae prior to

development and distribution will help to identify

the relevant tikanga.

You may find that iwi in other areas will have the

flexibility to customise an existing iwi-specific

resource, making it appropriate to their tikanga.

If you are contracted by an external

organisation, check their policy on

health resources. For example, Ministry

of Health resources need to be checked

during development and prior to

printing for things like:

• technical accuracy

• cultural appropriateness

• educational appropriateness

• being in line with national and

Government policy (PHC 1995a).

Analysing the informationyou have gatheredAssess the usefulness of the information you

have gathered. Information provides you with

insight into:

• the health issue and the people it affects

• previous successful attempts to

address the issue

• possible strategies to use in your project.

It is important to ensure that the resource is

accurate and does not mislead people (PHC

1995a). Seek advice from kaumätua. Discuss the

project as much as possible to firm up your ideas.

Identifying the resourcepriority groupCare should be taken in identifying the

priority group for the planned resource. Questions

to consider include:

• are you directing your resource to a particular

age group (eg, glue ear in tamariki – whänau

would be the priority group)?

• is the resource directed to the individual

or the whole whänau (eg, smoking)?

• is the resource intended for wähine rather than

täne (eg, cervical screening)?

• what setting are you focusing on

(eg, home or marae)?

• do you want the resource to be appropriate for

both rural and urban-based whänau?

Priority indicates ‘need’ - both

the need for a resource and the

need to be involved in its

development. As the need

changes, the priority groups

may change.

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OwnershipCollective ownership of a resource is important.

• Knowledge is a taonga (gift).

• A health resource represents knowledge.

• Being associated with a resource through consultation brings a feeling of ownership.

• People will want to use and promote the resource with others in the community.

Tamariki (Children)

Whänau, hapü and iwi are important support

mechanisms for the protection and nurturing

of tamariki. Addressing health issues from

the tamariki stage onwards should improve

the wellbeing of rangatahi, pakeke/mätua

and kaumätua in the long term.

(PHC 1995b)

Health education resources focusing

on tamariki should incorporate a

holistic whänau approach.

Rangatahi, taitama, taitamähine (Youth, young men and women)

The role and wellbeing of rangatahi is important to the future of Mäori society as well as the wider

community. Rangatahi who are secure in their cultural identity have a confident framework to help

them make choices and decisions. Those who are not secure within their culture may struggle with

their identity and may, as a result of this conflict, be at risk of health problems.

(PHC 1995b)

In addressing the wellbeing of rangatahi, the use of appropriate role models

is a key factor.

Wähine, täne – ngä mätua

(Women, men – parents)

For the good health of future generations of Mäori,

it is vital that parents lead healthy lifestyles and are

positive role models for their tamariki. It is import-

ant that health promotion programmes focus on

challenging lifestyle risk patterns within whänau.

(PHC 1995b)

Resources being developed for this group

should reflect the complementary roles of

Mäori men and women within the whänau.

Kaumätua (Older people)

Kaumätua are taonga of whänau, hapü and iwi. They are the guardians of wisdom, knowledge and

traditions. Their role is to nurture the whänau, hapü and iwi with knowledge.

(PHC 1995b)

Resources being developed for this group should reflect the guardianship and

nurturing roles between kaumätua, kuia and the whänau.

E X A M P L E S O F R E S O U R C E P R I O R I T Y G R O U P S

14

C O N S U L T A T I O N

Te HuarahiWhakawhitiwhitiWhakaaroEffective consultation will ensure appropriate collaboration among individuals

and organisations involved in public health in the widest sense (PHC 1994a).

What is the most effectiveconsultation process?

National consultation

A national hui involves:

• one hui

• pänui being sent out indicating that

it is a national hui

• only one opportunity to provide

verbal comment

• a follow-up hui report describing the

outcomes, identifying recommendations,

providing information and seeking

written submissions.

Anyone holding national hui to consult with Mäori

would need to ensure that the hui report is sent

out widely to groups, including key Mäori

stakeholders and providers, Mäori organisations

and iwi rünanga.

Consultation by national hui is very time-

efficient and cost-effective. However, this method

has disadvantages from a Mäori point of view

because it:

• usually involves large numbers of participants

• compromises the ability of people other than

the very outspoken to have their say

• involves travel constraints for everyone

outside the hosting region

• may result in biased consultation in favour of

those who can afford the registration costs

• assumes that all participants have the same

level of knowledge and can take in a lot of

detail in a short time

• requires written submissions from everyone

who cannot attend the hui.

14

15

Written submissions are not an

effective method of consultation

for seeking Mäori community

input. Given the common Mäori

preference for te kanohi ki te

kanohi processes, face-to-face

interaction and dialogue are

likely to result in more effective

Mäori input.

requirement for written submissions to

supplement the material already gathered. The

disadvantages of this method to the provider

include the extra time needed to produce

multiple reports.

Focus group hui

There will be occasions when ideal consultation

principles may be adversely affected by a limited

budget. In this situation using a focus or reference

group may be necessary. This involves bringing

together six to ten key stakeholders with current

experience in the area, and using their combined

knowledge and experience to advise on

the resource.

It is important to note that this model identifies

the minimum consultation that should occur when

developing a resource for Mäori. If effective

consultation is a goal, individual consultants

cannot effectively replace the Mäori focus

group process.

When planning the costs of a focus group hui

remember to consider koha for the participants’

travel and provision of kai. For accounting

purposes classify these expenses as ‘project

costs’. Providing koha makes it easier to call on

participants again if needed.

