Whanau Ora : Report of the Taskforce on Whanau-Centred Initiatives

4.4 Whānau <strong>Ora</strong> as an Outcome Goal
4.4.1 During <strong>the</strong> engagement hui <strong>the</strong> <strong>Taskforce</strong> heard that <strong>the</strong> usual indicators
<strong>of</strong> socio-economic status such as morbidity, hospital admissions, school
failure, low incomes or deprivation scores were inadequate measures <strong>of</strong>
whānau outcomes. There was wide support for an approach that focused
on positive achievements for whānau, ra<strong>the</strong>r than negative events for
individuals within whānau. Hui participants were not dismissive <strong>of</strong> o<strong>the</strong>r
approaches but saw Whānau <strong>Ora</strong> as an opportunity to aim for <strong>the</strong> best
possible outcomes and to give more attention to considering <strong>the</strong> results <strong>of</strong>
an intervention ra<strong>the</strong>r than simply recording <strong>the</strong> number <strong>of</strong> interventions
or <strong>the</strong> reason for <strong>the</strong> intervention.
4.4.2 The <strong>Taskforce</strong> considers that whānau outcomes have two unique
dimensions. First, <strong>the</strong> outcome <strong>of</strong> greatest interest is <strong>the</strong> outcome that
affects <strong>the</strong> whānau as a whole. It has already been noted that most
measures are centred around individual status or performance ra<strong>the</strong>r than
<strong>the</strong> status <strong>of</strong> collectives, partly because group measures are more difficult to
construct and apply. Measuring <strong>the</strong> capacity <strong>of</strong> a whānau to transmit values,
for example, raises complexities that far outweigh measuring <strong>the</strong> presence
or absence <strong>of</strong> an illness or <strong>the</strong> achievement <strong>of</strong> an educational standard. The
<strong>Taskforce</strong> is aware <strong>of</strong> <strong>the</strong> problems associated with group measures but
does not consider those problems are sound reasons for avoiding a focus
on collective whānau outcome measures. By <strong>the</strong> same token, outcomes for
individuals should not be ignored. A comprehensive measure <strong>of</strong> whānau
outcomes might <strong>the</strong>refore need to include a combination <strong>of</strong> individual
outcome indicators as well as indicators articulated by whānau.
4.4.3 A second dimension is related to <strong>the</strong> question <strong>of</strong> causality. An outcome
is usually assumed to be <strong>the</strong> result <strong>of</strong> an intervention. But establishing a
connection between an intervention and an outcome can be fraught with
uncertainty since <strong>the</strong>re are many o<strong>the</strong>r variables, apart from <strong>the</strong> known
intervention, that might have had a significant impact. Fur<strong>the</strong>r, desirable
outcomes may not be realised immediately but may evolve over a period <strong>of</strong>
years. The longer <strong>the</strong> time lag between input and result, <strong>the</strong> more difficult
it is to ascribe an outcome to a particular intervention. However, even if an
outcome has not (yet) been achieved, an intervention should none<strong>the</strong>less
identify how it might contribute to a longer-term outcome.
4.4.4 Involving whānau in outcome measurement was strongly emphasised
at a number <strong>of</strong> engagement hui. While similar high-level outcomes might
be applicable to most whānau, <strong>the</strong> relevant immediate indicators will
inevitably depend on current whānau situations and <strong>the</strong>ir own aspirations.
To that end, decision-making about outcome goals should be a shared
process. In an outcome-focused environment, it will be important that
whānau have <strong>the</strong> opportunity to contribute to <strong>the</strong> development <strong>of</strong> <strong>the</strong>ir
own agendas for change and agree on <strong>the</strong> indicators that might be used to
measure success. This approach moves away from an expert identifying
<strong>the</strong> problem and <strong>the</strong>n prescribing an intervention, to working with whānau
to identify preferred outcomes and <strong>the</strong>n jointly mapping a pathway to
achieve <strong>the</strong>m.
Each whānau has <strong>the</strong>
capacity to care for itself.
Any service should…
support <strong>the</strong>m to find <strong>the</strong>
ways to do this. And because
every whānau is different,
<strong>the</strong>y will find different ways
to do so…
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