Project Spotlight: 2017 IAP2 Australasia Health Project winner
Can you provide a general overview of your project?
Since 2013, Auckland and Waitemata District Health Boards (DHBs) have been working together to develop a plan for maternity services to meet our communities’ needs into the future. Researchers identified an increasing demand for maternity services in the Waitemata area as the population continues to grow and the DHB determined to explore the potential demand for increased primary birthing facilities. The DHB board requested that ‘quieter voices’ were heard from during the consultation.
Feedback was sought on:
- community demand and potential use of any new primary birthing units
- where a primary birthing unit should be located
- what facilities or services should be provided there
- how the unit should be managed
- what would encourage the community to use the unit
It was also important to understand any differences between cultural or demographic groups and between consumers and different health professionals, including Lead Maternity Carers (midwives and obstetricians).
Tell us about your project:
a. What types of engagement methods/tools did you use?
People were offered different ways of providing feedback: through an online survey or through one of a series of small group forums aimed to focus specifically on the views of Maori, Pacific, Asian and young parents. DHB-run forums (seven in total) took place on different dates and locations (including weekends and evenings).
b. What principles did you find most useful in carrying out this project?
The consultation on primary birthing units was carried out in alignment with principles that are also the DHB’s core values of ‘Connected’ and ‘Everyone matters’. It aimed to improve communication with partner organisations, health professionals and the wider community to build their understanding of primary birthing units and to ensure that Waitemata’s diverse community voices were able to be heard as part of the decision-making process.
c. Did you come across any surprises on this project?
The way we engaged allowed us to get to understand previously unknown views by Asian, Refugee and migrant communities – issues like the importance of providing culturally appropriate and nutritious meals in a warm environment for new mums and babies and what support might be needed – particularly for people who don’t have an extended family in New Zealand.
d. How were you able to reach such a large portion of the community?
Tapping into social media networks was really important for us while community partner organisations were key to the success of reaching specific demographics. Community leaders and elders were important to involve early which helped to build trust and encouraged others to participate while also providing insight into how families influence a mother’s choice of where to birth their babies.
Did you apply the IAP2 Spectrum or the IAP2 Core Values in this project ?
At an early stage we knew that the process would be at the ‘consult’ level of the Spectrum – to obtain public feedback on analysis, alternatives and/or decisions.
It was a great team to work with as they were already working in a way that was aligned with the IAP2 Core Values. There are community members who have an ongoing role within the team to ensure that they think of the needs of their community in everything they do and really wanted to make sure we did hear the community’s views before making a recommendation on whether or not to proceed with a primary birthing unit.
What did you find the most rewarding aspect of working on this project?
It was a real team effort. Partner organisations and staff went out of their way to help ensure that we heard views from our diverse communities and supported those who don’t usually get involved. So we had events at refugee and migrant playgroups, attended a wide range of pacific community activities and our Asian health partners helped to encourage people to attend the community forums by providing transport. In addition, senior staff attended events which helped both participants and staff to feel supported and to demonstrate their openness to community views – this has helped us to build trust within the community.
What are the current challenges or barriers that still exist in this area of engagement?
When I first joined the DHB, there was a perception that community consultation took place in cold draughty halls and no-one turned up so there is a lot of effort with very little reward. This consultation has helped to show people that providing people with an opportunity to get involved online is key (as long as it is done well) but that support is still needed for some communities.
The other big challenge within our sector is the difficulty in getting funding to facilitate this kind of engagement.
Were you able to overcome those barriers/challenges and if so how?
We were able to do quite a lot based on good will and using existing contacts, resources and partnerships. Funding is an ongoing issue and the budget was very low considering the extent of our engagement. Our main cost was in providing catering at each event but we felt this was essential to thank those people who did attend and helped to make it a family-friendly and engaging environment.
What are some of the learnt lessons from this project that others could learn from?
Community engagement within healthcare is still a growing field. There is a lot of focus on co-design and working with existing patients but less so on understanding population health issues and concerns. This consultation has received some really positive feedback from the health sector and I hope that winning this award will encourage other health organisations to consider the IAP2 framework and how it can help them to engage with their communities and particularly in a way that enables them to hear from the quieter voices too.