Regional consultation

Regional hui allow more opportunity for a wider

group of people to be involved in the consultation

process with minimal disruption to their whänau-

based responsibilities.

Models for Mäori regional consultation include:

• RHA regions model. The RHA boundaries cross

a number of iwi boundaries, therefore this

model may not be supported by Mäori as being

the most effective. Subsequent written

submissions may be required

• Mäori proportional population model (eg,

Midland and Northern RHA regions have the

highest Mäori population in the country). This

model would involve holding hui mainly in

these highly Mäori populated areas, restricting

access to people in other areas (eg,

Invercargill). Subsequent written submissions

may be required

• Mäori Land Court regions model. This model

may cost the provider more but is the ideal

and most effective consultation model from a

Mäori point of view. The eight regions to be

covered are -

Te Taitokerau, Tainui, Tämaki-makaurau,

Te Tairäwhiti, Aotea, Waiariki, Ikaroa and

Te Waipounamu.

To the provider, the advantages of the Mäori Land

Court regions model include the opportunity to

receive a wider range of community opinion, the

likelihood of smaller numbers of participants at

each hui and lower travel costs for a greater

number of people. There will also be minimal

16

Time constraints

There will be occasions when a resource is

needed urgently, making ideal consultation

impossible (eg, during a meningitis outbreak).

In these cases the need to get the information to

the community is greater than the need for time-

consuming consultation. Any information is better

than none to assist Mäori to make informed

health decisions. Consultation with a modified

reference group would still be recommended,

however, to meet minimal consultation standards.

When you need to convey urgent

messages to Mäori, use

information networks such as:

• iwi radio stations

• existing Mäori hui and

networks

• Mäori television programmes

like Te Karere and Marae

• people networking with Mäori

like Mäori community workers.

Who should be consulted?The two key consultation groups are the priority

group itself and organisations or groups that will

use the resource who currently work closely with

the priority group. For example, if the priority

group is tamariki (children) it is important to

check the suitability of the resource with them as

well as with the pakeke (adults). This is

particularly the case if the resource is to be taken

home. Kaiako and kaimahi who may teach or work

with the resource should also be consulted.

Organisations that

work with the priority group

Organisations or groups which work closely with

the priority group should be a part of the

consultation process. For example, if your priority

group is Mäori women aged 55 to 60 years,

groups such as the Mäori Women’s Welfare League

may be approached to nominate a representative

to advise on the resource development.

The priority group

Representatives of the priority group should be

consulted throughout the planning and

development stages, that is:

• when the resource is being planned

• when the content is being decided upon

• when the draft is finished.

Copies of the resource should be given to

participants who were involved in the

consultation. The end credits should acknowledge

the people who helped develop the resource if

they give their permission for this to occur.

(PHC 1995a)

FM96.9

Atiawa

17

C O N T E N T O F T H E R E S O U R C E

Your resource will contain information gathered by means of hui and other

consultation. You will probably need to check the accuracy of the content of

your resource with experts.

Content expertsThis term describes people who have a range of

expert knowledge and understanding. They need

to be involved in planning and developing the

resource. They include kaumätua, people with

technical knowledge, Mäori nurses, midwives,

doctors and te reo experts.

Content experts should be consulted when:

• detailed information is needed on the topic

(eg, what is glue ear? What are the correct

Mäori translations of words and messages?)

• you have identified that the project needs an

expert (eg, having a Mäori doctor present

when a programme is presented)

• you are open to options for the final

resource (eg, putting money into developing

people resources rather than producing a

health resource).

Consultation methodswith content expertsHave a reliable method to record information and

advice from content experts for future reference.

Telephone calls are quick but letters and faxes

provide a more permanent record. Conference

calls save the costs of travel but it is important to

record information which includes:

• date and time the call was logged

and completed

• the people who participated

• the körero and any recommendations.

Following the conference call the recorded

information should be sent out to all participants

to ensure they agree that it is accurate.

Managing conflictinginformation from content expertsAll resources should be checked for technical

accuracy by content experts during the planning

stages and before the final printing. It is likely that

differently skilled people and groups will have

varying viewpoints on an issue, depending on

their knowledge, training and background.

You need to decide how to manage conflicting or

varying views. Think about what is important. Do

you focus only on areas where people agree? Do

you present differing views in a balanced way so

the priority group can understand the issues and

make informed choices? Do you have policies to

assist your decision-making?

It is important to respect the time of others.

Payment should be discussed as a matter of

courtesy. Time may be freely given or may

require a koha.

(PHC 1995a)

17

Te Rarangi Takemo te Rauemi

18

Nga WahangaO nga MahiWhakaputa -He TirohangaWhanui

S T A G E S O F P R O D U C T I O N - A N O V E R V I E W

toru threeS E C T I O N

19

P L A N N I N G A R E S O U R C E

The planning stage is a very important part of any mahi. It is important to

know where you want to go before you begin.

Issues to consider during your planning phase are:

• what do you want to achieve?

• how are you going to get there?

• what sort of evaluation will you use to

measure how effective your plan was?

Planning is an activity happening all the time in

Mäori communities. Producing health messages

and resources is like building a whare. In the

following Hangaia He Whare example, a goal is

determined (to build a whare), objectives are set

(where it will go, what it will look like and what it

is for) and strategies are planned (how to get the

resources needed - people and money). Then the

work is completed and evaluated and adjustments

are made as needed.

What is a goal?A goal (te ara/path) is a statement about the

purpose of the project. It is a description of the

big picture (PHC 1995a). An example of a goal is

given in the Hangaia He Whare guidelines.

