![]() Turanga Health’s senior researcher Dr Shirley Keown breathed a sigh of relief then rang her boss when this year’s budget scrapped the $5 prescription charge for medicines. She knew the fee was damaging the health of vulnerable populations because she was a researcher in the Otago University FreeMeds study that proved it. “It’s just amazing to know that you have contributed to something that is going to have positive outcomes for whānau.” The study Dr Keown contributed to was published in the journal BMC Health Sciences Research and involved whānau from Tairāwhiti and other regions. It proves prescription fees are a major barrier to accessing health services and this leads to patients in vulnerable populations facing worse health outcomes. [See below]] Currently, people pay $5 for each new prescription item. “You pay a small contribution to the cost of the medicines prescribed by your doctor — which is $5 for most items. If your medicine is not fully subsidised, you might have to pay more.” Dr Keown says the current system was not supporting Māori to live long and healthy lives. “Māori didn’t seem to have full access to medicine and health care they are entitled to, and that really annoyed me. I needed to red flag this somewhere, and my earlier research and now this, is how I’ve done it.” Dr Keown, Rongowhakaata, is a senior researcher, clinical mentor, and quality manager at Māori health provider Turanga Health. Before taking part in the prescription copayment research, she earned her doctorate through the Otago University School of Pharmacy with a body of research looking at how Māori with type 2 diabetes access and use medicines they’re prescribed for the disease. Dr Keown has always hoped the research she’s involved in will lead to practical solutions for improving Māori health. “It was a hard slog to get this one over the line but once it materialized and was tangible, we knew we were on to something.” The researchers lobbied hard for the Ministry of Health and Pharmac to read the study. “The communities know that copayments are a barrier, but we needed to make sure others knew. We had to build the case. We didn’t want it sitting getting dusty on a shelf somewhere.” On the day of this year’s budget announcements, Finance Minister Grant Robertson referenced the study. He said, “the Otago University study that we based a lot of our decision-making on indicates that there is a significant cost where people don’t pick up their prescriptions and end up back in the health system.” Dr Keown says when she heard the news she immediately contacted Turanga Health chief executive Reweti Ropiha. “Boom! That’s what he said. Boom, and I couldn’t agree more.” Cost preventing patients from accessing medicines Between February 2020 and January 2021, researchers from University of Otago, Turanga Health and Victoria University looked at whether exempting people with high health needs and living in areas of high deprivation from a $5 charge reduces hospital use. The 1061 participants recruited were randomly split into two groups, an intervention group, that had their prescription copayments paid by the research team during the trial, and a control group that did not. Results of the study, published in the journal BMC Health Services Research, revealed the intervention group members were much less likely to be hospitalised during the trial. For every 100 people who received free prescriptions, 33 were admitted to hospital and stayed for 208 days. For every 100 people who still had to pay the $5 charge, 41 were admitted to hospital and stayed for 326 days. There were also statistically significant reductions for the intervention group in the number of hospital admissions for mental health problems and chronic obstructive pulmonary disease (or COPD) plus reductions in length of stay for COPD. Researchers involved in the study were Pauline Norris, Kim Cousins, Simon Horsburgh, Shirley Keown, Marianna Churchward, Ariyapala Samaranayaka, Alesha Smith and Carlo Marra. Dr Shirley KeownDr Shirley Keown has for a long time been recognised as one of Tairawhiti’s most senior nurses and health programme managers.
After working in hospitals in Wellington, Auckland and Gisborne, she came to Turanga Health in 1999 and created its Well Child Tamariki Ora programme which now looks after nearly half of the 700 babies born in Gisborne every year. In 2007 she led the organisation to achieve its first accreditation. Already armed with a Bachelor of Nursing, Dr Keown added a Master’s in health science to her qualifications in 2007, and has earned all the university-level pharmacology papers she needs should she decide to become a nurse prescriber. In 2020 she graduated with her doctoral research degree. Dr Keown is now supporting Turanga Health with three prominent nationwide studies. The first is looking at the ongoing impacts of Covid-19 and future pandemic responses. The second study, funded by Health Research Council of New Zealand, is looking at how iwi health providers can measure the impact and social value of their activities. The third study has been following whānau over a year to understand their experiences of accessing healthcare and medicines.
