Abstract
Background:
During the COVID-19 pandemic, the intensive vaccination rollout involved many innovations in an attempt to reach all sectors of the population, particularly those more vulnerable to the effects of infectious diseases.
Māori and Pasifika health providers were among the leaders of this, in the light of the well-known history of inequitable health outcomes for Māori and Pasifika in general, and specifically harking back to the early 20th century Spanish Flu epidemic, as well as their inequities in vaccination rates.
The authors were part of a research team contracted by the Ministry of Health to evaluate the COVID-19 vaccination training and workforce support provided by the Immunisation Advisory Centre (IMAC). As part of this, we had interviewed people at a selection of these health providers.
We were motivated to engage further with a subset of the Māori and Pasifika health providers to learn more about the innovations they had used during the COVID-19 vaccine rollout and how these were being transferred into their immunisation Business as Usual (BAU).
Project aims:
The aim of the project was to build relationships and develop research ideas with a diverse selection of Māori and/or Pasifika organisations who had participated in the COVID-19 vaccination rollout using innovative strategies.
We invited seven providers to participate, from diverse contexts across both the North and the South Island, with some based in large cities and some in smaller towns serving also rural populations. One pharmacy was selected to give the perspective of this sector which had an important role in the COVID-19 vaccination rollout.
The seven providers involved were (from north to south):
• Turuki Health (Tamaki Makaurau/Auckland)
• Te Kōhao Health (Kirikiriroa/Hamilton)
• Turanga Health (Tūranganui-a-kiwa/Gisborne)
• Horouta Pharmacy (Tūranganui-a-kiwa/Gisborne)
• Kōkiri Marae Hauora Services (Te Awa Kairangi/Lower Hutt, Wellington)
• Oamaru Pacific Island Community Group (Oamaru/Waitaki District)
• Awarua Whānau Services (Waihōpai/Invercargill)
Project methods:
During 2023, we held the following hui involving the seven health providers:
• Introductory Zoom meeting with representatives from each health provider
• Individual hui with representatives of each health provider, kanohi ki te kanohi at their premises
• One-day wānanga (kanohi ki te kanohi) with one representative from each health provider in Wellington (hosted by Kōkiri Marae)
This report summarises the immunisation strategies used by each of the health providers during and since the COVID-19 pandemic, in individual case studies that follow, and then draws comparisons, contrasts and lessons that can be learned from these experiences.
Supplementary data:
In tandem with this, we conducted a complementary study in which we held hui or interviews with community members and kaimahi of three of the Māori health providers to hear their experiences and thoughts around vaccination and vaccination services, particularly in the wake of the COVID19 vaccination rollout:
• Turuki Health
• Turanga Health
• Awarua Whānau Services
Community feedback from those who had experienced vaccination at these services is included as external commentary in a separate section.
The 77 participants in the supplementary project comprised:
• 46 community members (kaumātua, young parents and others)
• 31 kaimahi (vaccinators including nurses, kaiāwhina, health care assistants, health coaches)
Participants were invited to note one or more ethnicities in their own words. Nearly 60% of participants identified as Māori. Māori were invited to note their iwi.
In total, 67 of the 77 participants noted their ethnicity, with 6 specifying more than one ethnicity.
The self-reported ethnicities were:
• Māori: 45
• Pasifika: 11
• NZ or other European: 19
• Filipino: 2
In addition, we have also occasionally drawn on interviews conducted previously as part of the evaluation mentioned above in 2021 and 2022 (the date of interview is noted for each quotation).