What is an objective?Objectives (te kohikohi i ngä köhatu/all the stones

needed to be collected to make up the path) are

the statements which specifically describe what

needs to happen to achieve the goal and the result

intended. Examples of objectives are given in the

Hangaia He Whare guidelines.

Also, it is useful to prioritise the objectives so that

you know which are the most important,

especially if there is limited funding.

What is a strategy?Strategies (te whakatakoto tika i ngä köhatu/

placing the stones in the correct place to ensure

that the path is complete and the way you want it)

identify the specific things you will do and

complete in order to achieve the objectives.

Examples of strategies are given in the Hangaia

He Whare guidelines.

How do we evaluate?The goals, objectives and strategies you develop

should be evaluated after you have developed the

resource. Consider questions like:

• did your plan achieve what it set out to do?

• could the plan have been improved?

• were the objectives and strategies realistic

and achievable?

• what were the problems?

• could they have been avoided with

better planning?

• was the timeframe realistic?

Following is an example that demonstrates how

producing health messages and resources is like

building a whare.

Consultation is an integral part of

the whole process of building a whare.

The whänau has a vested interest in the

outcome and so needs to be actively

involved in its development. The same

applies to the development of

health resources.

Te WhakatakotoKaupapa mo teRauemi

19

20

H A N G A I A H E W H A R E ( B U I L D I N G A W H A R E )

Objective 1• The whänau decides that a draft plan needs

to be developed setting out what the whare

will look like and where it will go.

Strategies

• Discussion goes on among the

wider whänau.

• Kaumätua determine the site.

• A decision is made to hire someone to help

draw up the plans.

Objective 2• The whänau works out the costs.

Strategies

The whänau:

• checks out the cost of building the whare

and develops a budget

• raises funds (eg, by running raffles)

• applies to various funding agencies

• purchases the necessary materials

• employs kaimahi

• volunteers to assist where it can.

Goal: The whänau decides the old whare cannot be fixed.

It decides to build a new whare.

Objective 3• Tikanga requirements are observed.

Strategies

• Tikanga is observed throughout the

building process.

• Kaumätua bless the land.

• The foundations are established, the

poupou and pou tokomanawa (poles and

ridge pole supports) are put in place.

• Carvers and tukutuku people assist the

whänau with their specialist knowledge.

Evaluation• A problem is identified.

• The whare plan is adapted.

• Another window is added to let in more

light and air.

• Progress is reviewed to check the whare

will be completed on time.

The whare is completed• The whakatuwheratanga (the opening)

is planned.

• The whare is open ready for use.

Effective planning:• ensures that the röpü know what

they are all working towards

• ensures that everyone knows how each

will contribute to the completed task

• ensures that all the foundation work has

been covered, and that no oversight

will put the project at risk

(eg, kaumätua approval, checking te reo).

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C O N C E P T T E S T I N G Y O U R I D E A S

Talk to your priority groupYou will have some ideas about artwork, slogans,

images or diagrams. Before you put the ideas into

practice and start developing your resource, try

your ideas on some representatives of the priority

group. Concept testing may prevent you from

wasting time, money and energy.

Consultation with rangatahi could provide

information on the most effective ways of

reaching them (eg, is a radio campaign the most

appropriate method to use? Would a poster be

more effective?). Alternatively, they could endorse

your initial idea but may advise you to change

some things (eg, the music or use of rangatahi-

specific jargon). Consultation with rangatahi may

also help you with ideas on key phrases or images

to use or to avoid.

(PHC 1995a)

21

F O R E X A M P L E

You think an iwi radio campaign for 15 -

to 20-year-old rangatahi will get a safer sex

message across to Mäori youth. Find out a

number of things before going any further:

• do rangatahi actually listen to the

iwi station?

• do they listen at the times when you

can afford to advertise?

• do they like the music you are

thinking of using?

• are the voices you are planning to

use for the advertisement appealing

to rangatahi?

• is the scenario ‘real’ - will rangatahi

identify with the setting that is used?

Te Whakamatautaui te Aria Whakaaro

New health education resources can be

created and developed in the same way

as a new waiata or haka.

• The waiata is developed.

• It is tested with whänau.

• Changes are made to the harmony

to widen its appeal.

Similarly, new resources can be

developed, tested with the priority

group and changed to ensure that

whänau receive and understand the

critical messages.

22

P R O D U C I N G A D R A F T

Te Whakaputa i teTuhinga TuatahiYour draft will contain information gained from consultation with Mäori,

suggestions from your content experts, and information from other sources

such as literature searches. It will address an identified need and will have

been concept tested.

Language guidelinesWhen developing resources:

• keep the language simple and free of jargon

• if the resource has a national or regional focus,

consultation should occur with kaumätua on

the use of te reo and different regional dialects

• use transliterations for te reo terms only when

an accepted traditional equivalent does not

exist (eg, takuta - doctor)

• do not use labels which belittle people, for

example, a person with diabetes rather than

the diabetic; remember they are people with a

condition, they are not a condition

• focus on the behaviour rather than the person

because it is less threatening, for example,

instead of saying ‘smokers pollute the air

which others must breathe’, say ‘smoking

pollutes the air which others must breathe’ (the

former blames people, which is more

threatening than blaming the tobacco smoke)

• do not use labels which promote negative

stereotypes, such as sexist labels. Concentrate

on positive images

• avoid using the term ‘victim’.

If you eliminate the things that

offend in favour of things that

people appreciate seeing and

hearing, the resource is more

likely to be successful and

accepted by whänau.