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![]() Turanga Health nurse Riaana Higgins is passionate about hapori whānau nursing and is studying to become a prescribing nurse in the community. After a year working in Oranga Hinengaro Māori Mental Health in Manawatu, the 28-year-old has returned home to te Tairāwhiti and has been at Turanga Health for nearly a year. “I always wanted to work in the community,” says Riaana, Ngati Porou, Ngai te Rangi. “I missed my family, and I decided early on that if there was an opportunity to come home then I would try and work for Turanga Health.” Riaana was a community nurse with Oranga Hinengaro in Palmerston North. She was part of a team providing assessment, treatment, and care to tangata whaiora of all ages and their whānau. It was a for Māori, by Māori service. “I like being out and about in the community because you see a different perspective of someone. When they come to the clinic you just see them for a short time in one place but when you go into their home you can see their social situation as well.” Now working with Turanga Health’s community nursing team, Riaana is studying part-time to become a prescribing nurse in the community. The postgraduate diploma was created so nurses with prescribing qualifications could safely improve access to healthcare for people with long-term or common health conditions. Riaana is doing the study through EIT and looks forward to qualifying in 2025. Riaana lives with her beloved grandmother Mate Wanoa. “Nan is in Turanga Health’s Kaumātua Programme and always said nice things about Turanga Health.” It was just one more reason for Riaana to return home and do the mahi she loves. ![]() Awhina Kaihe, Ngāti Porou, Ruatoria, is living her best life as a kaiāwhina with Turanga Health. The former teacher aide and mother of one joined the iwi health organisation in September 2022 and says working in primary health services for whānau has changed her worldview. “It’s a job that’s opened my eyes to what is going on for some people and that there is no room for judgement.” Awhina is part of the tamariki ora team helping to look after around 350 pēpi born in Gisborne every year. Nurses and kaiāwhina provide the nationally-available Well Child Tamariki Ora programme of health visits for children from 6 weeks up to 5 years. They also provide ante-natal wananga and other support for māmā and their pēpi. As a single māmā, Awhina is more aware than most about what it’s like to feel vulnerable and in need of support from others. In 2021, while heavily pregnant with her daughter, she fell gravely ill with pneumonia and bronchitis. Struggling to breathe she was rushed to hospital in Gisborne and admitted to the intensive care unit (ICU). She was then transferred Tauranga Hospital’s ICU. “It was life-threatening for me and I could have lost her,” says Awhina in her husky voice, another reminder of what impact the illnesses had on her. “Yes, a lot of people notice that! The illness took my voice from me and two years later it’s still coming back slowly.” Another big change for Awhina has been an incredible weight loss over the past three years. Once weighing in at over 140kg Awhina is now a healthy body shape and size giving her the freedom to do the things she and her daughter love like spending time at a whānau farm near Ruatoria. “It’s so peaceful up there.” Awhina, whose name means helper, grew up on the East Coast and went to school at Te Kura Kaupapa Māori o Te Waiu O Ngati Porou, and Lytton High School. She worked towards getting her teacher’s certificate from Te Whare Wānanga o Awanuiārangi and says she will complete it one day. Awhina worked at Te Puna Reo o Raparapaririki in Ruatoria for three years before making the move to Gisborne and working at a kōhanga reo as a kaiāwhina, also for three years. On the day of this interview Awhina, 28, was observing nurse and kaiāwhina influenza and Covid-19 immunisations at a Turanga Health vaccination clinic. The experience is setting her up to work at Turanga Health’s popular and successful whānau vaccination drive-through events held most weekends around the rohe. “Joining Turanga Health has been a healthy decision for me, and my baby and I am grateful every day I have the opportunity to work here. I now see the difference we can make with the help that we can provide. I see it on their faces. I’ve told my mum and dad; ‘this is the workplace for me’.” ![]() Turanga Health hosted Hoops in Schools launches at four primary schools last week with help from New Zealand Breakers basketball player Tom Abercrombie. Hoops in Schools is a Basketball New Zealand programme that partners with schools, funders, local basketball associations and other basketball providers. The concept puts more fit-for-purpose hoops in schools, so young people are more active and having fun playing hoops in their communities. Abercrombie and the Turanga Health team visited Muriwai, Manutuke, Patutahi and Whatatutu Schools to the delight of students. Meeting a sports star and slam dunk competitions were just some of the fun enjoyed by the students. “It was a