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10-year plan for Pacific children’s health – Expert Reaction

Quality housing, sustainable incomes, and better access to healthcare and education would make a world of difference to Pacific children’s lives, according to researchers.

The recommendations are made in the Tamaiti Ole Moana report, containing a 10-year plan to drive better outcomes for Pacific children and families. It comes ahead of the Pacific Child Wellbeing Conference being held in South Auckland this week, which highlights that one in four Pacific children are still living in poverty compared to one in ten children in the overall population.

The SMC asked experts to comment. 

Associate Professor Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Associate Professor, Dean’s Department, University of Otago Wellington, comments:

“The Tamaiti Ole Moana Action Plan and report being launched today covers some of the child health and wellbeing issues affecting Pacific children in Aotearoa New Zealand, proposing specific recommendations to help address these.

“This 10 Year Action Plan is focused across four main areas (1) access to quality housing, (2) boosting incomes, (3) improving access to quality healthcare and (4) education.

“With respect to housing, the connection with health is undeniable – housing remains a significant health determinant, particularly for children. Education is also a determinant of health. Accessibility to timely health care remains problematic for some.

“Significant inequities still persist for Pacific peoples in Aotearoa New Zealand, and includes our children and tamaiki. Equity based approaches take into account the specific needs of respective communities in seeking to address inequities effectively and efficiently. “One-size fits-all” approaches that have dominated in the past, have benefitted many, but often left behind those most in need of help and assistance.

“During the COVID-19 vaccination roll-out, we saw how Pacific-led, community driven, properly resourced, targeted and tailored vaccination efforts that involved and included Pacific leaders and health professionals here in Aotearoa New Zealand, helped drive up vaccination levels for Pacific peoples over a very short space of time.

“These Pacific-led solutions provided visible demonstrations of equity based approaches in action – by not adopting a “one-size fits-all” focus, but rather taking into account the specific needs for Pacific groups, reducing barriers, and building trust.”

No conflict of interest declared.

Associate Professor Dr Teuila Percival, Paediatrician and Director of Moana Connect, comments:

“Inequitable health outcomes for Pacific children continue with high infant and perinatal mortality and the highest hospitalisation rates for infectious diseases and respiratory disease. Each infectious disease outbreak, be it measles, respiratory syncytial virus or Covid-19 hits our communities hard. Health promoting environments and accessing effective healthcare are critical and we have seen with the Covid-19 response that the Pacific Community and Pacific Providers can develop and deliver their own Pacific specific programmes that reach our community and deliver outcomes such as high vaccine coverage, important to Pacific people and the country.

“Healthcare is important but the underlying determinants of Pacific children’s health and wellbeing need to be addressed. Latest Government statistics tell us that 1 in 4 Pacific children are still living in poverty. Our Pacific families more than any other group live in overcrowded and poor housing.

“Tamaiti O Le Moana 2023 sets out a way forward, focusing on actions that can bring about thriving, well Pacific children now and in the future. We see the solutions as achievable building on decades of research, Pacific Provider experience and strategies and policies that can work if scaled up with a clear focus on lifting Pacific children and their families out of intergenerational poverty.

“Families living in homes that are substandard and overcrowded taking up most of the household income leaves our families at risk of poor health and locked in intergenerational poverty.

“We should also be cognisant that our large families which include grandparents are important for children’s and parent’s well-being. Grandparents in households connect with culture, language and identity and can mitigate health issues such as postnatal depression.

“We have the beginnings of housing solutions with Awhi and Healthy housing programme, but we need to do more, targeting the homes of 30,000 Pacific families with dampness and mould.

“We also need to build homes “fit” for our multigenerational large families. Again, we are seeing the beginning of this with Penina Trust in Auckland and the Central Pacific Collective in Porirua, but we need to upscale this to make a substantial difference to poverty and Pacific children’s health. We estimate a target of 5,000 intergenerational homes over the next ten years through Government, Community providers and Kainga Ora is needed to adequately house the large Pacific households with 7+ people.

“There are some good policies in Pathways to home ownership. The Pacific Community and Providers can improve access and scaling up these First Home products. It is critical too, that First Home buyer products incorporate the needs of multi-generational families.

“Pacific people are more likely to be living in low income households. Directly lifting those incomes will benefit our children. Our suggestion is to increase the minimum wage to a living wage and implementing a pay transparency law (as recommended by the Human Rights Commission) to address the pay gap between Pacific workers and other New Zealanders.

“It is pleasing to see that the Government is increasing WINZ benefits on April 1st. This is an important step to improve the lives of children. Increases in level of support through Best Start, Working for Families and the Winter Energy Payment should be next.

“Education is one of the most important determinants of health and well-being. Research and community experience tell us that investing in the pre-school years with Early Childhood Programme and Centres that connect with our community and cultures will give our children the best start in education. This requires investment in growing our ECE’s and workforce and will build on existing the strengths in our communities.

“Finally, healthcare for Pacific children has many needs including addressing implicit bias and racism and growing our Pacific clinician workforce. The lessons from Coivd-19 should not be forgotten and that is when Pacific providers work with an enabling supportive Funder, they can design, deliver and implement effective healthcare at scale and with speed.”

Conflict of interest statement: “I am part of the team that has commissioned this report.”