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Activity Based Funding Conference
Innovation and collaboration: Activity based funding for sustainability in health care
5 – 6 May 2022 | Virtual and free
Dr Amohia Boulton
Director, Whakauae Research Services and Adj Prof, Faculty of Health and Environmental Sciences, Auckland University of Technology
Dr Amohia Boulton (Ngāti Ranginui, Ngai te Rangi, Ngāti Pukenga, Ngāti Mutunga and Te Āti Awa o te Waka a Māui) is the Director of Whakauae Research Services, an Iwi-owned and mandated health research centre in Whanganui, New Zealand, and the 2021 recipient of the Royal Society of New Zealand’s Te Tohu Rapuora Medal, awarded for her demonstrated leadership, excellence, and contribution to advancing Māori health knowledge.
A health services researcher of some 20 years, Dr Boulton’s research focuses on the relationship between, and contribution of, government policy to improving wellbeing outcomes for Māori. Her recent work has explored areas such as research ethics, the place of Māori approaches to wellbeing (whānau ora) and Rongoā Māori (traditional healing) in the publicly funded health system, and the role of data in healthcare decision-making. She is currently leading a five-year program funded by the Health Research Council of New Zealand, entitled, ‘Kia Puawai ake ngā uri whakatupu: Flourishing future generations’, which seeks to identify the conditions necessary for a health system shift; a shift where resourced action is targeted to achieve equity of health outcomes for Māori.
Dr Boulton is also an Adjunct Professor at both the Health Services Research Centre, Victoria University of Wellington and in the Faculty of Health and Environmental Sciences at Auckland University of Technology and holds a number of governance positions including membership of the Healthier Lives, National Science Challenge Governance Group Kahui Māori and on the Māori Advisory Board of the Malaghan Institute of Medical Research.
What inspired you to enter your field of work, and what drives you to continue with your specific research?
I actually fell into research accidentally, as I was working as a policy analyst in Te Puni Kōkiri, the Ministry of Māori Development, New Zealand, when my then Masters’ supervisor suggested I undertake a PhD. I was awarded one of the last Health Research Council of New Zealand Training Fellowships in Māori Health, which allowed me to leave the public service and study for four years. In the course of my PhD and subsequent postdoctoral work, I found I really loved research, and was able to try and seek answers to the answers that had been vexing me as a public servant – the chief one being, why is it that we can develop policies which ostensibly address issues of Māori development and equity, but do not achieve the outcomes we want at the end of the day. In other words, why despite all the knowledge, evidence and data at our fingertips, are we unable to achieve the sustainable system transformation that is required to achieve equity of health outcome? The pursuit of this question – what are the policy, system and regulatory barriers that prevent Māori, as a partner to the Treaty of Waitangi, from experiencing equitable health and social outcomes – is what continues to drive me and the work I do, and the work we do in our centre.
What does sustainability in health care mean in your work or research?
When I think of sustainability in health care, I can’t help but think of how the health system as a whole must address and continue to address the needs of, in Aotearoa New Zealand, Māori – as tangata whenua (people of the land, Indigenous people), as partners to the Treaty of Waitangi, or even from a purely social justice perspective, as a population with the worst health outcomes in the country. Sustainable health care in my view is concerned with firstly ensuring Māori health outcomes are at least as good as those experienced by all citizens in this country and that the system as a whole is able to provide for the needs of the Indigenous peoples now and into the future. Currently we know those needs are not being met, so the issue is how we do better with the limited funding we have to ensure better healthcare outcomes for Māori – prevention or wellbeing approaches, greater investment in primary care, and greater investment in Māori workforce development may offer some answers to the sustainability challenge.
Where do you see the biggest opportunities for innovation in your work or research?
The opportunity for innovation in Māori health services abound, whether it be use or deployment of novel methodological approaches; the potential of mātauranga Māori (Māori knowledge) to assist us in addressing wicked problems; or in partnership opportunities to effect change in health services or health care. An area we are concentrating on, and which provides us with some of the biggest opportunities for innovation, is thinking about how we disseminate our research findings for greatest impact. Our centre has developed the ‘TUI’ framework – to guide our thinking around how we best achieve Translation, Uptake and Impact with our research results. The whole scale and transformational change we need to see happen for our people requires innovative approaches to research dissemination – approaches that capture the imagination and creativity of key decision-makers in health care, so they can drive the change that is required to achieve equity of health outcome.
Watch Dr Amohia Boulton's keynote address Sustainability in health care – an indigenous perspective.