Hoea te waka: Indigenous suicide prevention outcomes framework and evaluation processes
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Published by Te Rau Matatini, 2017
Hoea te waka: Indigenous suicide
prevention outcomes framework
and evaluation processes - Part 1
Volume 2 | Issue 2
Introduction
Article 6, September 2017
In Aotearoa (New Zealand) the prevention of
Kahu McClintock suicide presents as both complex and challenging.
Te Rau Matatini Official suicide data (Ministry of Justice, 2017)
shows that suicide has continued to increase.
Rachel McClintock Unfortunately, this situation infers that no single
Te Rau Matatini initiative or organisation on its own, has been
successful in the prevention of suicide and
Abstract particularly so for the Māori population
(indigenous to Aotearoa). A comprehensive and
In 2014, the first dedicated national Māori Suicide
coordinated approach had been recommended
prevention approach coupled with a Pasifika
by the government and one that requires
programme was launched, profiled as the Waka
partnership with the community (Ministry of
Hourua National Suicide Prevention Programme Health, 2013).
2014 – 2017 funded by the Ministry of Health. Te
Rau Matatini, a national Māori non-government The New Zealand Suicide Prevention Strategy 2006–
organisation and their Pasifika partner 2016 (Ministry of Health, 2013), recommended
organisation Le Va, established and offered the cross-government suicide prevention. In
programme. The “Hoea te waka: Indigenous addition, the strategy advocated for processes
suicide prevention outcomes framework and specifically relevant to Māori to build the capacity
evaluation processes” article provides a of Māori whānau (family), hapū (subtribe), iwi
summation of the outcomes framework and (tribe), and communities to prevent suicide
evaluation methodology utilised for the Waka (Ministry of Health, 2013). This was to be
Hourua National Suicide Prevention Programme supported by stronger leadership and culturally
2014 - 2017 with particular focus on the 47 Māori relevant education and training. The combined
community fund projects. development was to address the unacceptable
high prevalence of suicides experienced by the
Keywords: Suicide prevention, Māori Māori population.
community, outcomes framework.
In 2014, the first dedicated national Māori suicide
prevention approach coupled with a Pasifika
68Volume 2 | Issue 2 | Article 6 – McClintock & McClintock
approach, the Waka Hourua National Suicide 3. A national coordination centre for Māori
Prevention Programme 2014 – 2017 (Waka community suicide prevention. This
Hourua Programme) was launched. Te Rau programme will foster local leadership, and
Matatini, a national non-government build their capacity and capability to lead the
organisation and their partner organisation Le development and implementation of whole-
Va, funded by the Ministry of Health developed of-community suicide prevention plans.
the programme and completed in June 2017. The 4. A community fund to support the
Waka Hourua programme aimed to specifically establishment of community based initiatives
progress Action 1.1 of the New Zealand Suicide as a way to build the capacity of Māori
Prevention Action Plan 2013 – 2016 (Ministry of whānau, hapū, iwi, Pacific families, and
Health, 2013) to: communities towards suicide prevention.1
5. A Strategic Research Agenda and one-off
build the capacity and capability of Māori funding pool to build an evidence base of
whānau, hapū, iwi, Pacific families, and effective practices for Māori and Pacific
communities, to prevent suicide and to communities.2
respond safely and effectively when and if
suicide occurs;
Evaluation Processes
ensure that culturally relevant education and
training are available to Māori whānau, hapū, The Waka Hourua Outcomes Framework
iwi, Pacific families, and communities that (Figure 1) was developed by the Waka Hourua
focus on building resilience and leadership; Leadership Group3 as an umbrella for the work
build the evidence base of what works for streams as a means to demonstrate the progress,
Māori whānau, hapū, iwi, Pacific families, monitoring and measuring, providing evidence of
and communities to prevent suicide, through the impact of the Waka Hourua Programme
research carried out by, with and for these (Durie, 2014).