Use positive examplesBe positive and inclusive, rather than negative and

exclusive. The following list may help:

U S E A V O I D

smokefree anti-smoking

heart health cardiovascularprevention (medical)

person asthma sufferer orwith asthma asthmatic/victim

(implies no hope)

unintentional accidents (impliesinjuries you can do nothing

to prevent them)

sexual identity/ sexualorientation preference

priority group target group

people with the disabled(they are people have disabilitiesfirst, have

disabilities second)

It is important to check the priority group’s

thoughts on the use of certain language and

phrases. Remember that positive health education

and promotion focuses on what to do.

(PHC 1995a)

22

23

Key messagesDuring the early part of developing the resource it

is important to decide which critical messages are

to be used.

F O R E X A M P L E

Key messages were identified for a rangatahi

smokefree video resource called Kauruki

Kore - It Takes Attitude to be Smokefree.

These include ‘smoking harms developing

youth’ and ‘you can be happy and healthy

but still be smokefree’.

The first key message used rangatahi-specific

slogans including:

• smoke, choke, croak

• smoking kills.

The second key message was reflected in

images of healthy people dancing, and

sporting role models (eg, Jonah Lomu and

Glen Osborne).

Key messages identify all of the essential

messages that you want your priority group

to remember (ie, the must knows). Important

but non-critical messages may also be in the

resource (ie, the nice to knows).

An example of a non-critical message from the

same resource is ‘smoking smells’. This message

was combined using a rangatahi-specific slogan

and a peer approach (eg, ‘smoking is stink’).

Recognise diverse Mäori realities

Professor Mason Durie states that in

developing health education resources for

Mäori, it is important to note that Mäori

people fall into three broad groupings.

• Some Mäori are linked with conservative

Mäori networks, their children will attend

Te Köhanga Reo, they will be more or less

comfortable on a marae, they will be

members of a Mäori cultural group or a

committee, they will speak or at least

understand the Mäori language, they may

belong to a predominantly Mäori sports

team and they will attend tangi.

• Second, there is a group who will have

some limited contact with Mäori society,

but who will be for the most part well

integrated into mainstream New Zealand

society, their lifestyles may not be

significantly different from those of their

Päkehä neighbours, but they will strongly

resist any insinuation that they are

not Mäori.

• Finally, there is a third grouping who

would not be likely to access Mäori

institutions nor take advantage of

mainstream services. Their children will

have no early childhood education, they

may never be part of a marae activity,

visit a library, belong to a sports club,

attend a polytechnic, have a regular

general practitioner or even maintain

contact with a local Mäori community

heath worker. They will be on no electoral

role - Mäori or general. In effect they

will be isolated from both Mäori and

general society.

Yet they will all vehemently maintain they

are Mäori. And so they are.

(Durie 1994b)

Given this diversity, it is important to note

the difficulty of one resource meeting the needs

of all Mäori.

24

Te reo Mäori(Mäori language use)Te reo and culture play a central part in the

communication process with Mäori. Ideas about

Mäori wellbeing are evident in Mäoritanga today.

Taha wairua, taha tinana, taha hinengaro and taha

whänau represent the elements essential to

wellbeing, that is, spiritual, physical, mental and

social elements.

Health educators planning health promotion

programmes and resources for Mäori need to

carefully consider the use of te reo and Mäori

concepts in resources. The aim of health

education resources is to effectively influence

positive changes to behaviour which will produce

positive health effects.

Use of te reo, in all its dialectic forms,

promotes positive Mäori messages

as a means of development. The use

of Mäori tikanga (customs) and wairua

(the spiritual elements) in health

education messages may increase access

to health-related knowledge.

“Using the Mäori language to reach Mäori is more

effective, especially being sensitive to the

different tribal dialects” (personal communication,

Huia Beattie, December 1995).

Te reo and culture are important elements for the

development of mana motuhake and tino

rangatiratanga for Mäori. The following diagram is

a framework for Mäori health messages developed

by Daphne Ropiha of the Ministry of Health.

Ngä kete mätauranga

The development of whänau-hapü-iwi

recognition and development of these

political structures

Mäori concepts of health

Recognition and development of ngä taha

hinengaro, tinana and wairua me whänau in

health policies

Te reo rangatira me ngä

tikanga Mäori

Use of te reo rangatira as the language of

instruction and ngä tikanga Mäori as the

cultural construct and concept for delivery

of messages.

(Ropiha 1994)

If you have a contract with an organisation

(eg, Ministry of Health) check to see if there are

any policies related to te reo. Translations may

need to be audited by an external organisation

(eg, Te Taura Whiri i te Reo Mäori, the Mäori

Language Commission) prior to printing.

A t a w h a i t i a T e W h a r e t a n g a t a

C e r v i c a l S c r e e n i n g

25

P R E T E S T I N G

Examples of pretestingquestionsQuestions to be put to pretesting groups

could include:

• What do you think are the key messages

in the resource?

• What are the strengths and weaknesses

of the resource?

• For whom do you think the resource has

been developed (ie, age and gender)?

It is vital that all participants feel their

comments are valued, and that you take

responsibility for putting their comments

into action wherever possible.

Pretesting means checking the health resource before it finally goes to print

or air, while it is still in a ‘rough’ draft. This is the stage when changes can

be easily made.

25

Pretesting includes:

• selecting the pretesting group from:

- the priority group (eg, rangatahi, pakeke)

- the future users (eg, health educators)

- the location that the resource focuses on

(eg, urban and rural settings)

• presenting the final proposed draft of the text

or tape to the pretesting group

• asking some pre-determined questions about

what the group learned after seeing or

listening to the resource.

