Our research portfolio
Kaupapa Māori theory informs the basis of NHC health research.
On this page
Past research
Pacific Fono
This was a National Hauora Coalition led initiative. Rheumatic fever inequitably affects Māori and Pacific children in New Zealand. Counties Manukau has the highest national rates of rheumatic fever (4.7 per 100,000 for first recorded rates). School-based throat swabbing services, such as the South Auckland Mana Kidz programme, are a key element of rheumatic fever prevention interventions. Mana Kidz undertook an exploratory, community-based initiative to improve its service delivery for Pacific Peoples. Mana Kidz held a Pacific Leaders’ Fono (meeting) to discuss initiatives to improve rheumatic fever outcomes in South Auckland focused around challenges and solutions for addressing rheumatic fever, effective engagement strategies and leadership qualities needed to drive initiatives. Oral and written responses from 66 attendees were collected and thematically analysed.
Reference: J PRIM HEALTH CARE 2020;12(4):384–390. doi:10.1071/HC20022
Read the publication: (https://pubmed.ncbi.nlm.nih.gov/33349328/)
Impetigo trial
This project was led by Dr. Alison Leversha, Auckland DHB in partnership with National Hauora Coalition. Impetigo is a contagious superficial bacterial skin infection, predominantly affecting children. New Zealand experiences a particularly high burden of skin and soft tissue infections with as many as 11% of NZ children aged under 15 years consulting their general practitioner for skin infections annually. The highest rates of which are seen in children under 10 years of age and Māori and Pacific children. These ailments are treated with topical antibiotics such as fusidic acid. However there is growing concern about increasing antibiotic resistance driven by the wide-spread community usage of topical antibiotics. Alternative therapies must be urgently found to prevent increasing resistance. This project aimed to compare two alternative treatments with the current standard of care treatment for mild-to-moderate impetigo among school children. Data collection wrapped up in April 2021.
Current research
Sensors Project
This is a National Hauora Coalition led study. The project used sensors in the homes of whānau in South Auckland to better understand the potential influences that the interventions coordinated through AWHI healthy housing initiative may have on the indoor temperature and humidity of a home. High humidity, poor insulation, poor maintenance practices, and relatively low levels of heating mean that many New Zealand families live in damp and cold homes. Dampness can lead to mould growth which leads to health consequences including respiratory illnesses. Māori and Pacific peoples and those living in lower socioeconomic quintiles tend to live in areas with poor quality housing contributing further to health inequities. This project collected quantitative data on indoor temperature and humidity in AWHI homes both pre- and post- interventions in the home to influence indoor temperature and humidity alongside increases in healthy homes education with whānau. 40 whānau were onboarded to this project in the end of 2019 and this project is slated to finish in early 2021.
Reference: This is an Original Manuscript of an article published by Taylor & Francis in Kōtuitui: New Zealand Journal of Social Sciences Online on 31 August, available at http://wwww.tandfonline.com
Read the publication: Substandard South Auckland housing: findings from a healthy homes initiative temperature study
Te Puna Rongoā : Achieving medicines access equity for Māori – pharmacists’ role
This project is led by Dr Joanna Hikaka and is a partnership project between Ngā Kaitiaki o Te Puna Rongoā o Aotearoa (the Māori Pharmacists’ Association) and National Hauora Coalition. The study is a multi-phase, mixed methods Kaupapa Māori project that aims to explore how Ngā Kaitiaki o Te Puna Rongoā o Aotearoa can support equitable access to medicines and to understand Māori experiences and drivers of medicines adherence and non-adherence. It is intended that this study could be used to inform health intervention and service development in the future.