groups; and
In addition, a Results Based Accountability
build the leadership for suicide prevention. (RBA) approach was applied to the agreed
Five key work streams were a feature of the Waka deliverables that were negotiated by Te Rau
Hourua Programme consistent with Action 11.3 Matatini as the contracted provider. Te Kīwai
of the New Zealand Suicide Prevention Action Plan Rangahau the research and evaluation arm of Te
2013 – 2016 (Ministry of Health, 2013): Rau Matatini was commissioned to conduct the
monitoring and the RBA evaluation process
1. A national voice for Māori and Pacific suicide established to report the achievements of the
prevention through the formation of a initiatives (McClintock, 2014).
national leadership group of authoritative
leaders in suicide prevention. Measures
2. A national coordination centre for Pacific The measures used in the RBA approach were set
community suicide prevention. This centre out in the RBA framework as shown in Table 1
will lead the development and and considered the following:
implementation of effective, culturally
How will you know if these results have been
appropriate, prevention and postvention
achieved? What will this look like?
resources and training to Pacific provider
networks and their communities and will What new information or data do we need
develop targeted initiatives for identified at- for our indicators or measures (data
risk groups. development)?
What are the core indicators?
1 See wakahourua.co.nz/community-fund 3 See wakahourua.co.nz/national-leadership-group
2 See wakahourua.co.nz/research-agenda-projects
69Published by Te Rau Matatini, 2017
Figure 1: The Waka Hourua Outcomes Framework (Durie, 2014)
Table 1: Result Based Accountability Framework (McClintock, 2014)
Quantity Quality
Inputs How much did we do? How well did we do it?
# Resources developed and accessible # Daily/weekly/ monthly
# Programme enrolments completed basis?
# Programme pathways completed
Outputs Is anyone better off? Is anyone better off?
# No of participants completing programme % of participants report
milestones increased awareness
# What resources were accessed
# What plans were completed
Kaupapa Māori Kotahitanga – unity aimed at improving the
A kaupapa Māori approach provided a culturally health needs of Māori whānau at the
appropriate methodology to evaluate in the local community level
context. The greatest strength of using this Rangatiratanga – authority
approach is that Māori define the processes, Mātauranga Māori – Māori knowing and
doing the evaluation for and about Māori, with understanding
the eventual outcome targeting and benefitting Whānaungatanga – collaborative
Māori whānau and their communities (Smith, participatory evaluation processes
1999).
Awhi Mai Awhi Atu – a reciprocity process
Tiro Roa that allows information and knowledge to be
Kaupapa Māori theory and research is based on a transferred in a respectful and safe way
number of key principles. At Te Rau Matatini Tino Rangatiratanga – self-determination
Tiro Roa outlines a group of values and principles and autonomy, clarifying roles within the
and practices that guide a best approach by Māori monitoring and evaluation process
for Māori evaluation process (Te Rau Matatini, Whakakao – a purposeful system for
n.d.). These principles and practices include: thinking through the issues, monitoring,
70Volume 2 | Issue 2 | Article 6 – McClintock & McClintock
analysis, recommendations and the Te Kīwai Rangahau evaluators commissioned
dissemination of information. to conduct the evaluation.
Quantitative Approach Data Analysis
The Te Rau Matatini contract manager in The following methods were identified for
conjunction with the internal evaluators analysis:
developed a service management system and
progress tools based on a RBA process to collect Analysis of discussion of information using
relevant data at agreed periods in line with key themes;
individual project deliverables. These results were a narrative reporting style lending to case
presented to the national leadership and the study presentations; and
funder, the Ministry of Health. These findings a descriptive analysis of the quantitative data.
