Review of services for people living with HIV in New Zealand

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InquiryResponseLack of information, lack of access to culturally appropriate services,misinformation on HIV risks, no access to culturally tailoredinformation.lack of political or social power, low individual and community selfesteem.Urbanisation/trans‐Tasman migration, fragmentation of whānau,hapū and iwi.Geographic isolation.Poverty – Māori are disproportionately on low and very lowincomes.Poor general health – limited access to health care and resources,i.e., condoms.Low literacy and numeracy – lack of education.Māori have the highest STIs recorded population; 80% are Māoriunder 25.Substance abuse – alcohol and drug addictions.Discrimination within the community towards sexual diversity andstigma attached to that diversity.Men that have sex with men are identified as “the exact group mostat risk of infection” in Āotearoa, with national organisations stating“HIV in New Zealand continues to be almost exclusively a disease ofwhite men who have sex with white men”. 4Māori have lower rates of testing – test trials showed 3.9% testedidentified as Māori.The Treaty of Waitangi has been excluded or removed fromnational provider’s policies.The Ministry of Health 2003 HIV Strategy acknowledges Māori as avulnerable group, yet key national service providers bases allstatements on the HIV epidemiology and claims that this shows that“Māori are not adversely affected by the epidemic”. Nationalproviders have stated “Māori and other ethnic groups hardlyfeature on the radar ...”. 5Cultural determinants or whakapapa and the impact of HIV onwhānau, hapū, and iwi are not considered.8. How is the service working on anadministrative level?Administrative capacity (staff numbers)Administrative needsAdministrative strengths andweaknesses – how burdens affectoutputsAdministration is done by the Kaiwhakahaere. INA needs another staffmember to do all the administrative duties. With only one employee,time gets consumed and priorities are given to support and education.Administration is done when all other duties are not as important. Thisburdens the organisation with less time to source appropriate funding.Volunteers help wherever possible.45Quote from Gaynz.com 2/03/09 Racheal Le Mesurier(NZAF Exec Director) “Towards 2010: the NZAF’s progress”.As above.68 REVIEW OF SERVICES FOR PLHA
Inquiry9. How is impact, effectiveness and valueassessed, and what have those assessmentsindicated to date?Criteria employedFrequency and modes of assessmentsEvidence of data for policy10. Are there any gaps in service coverage thatneed future investment?11. Are there plans for service development orevolution?ResponseOutcomes are measured by short term, mid term and long term goals.Each programme that INA administers included a client evaluation andfeedback form. When education seminars are conducted whether inpartnership with other organisations or alone, INA is able to captureinformation relevant to results and performance, this is then collatedand analysed for evidential reasons and funding. This data is thenreported via minutes, reports and announcements.INA operates by donations and grants with $75,000 received in our firstyear of operation. However, the following year, showed a significantdecline in funding availability for our services. Issues facing funding forINA include; a small pool of funding available for HIV, other groupscompeting for same pool of funding, and the perceived ‘newness’ ofour organisation. When speaking to funders, they appreciate the needfor the service, but also voice concerns about lack of support fromlarger services that hold government contracts and MOH support.The identified gaps are the provision of culturally approved andappropriate services to Māori, indigenous and Pacific peoples. Withemphasis on; Māori for Māori (PI for PI) education and awareness onHIV to the community – whānau, hapū and iwi.There are non‐Māori specific services available to PLWHA; however INArecognised a gap for Māori for Māori support, whānau support, bybeing a member of the non‐māori specific services. Regardless ofwhere and when, the māori gravitated towards each other and grew innumbers, with the question of “Why don’t we have a Māori AIDSFoundation?”. 6 This question was answered by Māori; women, men,Takatāpui/MSM, transgender, PLWHA, kaumātua, whānau, hapū andiwi – that the time has come to have a Māori AIDS Foundation. Hencethe registration of INA (Māori, indigenous and HIV/AIDS) Foundation.INA is the gap and the need for future investment.INA has a comprehensive business plan highlighting the capacitybuilding and development of the services, including:continued training of PLWHA to be educators and advocatesHIV campaigns nationally for whānau, hapū and iwi usingmultimedia resources, and travelling road showresearch projectsohu mahi – development of key PLWHA graduates of previouswānanga to be satellite services throughout New Zealand; capacitybuildingdevelop communications strategy, to reach rural and remote areas,as well as urban. Incorporate Pacific Island AIDS ambassadors toeducate their New Zealand resident Pacific peoplessource rapid testing, and provide voluntary testing and counsellingemploy a whānau support coordinator to liaison and refer to otherservices, a Communications coordinator, an education coordinator,event coordinator and two HIV health promotersemploy a further mental health professional, HIV nurse specialist,administration team of three, and a research project manager.62005 Pan Pacific AIDS Conference, Māori Caucus meeting.REVIEW OF SERVICES FOR PLHA 69
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REVIEW OF SERVICES FORPEOPLE LIVING
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ACRONYMSAEGAMTACANCAPPARVBPCBOCSWDH
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CONTENTSACRONYMSACKNOWLEDGEMENTSEXE
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EXECUTIVE SUMMARYThis review has id
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INTRODUCTIONThe national clinical a
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The available data show that in the
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Family Planning is a not‐for‐pr
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METHODOLOGYThis review effectively
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* This does not include all DHB ser
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an adult sexual assault unit - SH r
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B. WAIKATO DISTRICT HEALTH BOARD (w
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perceived as formally (if implicitl
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Page 35 and 36: As indicated above, there is a stro
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Page 43 and 44: Despite INA’s development constra
Page 45 and 46: Difficulties in maintaining quality
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Page 51 and 52: CONCLUSIONSFrom the foregoing, some
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Page 63 and 64: InquiryResponseResearch, analysis,
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