Identifying strategic opportunities for Māori community organisations to respond to pre-diabetes: Building a platform for integrated care to deliver change that matters to communities.

Abstract or Summary

Background/Purpose: The aim of this research was to partner with Poutiri Charitable Trust, a Māori Development Organisation, to identify strategic opportunities that may be considered and applied by the organisation to respond more effectively to pre-diabetes for the benefit of Māori. Research questions and methodology: To support this aim, the following questions were explored: What organisational strengths and resources may be applied by Poutiri Trust to respond more effectively to pre-diabetes? What organisational barriers and constraints experienced by Poutiri Trust may be addressed to respond more effectively to pre-diabetes? Utilising case study methodology, a range of data sources were triangulated including semi-structured interviews, documentation, and a diabetes systems map to identify possible strategic opportunities for consideration by Poutiri Trust. Findings: A thematic analysis identified several key findings of relevance to Poutiri Trust: What organisational strengths and resources may be leveraged by Poutiri Trust to respond more effectively to pre-diabetes? • Strong leadership and reach are two core strengths upon which to build, which will support the development of a clear strategic plan that aligns with the mission and values of Poutiri Trust to deliver services in the Bay of Plenty. • Poutiri Trust and its network of providers have the potential to utilise organisational data as a key mechanism for enabling self-determination, performance improvement and innovation, under the auspices of the Te Mana Raraunga - Māori Data Sovereignty Network and Charter. • Poutiri Trust values a partnership approach and strengthened partnerships with a range of partners including funders, researchers and providers will support capability and capacity development and evidence-based change. What organisational and/or system barriers and constraints experienced by Poutiri Trust may be addressed by Poutiri Trust to respond more effectively to pre-diabetes? • A weak external environment scanning function may have hindered the identification of strategic opportunities to date. • Current contractual key performance indicators, which are largely clinical output measures, result in a high reporting burden. • Capability gaps exist in some areas; for example, reporting to communicate more persuasively service quality and achievements. • Current contracts are almost exclusively funded by the Ministry of Health and local District Health Board, which brings considerable risk and cost of change for the organisation and the communities it serves. Conclusion: Poutiri Trust is well positioned to build on its strengths and overcome challenges to deliver improved health outcomes. Furthermore, for funders and policy makers seeking to improve Māori health outcomes, particularly in relation to pre-diabetes and diabetes, the following actions would be beneficial: • Greater recognition of the strengths of Māori Development Organisations as partners to effect change, promote community engagement, and ensure consideration of the local context; • More seamless integrated planning and funding across government agencies to support intersectoral integration of health with social services, including those that influence the impact of social determinants of health; • Capability and capacity building for Māori organisations to ensure the potential for data to inform funding decisions, and to shift and measure organisation- and system-level performance in an equitable way; and • Greater recognition that strengthened partnerships with Māori-led organisations will support measurable, evidence-based change and service delivery; and to demonstrate a wider range of positive outcomes, particularly when Māori knowledge systems are valued alongside a Western scientific approach.