Read our press release about this study here >>
Bridging the gaps: applying rangatahi Māori and Pacific patient centered models of care to inform acute rheumatic fever and rheumatic heart disease service delivery
This Kaupapa Māori research is funded by Cure Kids and is being undertaken in collaboration with National Hauora Coalition, the University of Auckland, the University of Otago and Waikato DHB. The research aims to develop a rangatahi Māori, Pacific patient and whānau centered model to improve acute rheumatic fever (ARF) secondary prophylaxis health services, treatment and management. ARF is an autoimmune response to an untreated group A streptococcus (GAS) infection, usually in the throat. The most severe sequela is rheumatic heart disease (RHD) which may require cardiac surgery. Significant ethnic disparities exist in ARF with disproportionate rates among Māori and Pacific children between 5 and 14 years of age. To prevent ARF patients suffering further heart damage secondary prophylaxis is recommended. This involves monthly intramuscular penicillin injections for a minimum of 10 years. Recent research on Māori and Pacific Peoples’ experiences of ARF prophylaxis identified mismatches between ARF services and patient/whānau expectations of care, particularly for rangatahi (adolescents/young adults between 15-24 years). Furthermore, whānau and health providers reported difficulties with prophylaxis provision identifying significant challenges in transitioning from paediatric to adult ARF/RHD services. Collectively, these studies highlight notable gaps in culturally responsive, age-appropriate care for rangatahi Māori and Pacific. This research aims to bridge these gaps by developing a rangatahi Māori and Pacific patient centered model to improve ARF secondary prophylaxis health services and treatment.
Lockdown Doctors: Reducing health care inequities for Māori using virtual clinics and online platforms (a real-time response to COVID-19)
This is a collaborative study by National Hauora Coalition, The University of Auckland, Papakura Marae, Royal New Zealand College of General Practitioners, Te Rōpū Whakakaupapa Urutā, Te Ohu Rata o Aotearoa (Māori Doctors Association) and the University of Otago. Māori continue to experience significant barriers to accessing primary healthcare that contribute to ongoing health inequities. In direct response to COVID-19, primary healthcare practices quickly adopted virtual (online/video/phone) GP clinic models in order to continue to provide primary healthcare to New Zealand communities. Feedback from Māori health professionals involved with COVID-19 lockdown responses suggests that the ‘virtual clinic’ experience inadvertently removed barriers to healthcare for Māori patients in particular. For example, attending GP visits through virtual clinics (online) eliminated transport costs, travel and waiting times for consultation. This research aims to investigate and inform the use of virtual healthcare clinics within Māori communities as a catalyst to reducing barriers to accessing healthcare, and thereby reducing health inequities.
In the media
Reducing Healthcare Inequities for Maori using Telehealth during Covid
Telehealth consultations have the potential to improve access to healthcare for Māori, and thereby reduce health inequities. Conversely, Telehealth may present additional barriers that contribute to inequities overall.
Researchers Erena Wikaire, Matire Harwood, Kayla Wikaire-Mackey, Sue Crengle, Rachel Brown, Anneka Anderson, Rawiri McKree Jansen, Rawiri Keenan carried out a scoping project, that investigated Māori experiences of Telehealth consultations during the March 2020 COVID-19 lockdown.
If rheumatic fever affected Pākehā, more would be done
Dr Anneka Anderson is a leading academic in rheumatic fever and says if it was a disease that affected Pākehā children, much more would have been done. She spoke to Māni Dunlop in this Radio New Zealand Health episode.
Is it time for a rheumatic fever register?
Dr Anneka Anderson joins RNZ to talk about the implications of hard to access, untargeted treatment for rheumatic fever, and what needs to happen.
Eradicating rheumatic heart disease
Dr Anneka Anderson chats on the Cure Kids NZ podcast
Research to improve medicines access for whānau
NHC has partnered with Ngā Kaitiaki o Te Puna Rongoā o Aotearoa (the Māori Pharmacists Association) to carry out research into equitable medicines access for whānau Māori.
Study to prevent Paracetamol poisoning in children
NHC Clinical Director, Dr Rawiri McKree Jansen is the lead researcher in a Māori-led study looking at the challenges caregivers can face in accurately dosing paracetamol.
Ngā kairangahau
Our research staff
Click on a staff photo to view selected works.