were provided quarterly during the three-year
duration through verbal face to face meetings and Māori Community Project Selection
by written submissions. Process
In 2014, Te Rau Matatini and Le Va provided an
Data analysis. Cumulative data was displayed at open tender process to community groups and
agreed upon frequencies to track the whānau and selected community applicants with
development and implementation of the Waka proven commitment to Māori suicide prevention,
Hourua programme by the participating groups. and or wellbeing, or Māori hauora (health), or
Reflective comments were made about the data. rangatahi (youth) activities, or cultural activities, or
education that aligned to action 1.1 of the New
Qualitative Approach (Case study
Zealand Suicide Prevention Action Plan 2013 – 2016
reports) (Ministry of Health, 2013). The Fund was a one-
A qualitative method lends itself well to the off contestable fund of $2 million established to
intentions of this programme. The presumptions support community-based suicide intervention
of a qualitative method is that it must provide a project. To support this development Te Rau
holistic contextual portrayal, and give emphasis Matatini brought together a Māori suicide
to the uniqueness and diversity of peoples’ prevention expert panel that utilised a selection
experiences and beliefs (Patton, 1990). Like the framework aligned to Action 1.1 that selected 47
kaupapa Māori approach, this is not a definitive projects4. Te Kīwai Rangahau has located the 47
statement about qualitative research, but rather, a Māori Community Projects under their outcome
brief outline of concepts to assist in the goals and their associated pathways and actions.
completion of the project. The qualitative results Table A1 seen in Appendix 1, provides a
were presented to the national leadership and the cumulative record of the 47 completed
funder, the Ministry of Health. These findings evaluations. The spread of evaluations included:
were provided quarterly during the three-year
duration, through verbal face to face meetings GOAL 1: Informed, cohesive and resilient
and by written submissions. community initiative (19 projects total).
o Primary prevention: Whole of
Document Review and Analysis Population
Review of key Waka Hourua programme o Secondary prevention: Targeting at risk
documents, and planning tools was useful in individuals (5 projects).
determining how the programme o Tertiary prevention: Minimising adverse
implementation aligned to the overall intent, impact (14 projects).
design and planning stages of the programme and
GOAL 2: Strong, secure and nurturing
what happened during its implementation.
whānau initiatives (11 projects total).
Periodic monitoring reports, programme data o Secondary prevention: Targeting at risk
and internal evaluation documentation was used individuals (6 projects).
in the programme as developed by the Te Rau o Tertiary prevention: Minimising adverse
Matatini contract manager in conjunction with impact (5 projects).
4 wakahourua.co.nz/community-fund
71Published by Te Rau Matatini, 2017
GOAL 3: Safe, confident and engaged http://teraumatatini.com/m%C4%81ori-health-
rangatahi initiatives (17 projects total). research.
o Secondary prevention: Targeting at risk
Dr Kahu McClintock (Waikato/Maniapoto,
individuals (17 projects).
Ngāti Mutunga, and Ngāti Porou) is the
Managing Editor of Te Mauri-Pimatisiwin: Journal of
Conclusion Indigenous Wellbeing and is the Manager of
The “Hoea te waka: Indigenous suicide Research at Te Rau Matatini. Kahu has worked in
prevention outcomes framework and evaluation the health and disability sector for over 20 years,
processes” article provides a summation of the with a special focus on Māori health research and
outcomes framework, an umbrella for the Waka child and adolescent mental health. Kahu holds a
Hourua work streams and a means to Dip Nursing (Psychiatric), Higher Dip Teaching,
demonstrate the progress, monitoring and B Ed, M Phil (Māori), D Phil (Psychiatry). She
measuring, providing evidence of the impact of was a Member of the Māori Health Committee,
the Waka Hourua National Suicide Prevention New Zealand Health Research Council from
Programme 2014 – 2017. It further details the 2008 to 2014, and Chair of Ngā Kanohi Kitea
Māori evaluation processes that were successfully Community Research Committee, New Zealand
undertaken as part of the evaluation of the 47 Health Research Council during that term. In
Māori community projects of the Waka Hourua 2015, Kahu was a ministerial appointment to the
programme. Both the outcomes framework and National Ethics Advisory Committee. Dr
the evaluation processes conducted provide a McClintock is currently lead for Te Rā o Te Waka
guide for other indigenous people to replicate Hourua the Waka Hourua Māori and Pasifika
and strengthen their suicide prevention Suicide Research Programme.