huge moment for them to meet a real-life New Zealand sports star and Olympic athlete,” says Turanga Health population kaiwhakahaere Dallas Poi. “A lack of suitable equipment and facilities is one of the biggest barriers to school sport participation so when the children see the new equipment, they are excited and want to start playing straight away.” “We know the significant impact that it has had across other schools where hoops have been installed previously – increased participation, more students physically active and schools engaged with local associations. It’s a win for everyone.” ![]() Ko Mātiti te maunga Ko Maraetaha te awa Ko Ngāi Tāmanuhiri te iwi Ko Horouta te waka Ko Muriwai ahau Former Ministry of Social Development employee Alisha Kemp brings experience helping people in need to her new role with the māmā and pēpi team at Turanga Health. Alisha says working in a role where you assist whānau facing complex and challenging circumstances helped her understand the importance of listening to the whānau voice. “It helps break down barriers and meet whānau needs - similar to what we do here at Turanga Health.” At Turanga Health, Alisha, Ngāi Tāmanuhiri, works with E Tipu e Rea, a holistic program that helps look after māmā who are facing challenges while they are pregnant, or when they have a new-born or young child. E Tipu e Rea referrals from around the rohe are managed through the Turanga Health team. Once approved, staff from Turanga Health, Ngāti Porou Hauora, and Te Whare Hauora o Te Aitanga a Hauiti work with these families. Alisha says it's rewarding to be working with whānau for whānau at an innovative, forward- thinking, mobile organisation. Last weekend, nurses and kaiāwhina hosted a Turanga Health Whānau Day for vaccinations on the grounds of a school. “Turanga Health is so far ahead in culture and what they do for whānau. They go to the people and never see any barriers.” Alisha worked in Government services for 15 years, most recently with Work and Income NZ. Before that, she was with Study Link helping students with their finances. After she saw the Turanga Health administration vacancy advertised Alisha had to ask her māmā Louise Kemp for her blessing to apply. Louise has worked for the iwi health provider for over 20 years. “I have seen my mum start each day so passionate about her mahi and now I can see why.” Outside of work, Alisha is a proud māmā to daughter Jayda Riarn and son Eli-Brooks. She enjoys spending time with whānau and friends, keeping fit, and giving things a go including the social and sporting opportunities Turanga Health creates for its staff. ![]() LOUISA-MAY Robinson went from client to staff member after existing Turanga Health staff encouraged her to apply for a recently advertised kaiāwhina role. Louisa-May, Ngati Porou, was receiving support from the Turanga Health emergency housing team when kaiāwhina Naleya Ahu identified her quiet abilities. “She had a lot of potential for a young person, took on a lot of ownership and responsibility for her whānau and the way forward.” Naleya was particularly drawn to Louisa-May’s aptitude for problem solving and communicating. “She’s approachable, honest with people, and always upbeat with a smile.” Louisa-May was taken aback by the suggestion. Too much self-doubt she reckons. “But I did it anyway, and I love it so much now.” Previously, Louisa-May, 25, has been raising her nearly-three-year-old daughter alongside taking on some work in kōhanga reo. Now she has thrown herself into kaiāwhina on-the-job training and qualifications by shadowing nurses and kaiāwhina, and working alongside hapū wahine. This month she’s studying to become a vaccinator so she can administer influenza, Covid and booster vaccinations, as well as some childhood and hapū māmā immunisations. There’s theory and practical modules to advance through. On the day she was interviewed Louisa-May had vaccinated a fellow staff member with this year’s influenza vaccination. “I love that Turanga Health upskills all its kaimahi. You never get bored here.” Louisa-May began with Turanga Health just days before Cyclone Gabrielle hit the district. She joined forces with other Turanga Health kaimahi cooking meals for whānau flooded out of their homes and emergency response staff working on the frontline. “I enjoyed it, it was cool to know we were doing something that was helping.” Louisa-May feels like she’s “home” now she’s working at Turanga Health. The organisation prioritises kaimahi physical and mental health, ensuring staff can manage family life around their work commitments, and access fitness and team building opportunities. It’s a good fit for Louisa-May, who values personal health to best support the growth and development of her own moko. And it’s another attribute Naleya noticed when they first met. “You have to start with selfcare in order to be able to help others, and Lou is all about that.” Louisa-May is grateful for the opportunities on offer and hungry to learn more. “I’m so glad I came out of my comfort zone and applied for this job.” |
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