Resources should be

pretested with:

• the priority group on which

the resource focuses

• future users of the resource

(eg, Mäori midwives and

nurses, kaimahi Mäori ).

Feedback is essential to show:

• whether the key

messages were clear and

identified correctly

• how easily the resource

can be used in a variety

of settings.

Te Whakamatautaui te Kaupapa

26

Resource-specificmaterials to pretest

Printed material

• Pretest the key messages to ensure they have

been identified and understood.

• Pretest rough drafts of leaflets.

• Pretest intended artwork.

Video

• Pretest using the story-board produced (ie, a

series of still drawings).

• Pretest videos with intended final draft while

still in rough cut, before graphics are inserted.

Media

• Pretest draft scripts for radio advertisements

and use simple recording equipment to

present the advertisement before it goes to air.

If you are pretesting a national Mäori resource,

take it to a range of whänau, iwi, locals and

communities to check for regional acceptability.

Pretesting methodsand process

Self-administered questionnaires

• Send the resource to participants with pre-

determined questions.

• Collate the information they mail back.

• Individual interviews by phone or in person

are useful for more in-depth, complex or

sensitive issues (PHC 1995a).

Focus groups

• Gather together small focus groups (eight to

ten people) to evaluate the resource.

• Participants should know how, why, where and

when the pretesting will happen.

Hui

• Hui may be used to pretest resources designed

to be used in a large lecture hall situation

(PHC 1995a).

• Comments may be recorded individually in

writing using a marking grid, or collective,

verbal feedback can be recorded.

Pretesting numbers

Group numbers for pretesting will vary according

to the funds available and the potential

controversy associated with the resource topic.

For a small resource such as a flyer, a minimum of

20 to 30 people could provide you with adequate

information. For a large and/or controversial

resource, bigger numbers from a variety of

backgrounds and regions may be necessary.

Readability

Assess the readability of the text. Check that

the priority pretest group for the resource

demonstrates that:

• the content is clear, readable and

easy to understand

• the key messages are correctly identified.

Ask the pretest group to identify any text that

needs to be changed. If it is too difficult, use

simpler language.

Refinement

Check the feedback from the pretest groups.

Make the changes requested by the pretesters if

appropriate. Recheck the text before having it

signed-off (if that is required) prior to printing or

going to air.

(PHC 1995a)

27

S I G N - O F F

If you have a contract with a purchasing organisation such as a RHA, make

yourself familiar with any sign-off requirements it may have.

Once the resource is at the final stage of development, and before printing

begins, carefully proof read the text before sign-off. Remember that if early

drafts have been signed-off, and changes are made following pretesting, the

updated text will have to be signed-off again - prior to printing.

Who may be included in thesign-off process?• The funding organisation (eg, project manager).

• Focus or reference groups.

• Content experts.

• An external translation organisation

(eg, Te Taura Whiri i te Reo Mäori, the Mäori

Language Commission).

If you receive feedback that the resource is

technically inaccurate during the sign-off

process, the resource needs to be corrected.

TohuWhakawatea

27

The updated draft will have to be signed-off

again. Once sign-off has been completed, no

further changes can occur and the resource is

ready to be printed.

A sign-off sheet demonstrates that the proper

consultation has been carried out and that the

final copy has been approved for printing. A

sample sign-off sheet is at the end of this manual

(see Appendix 2).

28

P R O D U C T I O N M A N A G E M E N T

Te WhakahaereMahi WhakaputaThere are a number of steps that need to be taken when producing health

resources, some of which are set out below. Refer to Do We Really Need This

Resource? for further useful information on production management

(see Appendix 3).

Budget planning

• Develop a draft budget.

• Obtain estimates.

• Calculate the cost of staff hours and time.

Accountability is paramount, especially when

using public or iwi money. Appendix 4 provides

an example of a budget for a small health

resource project.

Funding

Funding plays a major part in resource

production. Many of the providers identified in

Appendix 1 develop from within their

organisations (or contract others to develop)

health education resources on a variety of issues.

If you have a contract with such a purchaser it is

likely that there will be some quality assurance

requirements in the contract. Make sure you know

what they are, and what they mean for

your project.

Examples of quality assurance requirements

include having to develop the resource:

• within the agreed budget

• within the agreed timeframe

• to an acceptable standard.

However, röpü (groups) that fund

themselves will develop their own quality

assurance requirements.

Costing

Consider the project costs carefully. Include all the

things which you may normally take for granted.

Costs will include:

• your time

• travel/vehicle expenses

• stationery

• telephone and fax charges

• postage/couriers

• photocopying

• producing and collating a report.

You may not need to recover all costs. Costing

will, however, help you to work out the full cost of

the project. It will also help cost similar projects in

the future.

Quotes and estimates

Obtain at least three quotes or estimates for your

project before committing yourself to a supplier.

This will allow you to compare a range of

proposals and costs for proposed work. A quote is

a fixed price usually given in writing. It will

change minimally or not at all. An estimate is a

guess and changes may vary greatly. Make sure

you write down your requirements.

A leaflet called Quotes and Estimates; A Guide to

Your Rights has useful information on this and is

available from the Ministry of Consumer Affairs

(PO Box 22-549, Otahuhu, Auckland; PO Box

1473, Wellington; PO Box 4145, Christchurch).

28

29

GST

Always include GST in your costings and register

with the Inland Revenue Department if your

income is over $30,000.

Record keepingKeep records on what you plan to spend as well

as what you actually spend (PHC 1995a).