programmes. kahu.mcclintock@teraumatatini.com
Rachel McClintock (Waikato/Maniapoto,
References Ngāti Mutunga, and Ngāti Porou) is a Researcher
in Te Kīwai Rangahau, Te Rau Matatini’s
Durie, M. (2014). Waka Hourua, Māori and Pasifika
research and evaluation unit. She has a
suicide prevention outcomes framework. Wellington,
background in Kaupapa Māori community based
New Zealand: Te Kīwai Rangahau, Te Rau
research and evaluation, with experience of
Matatini.
research with Māori whānau (families) and
McClintock, K. (2014). Evaluation framework, communities, across areas such as youth
Waka Hourua community funded initiatives. development, mental health and wellbeing,
Wellington, New Zealand: Te Kīwai Rangahau, gambling, palliative care, and intergenerational
Te Rau Matatini. communication. Rachel holds a BSocSci
(Psychology), a Post Graduate Diploma in Public
Ministry of Health. (2013). New Zealand Suicide Health, and is currently enrolled in a Masters of
Prevention Action Plan 2013 – 2016. Wellington, Public health through the University of
New Zealand: Ministry of Health. Auckland. rachel.mcclintock@teraumatatini
Ministry of Justice. (2017). Annual suicide statistics:
Provisional figures – August 2017. Wellington, New
Zealand: Ministry of Justice.
Patton, M. Q. (1990). Qualitative evaluation and
research methods (2nd ed.). Newbury Park, CA:
Sage.
Smith, L. (1999). Decolonising methodologies research
and indigenous people. London, United Kingdom:
ZED books.
Te Rau Matatini (n.d.). Māori health Research.
Retrieved from
72Volume 2 | Issue 2 | Article 6 – McClintock & McClintock
Appendix 1
Table A1: Detail of the Waka Hourua Outcomes Framework
WAKA HOURUA OUTCOMES FRAMEWORK
Reduce suicides
Reduce suicidal attempts
Minimise impacts of suicide
PREVENTION GOAL 1 GOAL 2 GOAL 3
Informed, cohesive, & resilient communities Strong, secure, and nurturing whānau Safe, confident, and engaged rangatahi
PRIMARY PATHWAY/ ACTION INDICATOR
Whole of population Build community leadership networks Community leaders have eliminated a known risk factor
activities Develop a common community agenda Community have in place a plan to prevent and respond effectively to suicide
SECONDARY PATHWAY INDICATOR PATHWAY INDICATOR PATHWAY INDICATOR
Targeting at risk /ACTION Communities have /ACTION Whānau have solidified /ACTION Communities, education and
individuals Strengthen community established innovative Facilitate whānau links with each other and Support positive initiatives health services enter into a
resources including cultural, learning pathways and engagement with each other, whenua for rangatahi (culture, sport, partnership to foster positive
economic and social resources suicide prevention resources and to whenua learning, music) engagement for rangatahi with
Kura Productions Takarei Ruha Whānau He Konae learning
(National) Trust (Northland) (Northland)
Ngāti Tahu, Ngāti Eddie Harawira Trust Ngā Waka o Te Tai
Whaoa,Rūnanga (Bay of Plenty) Tokerau (Northland)
Trust (Lakes)
Tau iho i te po
Te Wamana Kaaku Ahipene Takuta (Bay (Northland)
(Bay of Plenty) of Plenty)
Te Hauora o te Hiku o
Te Rongo Toi Uru Ngāti Haua te Ika : RAID
Arts (Wanganui) (Waikato) (Northland)
Awareness of Suicide
in Kaipara (ASK)
(Northland)
73Published by Te Rau Matatini, 2017
GOAL 1 GOAL 2 GOAL 3
