Iwi Māori Partnership Boards - data challenges and aspirations

FEATURE - eHealthNews editor Rebecca McBeth 

Iwi Māori Partnership Boards (IMPBs) are at the forefront of ensuring the health system delivers equitable outcomes for Māori and access to accurate, timely, and relevant data is essential to fulfil their role.

IMPBs were established under the Pae Ora (Healthy Futures) Act 2022 and to date 15 have been recognised.

One of their key functions is to engage with whānau and hapū about local health needs, evaluate the current state of Māori health, identify priorities, and monitor local performance.

In October 2024, all submitted their Community Health Plans, which include a local needs assessment to determine hauora Māori priorities.

IMPBs need to collect and analyse data relevant to Māori health outcomes in order to fulfil their statutory role, but access to data varies hugely across the country and is often fragmented, our out of date.

eHealthNews spoke to three IMPB representatives about the data required to support their crucial role in advancing their tino rangatiratanga aspirations that ensure the health needs and priorities of Māori communities are met.

Te Taumata Hauora o Te Kahu o Taonui IMPB

Boyd Broughton, Tumu Whakarae chief executive, Te Taumata Hauora o Te Kahu o Taonui IMPB says data collection and monitoring are essential to strategic decision-making for Māori health and IMPBs are pushing for better access to relevant, real-time data. 

He says most IMPBs are still working on understanding their data requirements and monitoring frameworks, and rely on publicly available information like census data and basic health statistics.

Health NZ | Te Whatu Ora has also provided IMPBs with a dashboard covering the five health targets, such as shorter ED stays and cancer treatment wait times, but Broughton says the dashboard updates quarterly and does not include data on many local or iwi-specific priorities.

Where priorities align, such as childhood immunisations, this works well, but IMPBs’ priorities, developed from whānau voices, often differ from national health targets.  

“One of our priorities is, warm, affordable housing, which directly affects health but falls outside traditional health data. Other priorities include specific health needs within the “māmā and pēpi health ecosystem,” Broughton explains, adding that not all IMPBs have the same priorities, so need different data sets.

He says that IMPBs are working to determine which data points are essential and the systems needed to track their priorities effectively and that realising this goal will require significant investment in skills and resources. 

“First we need to understand what data we want, what data will tell us if whānau-voiced priorities are improving and where do we get that from? What is the data needed to show that our whānau and communities are living healthy and happy lives and fulfilling their potential?”

Building a strong data infrastructure will involve both training new data experts and creating high-trust relationships across health providers. Until the IMPB has inhouse capacity, they are collaborating with Te Whatu Ora to leverage their expertise.

While government health agencies have generally been very helpful in accessing data, there have been times when requests have been declined due to data privacy, especially when there are too few data points to ensure anonymity, Broughton says. 

The restructure and funding issues at Health NZ | Te Whatu Ora add to the challenge of stretched resources.

“We need to show that there are safe ways for Māori organisations to interact with data, to share data, and to utilise data efficiently,” he says.

IMPBs also need data related to GP services and unenrolled populations. Te Taumata Hauora o Te Kahu o Taonui has varied access to data from Primary Health Organisations (PHOs), as each organisation approaches data sharing differently.

“Two PHOs have afforded us a high-trust relationship and indicated a willingness to collaborate with sharing of critical data, the others are a work in progress,” Broughton explains.

As IMPBs develop, he hopes to see data systems become more community-centred, capable of capturing both short-term metrics and long-term impacts. 

Tairāwhiti Toitū Te Ora IMPB

Georgina Johnson, kairarāunga (data analyst) at Tairāwhiti Toitū Te Ora IMPB, says a key priority for IMPBs is getting access to detailed and timely health data to monitor healthcare services effectively and improve Māori health outcomes. 

However, inconsistent data quality and varied access across the region make it challenging to make accurate assessments.

"We need health outcomes data like morbidity, mortality, disease prevalence, patient satisfaction, and service delivery," Johnson explains. 

“These help us make informed decisions about where we are going and what our future could look like.”

However, the current data landscape is fragmented, often outdated, and data is not standardised making it difficult to link and see the bigger picture.

"There is data fragmentation across systems and organisations. Different systems use incompatible formats, making data exchange challenging," she says. 

"Sometimes, providers hide behind data privacy regulations, limiting our ability to access essential information."

Johnson relies on national datasets from Health NZ | Te Whatu Ora as well as regional sources - including hospitals and the cancer registry - to access the information needed and says relationship-building and local partnerships are hugely important. 

"The best solutions come from respectful, working relationships with data providers, including hospitals and iwi organisations," she says. 

Johnson hopes to enhance the IMPB’s data capabilities by establishing integrated dashboards and data-sharing agreements. 

"The foundation of IMPBs' work is relationships, but what we really need is a stable platform for real-time data access,” she explains.

This would allow the IMPBs to analyse population health trends more effectively, plan for future healthcare needs, and align with government priorities. IMPBs could also advocate for resources, such as increasing midwifery support in regions with high birth rates, she adds.

The ultimate vision is a holistic, integrated view of health data that includes socioeconomic factors such as housing and education.

"If we can connect health data with housing and justice data, we can start identifying broader trends and areas for intervention," Johnson explains. 

"Everything we do has to be backed by strong data. It is about moving beyond ‘what we don’t have’ to focusing on what we can achieve.” 

Te Tiratū IMPB

Tureia Moxon, board member of the Te Tiratū IMPB, says that having real-time, standardised data access would transform IMPBs’ ability to monitor and improve health outcomes.

However, there are significant gaps in the existing data-sharing frameworks, the data available is often fragmented and the providers collecting data do not align with the IMPB areas, leaving them dealing with multiple disparate datasets.

“It very much seems like this was a reactive process after Te Aka Whai Ora was disestablished to then give it to IMPBs to monitor these things without any real mechanisms in place,” he says.

One of the priorities set in Te Tiratū IMPB’s Community Health Plan is to monitor health outcomes by their specific area instead of by District Health Board areas, which do not always reflect local needs, he explains.

“Merging data is more difficult than it should be. Health boards often capture ethnicity data differently, and there is no standardisation across providers,” Moxon says.

Without a standard system, IMPBs must “mush” the data sets manually, he tells eHealthNews.

“Imagine if we could follow a whānau’s journey across the health system? It sounds simple but is incredibly difficult to implement without standardised reporting and sufficient funding.”

He says IMPBs want to address key health indicators more closely aligned with the communities they serve, which could be achieved through data on local population health and specific barriers Māori face in accessing healthcare including financial, geographic, and cultural.

Te Tiratū IMPB decided the best way of determining these was by asking whānau directly and collecting the data themselves.

The IMPB also wants to be able to view the impact of broader social determinants like housing and education, which significantly impact Māori health outcomes.

However, getting data on these wider determinants remains a future goal.

“It is hard enough getting a unified health data set from Te Whatu Ora,” Moxon explains.

“Integrating that with data from housing or education agencies is practically impossible with the current systems.”

He adds that a lack of dedicated funding makes it difficult to build comprehensive data analytics teams, but says IMPBs are pushing forward, often with limited resources and personnel.

“We have partnered with other IMPBs in Te Manawa Taki and pooled our funding to create shared back-office support and leverage analytics resources,” Moxon explains.

If you would like to provide feedback on the above feature article, please contact the editor Rebecca McBeth.

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