Intersectoral Community Action for Health (ICAH) Evaluation: An Overview

The Public Health Consultancy (Wellington School of Medicine)

In 2001 the Ministry of Health funded ICAH groups in four areas to develop different ways of bringing together community and health sector organisations to improve the health status of Māori, Pacific and Quintile 5 people living in those areas.

In the Northland DHB there were three sub-projects established (a community garden project and two school related projects).

In Counties Manukau District Health Board (DHB) the Ministry and the DHB funded two co-ordinators who became involved in a number of projects. These included the Youth Inter-agency Project (YIP) and the Healthy Housing Project.

In Otaki (MidCentral DHB) the Kapiti Community Health Group Trust (KCHGT) was active in the establishment of the local PHO and increasing community knowledge of health services. A Community Health Worker position improved access to primary health care services for the people of Otaki, particularly Māori.

In Porirua (Capital and Coast DHB) there were two main projects. The Healthlinks project was responsible for increasing knowledge of health services and was active in a number of community developments. The Porirua Increasing Access initiative (PIA) involved a range of primary health care providers in Porirua. PIA focused on reducing financial, information and transport-related barriers to health care. General practitioner and nurse utilisation increased, but not always at the expected time or in all practices. Ambulatory Sensitive Hospitalisations remained steady reversing previous increases in rates.

The evaluators concluded that:

• each of the ICAH initiatives showed evidence they were working to reduce inequalities
• all the projects were intersectoral in terms of developing relationships with different parts of the health sector
• in all the ICAHs, the role and wisdom of the community was vital
• the capacity of the community to help as volunteers was often limited in areas of high need
• the role of the Ministry of Health in the contracting process was generally seen positively
• the future of the ICAHs, which were developed before the introduction of DHBs and Primary Health Organisations (PHOs), will rely on closer relationship between these groups.

The reports provide examples of ways that PHOs can work with the local DHBs and their community. It also highlights ways that high-need communities and health care providers can address health needs together.