Informed, cohesive, & resilient communities Strong, secure, and nurturing whānau Safe, confident, and engaged rangatahi
SECONDARY PATHWAY INDICATOR PATHWAY INDICATOR PATHWAY INDICATOR
Targeting at risk /ACTION Communities have access to /ACTION Whānau access educational /ACTION Communities, education and
individuals Initiate actions that meet the cultural education and Increase whānau access to opportunities and health Support positive initiatives for health services enter into a
needs of Takatapui suicide prevention resources suicide resources and service services rangatahi (culture, sport, partnership to foster positive
Tiwhanawhana Te Hauora o Kaikohe learning, music) engagement for rangatahi with
Mental Health (Northland) Otara Board’s Forum learning
Foundation Incorporated
(National) (Auckland)
Hapaitia te Rūnanga o
Kirikiriroa (Waikato)
Te Awanui
(Bay of Plenty)
Ngā Kākano Trust
(Bay of Plenty)
Te Manu Toroa
(Bay of Plenty)
INNOV8
(Hawkes Bay)
Tai Timu Trust
(Hawkes Bay)
Mahia Rangatahi toa
(Hawkes Bay)
Facilitate whānau and Whānau and rangatahi have PATHWAYS INDICATORS
rangatahi engagement with re-established links with /ACTIONS Self-care resources and
key institutions (schools, marae and hapū Support positive initiatives for programmes are available for
services, marae and churches LGBTQ that address Māori LGBTQ
Maketu (Bay of bullying, alienation and suicide
Plenty) risk amongst Māori youth
Mika (National)
74Volume 2 | Issue 2 | Article 6 – McClintock & McClintock
Foster peer support groups (e- Rangatahi suicide prevention
Communications appropriate on-line resources
Live More Awesome have been developed
(National)
Encourage rangatahi A leadership network is
leadership in key situations established to increase
(whānau, hapū, iwi and rangatahi capability, skills
communities. and knowledge to prevent
Taikura Trust suicide
(Auckland)
Piritahi Hauora
(Auckland)
TERTIARY GOAL 1 GOAL 2
PREVENTION Informed, cohesive, & resilient communities Strong, secure, and nurturing whānau
Minimising the adverse
impacts arising from
PATHWAY INDICATOR PATHWAY INDICATOR
suicide
/ACTION Community health and social /ACTION Whānau have developed and implemented a suicide prevention
Identify risk within service providers have Build whānau capabilities to manage stress, disadvantage, loss education plan
communities established a common agenda and risk
He Waka Tapu for working with Tū Tama Wāhine (Taranaki)
(Canterbury) communities Waiariki Purea (Lakes)
Te Roopu Tautoko ki Ngā Iwi o Mokai Patea Trust (Wanganui)
te Tonga (Southern) Ngāti Kahungunu ki Wairarapa (Wairarapa)
PATHWAY INDICATOR PATHWAY INDICATOR
/ACTION Communities have /ACTION Whānau have resolved the impacts of self-harm and suicide
Initiate actions that will established a safe forum for Build whānau capabilities to manage self-harm and suicide
reduce community risks discussing suicide prevention
Te Hauora o Te Hiku and resourcing Te Hau Ora o Whānau (Southern)
o Te Ika (Northland)
Ngāti Hine
(Northland)
Te Ringa Atawhai
(Northland)
Raglan Community
House (Waikato)
75Published by Te Rau Matatini, 2017
Rauawaawa (Waikato)
Ngāti Awa (Bay of
Plenty)
Tūwharetoa ki
Kawerau (Bay of
Plenty)
Te Kupenga Trust
(Tai Rawhiti)
Gisborne Rape Crisis
(Tai Rawhiti)
Best Care (Manawatū)
Aranui Sea Eagles
(Canterbury)
Ngā Kete Mātauranga
Pounamu Charitable
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