Keep records of everything that happens in the

project which will include:

• official documentation (eg, approved

project proposal)

• contracts (eg, signed release forms for

people appearing in the resource)

• helping to keep on track information

(eg, summaries of phone calls)

• expenditure (eg, estimates and quotes)

• other relevant information (eg, minutes

of meetings and correspondence).

Appendix 5 gives further details of the items

you may include in your record keeping.

Professional suppliersA professional supplier is anyone who provides

you with a service for your project. Make a

priority list of suppliers you may need to employ.

Employing Mäori suppliers may save you time.

They are likely to understand your needs very

quickly (eg, a Mäori artist is likely to easily

interpret a Mäori concept). Ask to see samples

of previous work.

Instruct your suppliers to contact you if they

have a problem before they attempt to solve

it themselves, especially if it is likely to

increase the costs.

Ensure the production person (printer, publisher,

producer, etc):

• is clear about what you want

• has written instructions to confirm your

verbal arrangements

• delivers what you actually ordered.

Realistic timelinesEnsure the timeline is reasonable. When planning

your time, remember to add a time ‘safety net’

period. If you think a task will take ten hours, add

on extra time to allow for any unexpected delays.

(PHC 1995a)

Recognise kaitüao timeand inputIf kaitüao (volunteers) are assisting you in your

project remember:

• their services are valuable

• their time should not be wasted

• their work will warrant the offer of a koha,

either to them individually, to their marae or to

an organisation

• assigned tasks require realistic timeframes

and deadlines

• accountability lines must be clearly identified

and understood.

Learn to delegate, giving clear instructions

and deadlines. Acknowledge jobs that

are well done. Listen to and use creative

ideas if possible.

(PHC 1995a)

30

D I S T R I B U T I O N & M A R K E T I N G

Identify who should receivethe resourceIf you have kept effective records you will have

a list of people who helped develop the resource.

They may also help you distribute the resource.

Identify the key people working with Mäori in

the area of your resource focus. Write a letter

that outlines the purpose of the resource and

its proposed priority group. Include a post-testing

questionnaire with a return address. Keep a

record of who received the resource for any

follow-up evaluation.

Mäori access to Mäori-targeted resourcesKaimahi Mäori need to have easy access to

resources specifically directed to Mäori.

Distribution of such resources through the usual

provider networks, which are primarily CHE-

based, may present access barriers for Mäori.

Established Mäori organisations and groups may

be better placed to directly supply Mäori groups

with Mäori-specific resources. Careful planning of

the distribution process is required to ensure that

priority Mäori groups are able to obtain, use and

benefit from Mäori-specific resources.

Ensure that the resources specifically

focusing on Mäori are primarily provided to

kaimahi Mäori and providers who work

closely with the identified priority group.

Launch the resourceLaunching the resource involves the first public

viewing of the resource. The process includes

acknowledging the completion of the mahi and

recognising everyone who contributed to the

resource development. The process occurs before

the resource is distributed nation-wide.

Training-for-trainers• A training-for-trainers hui involves training

people to use the resource to teach others.

• A training-for-trainers hui allows te kanohi ki te

kanohi distribution and delivery methods.

• Training is likely to be more effective if the

messenger is Mäori.

• Training should be held in a place where Mäori

feel comfortable.

Essentially, this process recognises the

importance of the messenger and the effect that

the messenger has on the message. People are

the primary resource. While health education

resources may enhance and support the mahi

undertaken in the community, they cannot

stand alone.

Training-for-trainers programmes need to address

issues related to:

• the use of te reo in the resource

• translation of the concepts to meet whänau,

hapü and iwi needs

• interpretation of the key concepts

at a whänau level.

Te Hoko me teTohatoha i nga Hua

30

31

E V A L U A T I O N

Te Arotakenga

Decide what to evaluateand when to evaluateDecisions about what and when to evaluate

should be made during the project planning stage.

Every project should have some form of

evaluation as part of its design. Questionnaires,

evaluation forms and hui are ways of evaluating

resources. For many Mäori, hui is the preferred

way to evaluate. This method offers the

opportunity to debate the strengths and

weaknesses of the resource and provide a

collective response.

(PHC 1995a)

It may be useful to seek expert advice on

evaluation. There are Mäori researchers who

specialise in health-related research who can

assist you in this area. Universities and colleges of

education may assist with advice and the design

of an evaluation.

31

The purpose of evaluation is to:

• decide if the project achieved what it set out to do

• measure whether the project was completed within budget

• identify any areas of the project needing improvement or modification

before proceeding to the next stage or repeating the project.

32

Types of evaluation

Quantitative and qualitative evaluation

Quantitative information refers to items which can

be counted, or expressed as numbers. Qualitative

information refers to information which has

impressions of feelings and emotions.

A questionnaire usually attempts to get

quantitative information, whereas a focus group

session usually tries to gain impressions of feelings

and emotions. It is important to decide at the

planning stages of the project what you will

measure, and how you will measure it (PHC 1995a).

Formative evaluation

This type of evaluation is carried out during the

project and:

• may be prior to and separate from any

formal evaluation

• may consist of feedback on whether the

project is doing well or how it could

be improved

• may provide valuable information on progress,

which enables changes in project direction

if required.

Process evaluation describes what happened

during the project.

Outcome evaluation (sometimes called impact

evaluation) identifies whether the project has

achieved its objectives (PHC 1995a).

Post-testingThe principles of post-testing are similar to those

for pretesting identified previously in the text.

Post-testing occurs once the resource has been

used in the community for a reasonable period

of time. Questions will be developed to determine

whether the resource:

• was effective

• needs to be adapted or updated

• can be reprinted without change.