Dr. Rachel Brown
Dr. Anneka Anderson
Dr. Rawiri McKree-Jansen
Donna Kielar
Jadene Wheeler
Dr Ainsleigh Cribb-Su’a
Jonathan Murray
Melaney Tkatch
Dr Rachel Brown
Te Ātiawa ki Wharekauri, Kāi Tahu
Selected works
– Bennett, J., Anderson, A., Ofanoa, M., Anderson, P., Brown, R., Devlin, G., Eggleton, K., Harwood, M., McKree-Jansen, R., Kielar, D., Malcolm, J., Moreland, NJ., Poskitt, N., Sika-Paotonu, D., Webb, R. & Wilson, N. (2021). Acute rheumatic fever- a preventable, inequitable disease: a call for action. The New Zealand Medical Journal, 134(1535): 93-95.
– Brown, R. (2018) Surviving the system: Māori and Pacific whānau coping strategies to overcome health system barriers. PhD thesis. Auckland University of Technology.
– National Hauora Coalition, Anderson, A., Brown, R., Wheeler, J. & McKree-Jansen, R. (2020). Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland. New Zealand Journal of Primary Health Care, 12(4): 384-390.
Dr Anneka Anderson
Kāi Tahu, Kāti Māmoe
Selected works
– Anderson, A. & Spray, J. (2020). Towards a critically conscious health promotion for rheumatic fever in Aotearoa, New Zealand. Social Science and Medicine, (247) 112798.
– Bennett, J., Anderson, A., Ofanoa, M., Anderson, P., Brown, R., Devlin, G., Eggleton, K., Harwood, M., McKree-Jansen, R., Kielar, D., Malcolm, J., Moreland, NJ., Poskitt, N., Sika-Paotonu, D., Webb, R. & Wilson, N. (2021). Acute rheumatic fever- a preventable, inequitable disease: a call for action. The New Zealand Medical Journal, 134(1535): 93-95.
– Bryers, C., Curtis, E., Tkatch, M., Anderson, A., Stokes, K., Kistanna, S. & Reid, P. (2021). Indigenous secondary school recruitment into tertiary health professional study: a qualitative study of student and whānau worldviews on the strengths, challenges and opportunities of the Whakapiki Ake Project. Higher Education Research & Development, 40(1):19-34.
– Enright, JH., Anderson, A., McKree-Jansen, R., Murray, J., Selak, V. & Harwood, M. (2021). Iwi (tribal) data collection at a Primary Health Organisation in Aotearoa. Journal of Primary Health Care, 13(1): 36-43.
– Meher, M., Spray, J., Wiles, J., Anderson, A., Willing, E., Witten, K., Ofanoa, M. & Ameratunga, S. (2021). Locating transport responsibilities for the wellbeing of mobility-challenged people in Aotearoa New Zealand. Wellbeing Space and Society, 2:100034.
– National Hauora Coalition, Anderson, A., Brown, R., Wheeler, J. & McKree-Jansen, R. (2020). Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland. New Zealand Journal of Primary Health Care, 12(4): 384-390.
– Wyber, R., Wade, V., Anderson, A., Schreiber, Y., Saginur, R. & Carapetis, J. (2021). Rheumatic heart disease in indigenous young peoples, Lancet Child and Adolescent Health, 5(6): 437-446.
Dr Rawiri McKree-Jansen
Ngāti Raukawa, Ngāti Hinerangi
Selected works
– Bennett, J., Anderson, A., Ofanoa, M., Anderson, P., Brown, R., Devlin, G., Eggleton, K., Harwood, M., McKree-Jansen, R., Kielar, D., Malcolm, J., Moreland, NJ., Poskitt, N., Sika-Paotonu, D., Webb, R. & Wilson, N. (2021). Acute rheumatic fever- a preventable, inequitable disease: a call for action. The New Zealand Medical Journal, 134(1535): 93-95.
– Enright, JH., Anderson, A., McKree-Jansen, R., Murray, J., Selak, V. & Harwood, M. (2021). Iwi (tribal) data collection at a Primary Health Organisation in Aotearoa. Journal of Primary Health Care, 13(1): 36-43.