Post-testing is always a good idea before

reprinting a resource. Problems may be found

which can be fixed before the reprint occurs.

33

S U M M A R Y

Model for producing effective resources for Mäori

The model below summarises the processes that should be used for

identifying or producing effective health resources for Mäori.

He Tätai i te Ara (Determining the Path)

Te Huarahi Whakarite Hiahiatanga (Identify a Need)

• Develop an idea

• Gather your information

• Identify the priority group

• Plan your consultation process

• Plan the evaluation process

• Begin to develop the content of your resource

• Have your content checked by content experts

• Whakahaere tonutia, kahore ränei? Should you continue?

Ngä Wähanga o ngä mahi whakaputa - He Tirohanga whanui (Stages of production)

• Plan your budget

• Plan the resource

• Try the idea out with Mäori (concept test)

• Produce a draft of the resource

• Pretest the draft with the priority group and future users of the resource

• Sign-off the resource

• Finalise your budget planning

• Keep records

• Plan realistic timelines

• Plan training-for-trainers process

• Print the resource

Te Hoko me te Tohatoha i ngä Hua (Distribution and marketing)

• Identify who should have the resource

• Launch the resource

• Complete training-for-trainers process

• Distribute the resource

Te Arotakenga (Evaluation)

• Decide what and when to evaluate

• Review and post-test the resource before reprinting

HeWhakarapopotonga

33

34

R E F E R E N C E S

Durie M. 1989 The Treaty of Waitangi and Health Care. NZ Med J 102: 283-5.

Durie M. 1994a Te Ara Whakamua Proceedings of the Mäori Health Wellington: Te Puni Kökiri.

Decade Hui Speech, Rotorua, March 1994.

Durie M. 1994b Whaiora Mäori Health Development. Auckland:

Oxford University Press.

Martin H. 1995 Health Promotion. Auckland: Auckland

University. Unpublished.

Minister of Health. 1995 Policy Guidelines for Mäori Health 1996/97. Wellington: NZ Government.

MOH and 1995 Reproductive and Sexual Health Wellington: Ministry of

PHC. Issues in New Zealand. Health and Public Health

Commission. Internal paper.

Northland Health. 1995 Whäia te Hauora 1995 Plan. Unpublished.

PHC. 1994a Consultation Guidelines. Wellington: Public Health

Commission.

PHC. 1994b The CHI Model: A Culturally Appropriate Auditing Wellington: Public Health

Model, Guidelines for Public Health Services. Commission.

PHC. 1995a Do We Really Need This Resource? Wellington: Public Health

Commission.

PHC. 1995b He Matariki: A Strategic Plan for Mäori Public Wellington:

Health: The Public Health Commission’s Public Health Commission.

Advice to the Minister of Health, 1994-1995.

PHC. 1995c Pacific Island Health Education Guidelines: Wellington: Public

Guidelines for Developing Pacific Islands Health Health Commission.

Education Resources.

Ropiha D. 1994 Kia Whai te Märamatanga. Wellington: Ministry

of Health.

Royal Commission 1988 The April Report Volume IV Social Perspectives: Wellington: Royal

on Social Policy Report of the Royal Commission on Social Policy. Commission on Social Policy.

Stuart K. 1994 The Evaluation of the Public Health Commission Wellington: Ministry

Education Hui to Promote Immunisation Among Mäori. of Health.

TPK. 1994 Te Ara Ahu Whakamua Proceedings of the Mäori Wellington: Te Puni Kökiri.

Health Decade Hui.

WHO. 1986 Health and Welfare Canada, Canadian Public Ottawa: World Health

Health Association. Ottawa Charter For Health Organization.

Promotion.

Nga Matapuna

35

ALAC Alcohol Advisory Council of New Zealand

awhi help

hapü sub-tribe

höhä bored

kai food

kaiako teacher

kaimahi workers

kaitiaki caregivers and protectors

kaitüao volunteers

kaumätua elders

kaupapa issue

koha donation, usually food or money

köhanga reo Mäori language ‘nests’

mahi work

mana motuhake right to control one’s own destiny

mätua parents

MOH Ministry of Health/Manatü Hauora

mokopuna preschoolers

pakeke adult

PHC Public Health Commission/Rangapü Hauora Tümatanui

poupou poles

pou tokomanawa ridge pole support

pütea money, fund

rangatahi young adults

rangatiratanga chieftainship, authority

rohe region

röpü group

take issue

tamariki children

täne man, men

taonga treasures, special possessions

te kanohi ki te kanohi face-to-face

Te Puäwai Tapu Mäori group within the Family Planning Association

tikanga customs

tino rangtiratanga absolute sovereignty

tohunga an expert with special skills

TPK Te Puni Kökiri

wähine, wähine woman, women

waiata song, to sing

wairua spiritual, spirituality

whänau family

whare rapuora health clinic

Glossary

36

There are many agencies working to improve

Mäori health. Get to know about them and the

people who work there - you will often meet them

at Mäori health hui held around the country. You

will get lots of health promotion ideas.

Spend time contacting iwi rünanga or pan-tribal

organisations. This is a good way of finding out

which Mäori agencies are active in your

community.

This list is just a beginning. There are many,

many more.

National level, issue-focused röpü

• Asthma Foundation (Kaimahi Mäori)

• Te Puäwai Tapu

• Mäori Women’s Welfare League

• Te Röpü Mate Huka

• Royal New Zealand Plunket Society

(Kaimahi Mäori)

• Te Röpü Tautoko

• Te Hotu Manawa Mäori

• Tipu Ora

• Te Köhanga Reo

Crown agencies

• Accident Rehabilitation and Compensation

Insurance Corporation (ACC)

• Land Transport Safety Authority

• Alcohol Advisory Council of New Zealand

(ALAC)

• Ministry of Health

• Employment New Zealand

• Ministry of Youth Affairs

• Housing New Zealand

• Ministry of Women’s Affairs (Te Ohu

Whakatupu)

• Hillary Commission

• Police

• Health Sponsorship Council

• Te Puni Kökiri

Regional, provincial and district level

• Regional offices of the above named

organisations

• Regional and district councils

• Regional health authorities (RHAs)

• Iwi rünanga

• District offices of pan-Mäori organisations like

the Mäori Women’s Welfare League, Women’s

Health League, New Zealand Mäori Wardens, etc

• Polytechnics

• Universities

• Crown health enterprises (CHEs) (including the

public health services)

Community, neighbourhood level

• Churches

• Plunket nurses

• Community centres and houses

• Retailers who are supportive

• Community constables

• Schools - Kura kaupapa Mäori

• Extended whänau

• Self-help groups (eg, Mäori breast feeding

support röpü)

• GPs

• Sports clubs

• Marae

• Te Köhanga Reo

• Pharmacists

• Whare rapuora

Remember that CHEs employ a range of people

whose work involves health promotion and

education. Health protection officers, dental

therapists, health educators, health promoters,

public health physicians, community health

workers and public health nurses are all important

in this work. Mäori kaimahi are also involved in

this mahi. These people often have

comprehensive networks that you could tap into

with their support.

AppendicesAppendix 1:Mäori health promotion and education providers in Aotearoa

37

Appendix 2:Sample sign-off sheetThis sheet is designed for you to adapt as necessary, and include with the final draft of any part of a

resource that needs signing-off.

L O G O

S I G N A T U R E D A T E

• The attached diagram meets my assessment of the criteria necessary to fulfil the technical

accuracy requirements for the above resource.

• I have initialled all the pages to verify that I have checked all provided content.

• I do not agree to be responsible for any subsequent changes made to the attached

content without my written consent.

H E A L T H E D U C A T I O N R E S O U R C E

P R O J E C T T I T L E

P R O J E C T M A N A G E R

H E A L T H I S S U E B E I N G A D D R E S S E D I N T H E R E S O U R C E

S I G N - O F F P E R S O N ’ S N A M E

D E S I G N A T I O N

O R G A N I S A T I O N

C O N T A C T F A X N U M B E RC O N T A C T P H O N E N U M B E R

Y O U R O R G A N I S A T I O N ’ S N A M E

38

Appendix 3:Other useful informationRefer to the appendices of Do We Really Need This Resource? for helpful information on:

• Ottawa Charter pp 83-84

• health belief model p 85

• sample planning sheets and sign-off sheets pp 86-90

• sample supplier brief p 91

• sample leaflets - pretest and final versions pp 92-94

Appendix 4:Sample budgetThis outline gives an idea of the components and layout of a budget for a small health education

resource project.

Whäia Te Hauora Tätari Moni (Draft Budget for Te Hauora O Aroha)

As at 31 January 1996. Kaiwhakahaere: M. Waru

Personnel $

1 x kaimahi (P. Tahi) 16 days @ 135.00 per day 2,160.00

1 x Nähi (M. Rua) 16 days @ 135.00 per day 2,160.00

1 x Äwhina ( J. Toru) 8 days @ $80.00 per day 640.00

Support

1 x pool car 16 days @ $30.00 per day 480.00

Stationery, photocopying, fax, courier 150.00

Fees and expenses

Project research, - computer search 50.00

Te Maunga Health and Sports Clinic (for photo shoot) 200.00

D. Rima and S. Whä (Poster models) 100.00

Mai Photography (Photography and proofs) 400.00

Printing

Nau Printers (200 sets of 3 posters, as per attached brief) 2,375.00

Distribution

Postage (initially 100 sets) 160.00

Packaging (materials and labour) 60.00

Advertising

Te Iwi Nupepa x 2 70.00

Evaluation 850.00

Contingency 145.00

T O T A L $10,000.00

Project funds contributed by

Whäia te Hauora Pütea Pütahi 7,000.00

Hirawi Kömihana 2,000.00

Koha Te Kotahi Rünanga 1,000.00

T O T A L $10,000.00

D A T E F O R R E V I E W : 15 June 1996

39

Appendix 5:Records checklistThis is a checklist to help you keep records of

your progress. It has been designed to give you

an idea of the sorts of items that need to be

kept permanently.

Official documentation

• Approved project proposal.

• A timeline chart.

• Summaries of consultation hui and

pretesting sessions.

• Approval from senior staff.

• Agreements from sponsors.

• Letters from röpü commenting on the report.

• Budget plans and revisions, and project plans

and revisions.

Contracts

• Signed-off texts, diagrams.

• Release forms (for people in photos, on audio

tapes, or in videos).

Helping to keep on track

• Summaries of phone calls from

content experts.

• Staff work and home number lists.

• After-hours phone and fax numbers of

suppliers and other organisations’

staff involved.

Expenditure

• Estimates and quotes.

Other

• Minutes of meetings and correspondence.

• Sample leaflets, posters that were useful for

the project plan.

• A list of good ideas that the team suggests

during the project.

• List of references, including publisher, date,

catalogue number and computer searches.

• Rough tally of time taken to complete different

parts of the project.

• Draft scripts, texts etc and written responses

to circulated drafts.

• Any programme lists you have for distribution,

advertising, or promotion.

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