– Henare, KL., Parker, KE., Wihongi, H., Blenkiron, C., Jansen, R., Reid, P., Findlay, MP., Lawrence, B., Hudson, M. & Print, CG. (2019). Mapping a route to Indigenous engagement in cancer genomic research. The Lancet Oncology, 20 (6): 327 – 335.
– Lennon, D., Anderson, P., Kerdemilidis, M., Farrell, E., Crengle Mahi, S., Percival, T., Jansen D. & Stewart, J. (2017). First Presentation Acute Rheumatic Fever is Preventable in a Community Setting. The Pediatric Infectious Disease Journal, 36 (12): 1113-1118.
– McKree-Jansen, R., Sundborn, G., Cutfield, R., Yu, D. & Simmons, D. (2020) Ethnic inequity in diabetes outcomes-inaction in the face of need. The New Zealand Medical Journal, 113 (1525): 8 – 10.
– National Hauora Coalition, Anderson, A., Brown, R., Wheeler, J. & McKree-Jansen, R. (2020). Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland. New Zealand Journal of Primary Health Care, 12(4): 384-390.
– Teng, A., Blakely, T., Scott, N., Jansen, R., Masters-Awatere, B., Krebs, J. & Oetzel, J. (2019). What protects against pre-diabetes progressing to diabetes? Observational study of integrated health and social data. Diabetes Research and Clinical Practice, 148: 119 – 129.
Donna Kielar
Ngāti Hine, Ngāpuhi, Pukapuka Kūki' Āirani
Selected works
– Bennett, J., Anderson, A., Ofanoa, M., Anderson, P., Brown, R., Devlin, G., Eggleton, K., Harwood, M., McKree-Jansen, R., Kielar, D., Malcolm, J., Moreland, NJ., Poskitt, N., Sika-Paotonu, D., Webb, R. & Wilson, N. (2021). Acute rheumatic fever- a preventable, inequitable disease: a call for action. The New Zealand Medical Journal, 134(1535): 93-95.
Jadene Wheeler
Selected works
– National Hauora Coalition, Anderson, A., Brown, R., Wheeler, J. & McKree-Jansen, R. (2020). Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland. New Zealand Journal of Primary Health Care, 12(4): 384-390.
Dr Ainsleigh Cribb-Su'a
Ngāti Maniapoto, Ngāti Kauwhata, Ngāti Tamaterā
Selected works
– Merry, SN., Hopkins, S., Lucassen, MFG. et al. (2020). Effect of Clinician Training in the Modular Approach to Therapy for Children vs Usual Care on Clinical Outcomes and Use of Empirically Supported Treatments: A Randomized Clinical Trial. JAMA Netw Open, 3(8): e2011799-e2011799.
Jonathan Murray
Selected works
– Peiris, D., Murray, J., Scully, D., Tilakawardene, V., Hetaraka-Stevens, L., Stewart, T. & Patel, A. (2008). Cardiovascular risk management at a Maori-led primary health organisation – findings from a cross-sectional audit. The New Zealand Medical Journal, 121(1285): 35-46.
– Murray, J. (2015). General Practitioners’ Information System Acceptance in a New Zealand Primary Healthcare Organisation. Dissertation. Bradford University School of Management.
Melaney Tkatch
Selected works
– Bryers, C., Curtis, E., Tkatch, M., Anderson, A., Stokes, K., Kistanna, S. & Reid, P. (2021). Indigenous secondary school recruitment into tertiary health professional study: a qualitative study of student and whānau worldviews on the strengths, challenges and opportunities of the Whakapiki Ake Project. Higher Education Research & Development, 40(1):19-34.
– Tkatch, M., Towers, A., Keller, H. & Wham, C. (2021). Nutrition risk prevalence and associated health and social risk factors in Māori and non‐Māori: Results from the New Zealand Health, Work and Retirement Study. Australasian Journal on Ageing.