Passionate about health promotion: the Health Promotion Forum

10 years on and growing

(Adapted from an article in the Health Promotion Forum newsletter, Issue 40, April 1997, updated February 2009.) In 1986, the five strands of the Ottawa Charter became the international guiding principles of health promotion practice. In New Zealand these, combined with Te Tiriti of Waitangi, became the foundations on which health promotion practice was to develop. In 1983 Professor Lawrence Green, regarded as one of the leading lights in health promotion, was brought to New Zealand by the Medical Research Council (MRC) to speak at a series of workshops on the planning and evaluation of health education and health promotion. Health promotion as a profession was evolving around the world from a more traditional health education practice. Professor Green’s visit highlighted a need for an independent forum to co-ordinate regional and voluntary opinion on health education and health promotion and to liaise with government organisations in the establishment of national goals. Over the next few years the MRC supported the development of such a forum through the establishment of an ad-hoc steering committee. It included the Departments of Health and Education, Auckland and Otago universities, the Mental Health Foundation, the National Heart Foundation, the Cancer Society, Maori Women’s Welfare League (MWWL), the Accident Compensation Corporation and the Alcoholic Liquor Advisory Council (ALAC). Funding from several of these organisations, as well as grants from the McKenzie and Sutherland Self Help Trusts, provided the financial support which established the Health Promotion Forum secretariat and allowed the appointment of its first research and executive officer in 1986. The Forum’s first home was at the University of Auckland’s Department of Community Health. An interview with former directors Cheryl Hamilton, Candace Bagnall and Kim Conway, provides a historical journey through the Forum’s development. Each of these women share a background of involvement in social change movements and a strong commitment to social justice and community participation. These principles along with the energy and vision of each director helped to create the dynamic organisation the Forum is today. Larry Peters, from Waikato University’s Department of Community Psychology was the Forum’s first director. Larry began to establish a national database of health promotion research and programmes and involved the Forum in co-ordinating a national nutrition symposium before returning to his native Canada after one year. By the time of Larry’s departure, the Forum was ready to develop a broader community base. Kim Conway, who had been working with ALAC, then at the cutting edge of health promotion and community action initiatives, and who had been in the alcohol field for a number of years, was recruited for this purpose on a part-time basis. Kim’s first task was a needs assessment with the health promotion community. This brought a call for information on issues and training, as well as advocacy on behalf of the health promotion field. In response, a directory of health promotion organisations was created and info sheets, which led to the development of the newsletter, were published. An initial series of training workshops was also set up. Kim established the Forum’s legal structure and its inaugural general meeting as an incorporated society was held in November 1988. A national body, the Forum is administered by an Auckland based secretariat. Its governing body is a council of representatives from elected member organisations. Founding members, wanting to ensure a bi-cultural perspective for the organisation, reflected this in the constitution. Kim recalled that in 1988 “a lot of organisations were just finding their feet with treaty issues” and commitment to Te Tiriti o Waitangi was still too controversial for one organisation which withdrew its support. All three past directors acknowledged the Forum’s first chairperson, the late Dr Erihapeti Rehu-Murchie (MWWL), for her commitment to partnership and her wise leadership and nurturing of the Forum during those formative years. By 1990, health promotion as a discipline had grown and so had the Forum. While Kim remained with the organisation part-time she handed over to full-time director, Candace Bagnall. Candace brought a strong social advocacy and policy background as well as education resource production skills to the Forum. She had recently returned to New Zealand from working as a programme and policy advisor in the Premier’s department in Victoria, Australia. She had also spent some years living in Northland at a critical time of what is now called the Maori cultural renaissance. Through her involvement in HART (Halt All Racist Tours) she was part of a small group which hosted the hikoi of 1994 through Tai Tokerau to Waitangi. Candace applied her passion and experience in these areas to the continued bicultural development of the Forum, the production of a national newsletter and launched the Forum’s bi-annual conferences. The Forum’s membership doubled as Candace further strengthened the health promotion networks. “The establishment of the database and health promotion directory named those who were interested in health promotion. It allowed them to feel part of a new and emerging health promotion profession.” Candace’s success in building relationships with key stakeholders also contributed greatly to consolidating the Forum’s position and increasing its profile and credibility. This included gaining the support of the Auckland Area Health Board and the late Dr John McLeod to set up the Forum at the health promotion community resource centre in Newmarket. In March 1992 the Forum shifted to the present site at 27 Gillies Avenue Newmarket. In 1991, Cheryl Hamilton, a women’s health activist enjoying a break from being a parliamentary electorate secretary, came on board to organise Health Workforce Development Fund training workshops. While this one-off series met some of the identified training need, the workforce was also asking for a qualification from a practical course for workers on the ground. Kim developed the course curriculum for a Certificate in Health Promotion for the Central Institute of Technology and, with Cheryl, tutored the first intake in 1992. The development of a rapidly expanding health promotion practice was affected considerably by the changing political environment of the early 1990s. The health reforms signalled a new era for the Forum and its members. The organisation’s focus became on the concept of health promotion rather than the specific issues of much of the workforce. In the new political climate the advocacy role became more of a challenge and the Forum, at times, walked a difficult political tightrope. Contracting and the purchaser provider split were also key components of this new era and the Forum developed contracts with the newly established Public Health Commission for workforce development at the national level and with North Health for regional services. Candace acknowledged the importance of the shift towards the workforce development work “that Kim and then Cheryl took such a strong lead in. In the end I think it became the main reason for the Forum’s continued existence.” In 1995 Cheryl exchanged her training role for that of director when Candace moved on to North Health to establish the structure for joint purchasing of national contracts for the four Regional Health Authorities. Cheryl remained in this role until early 2003 and during her years major initiatives at the Forum included the development TUHA-NZ: Towards an Understanding of Hauora in Aotearoa-New Zealand and Nga Kaitakatanga Hauora mo Aotearoa: Health Promotion Competencies for Aotearoa-new Zealand; three national health promotion Conferences were held biennially, and the course MIT/HPF Certificate of Achievement in Introducing Health Promotion was established.

Coming of age, 2009

2003 signalled a period of intensive change for the Forum. For a period after Cheryl left and the Forum was managed by a series of acting directors including Keith Preston, Diana MacDonald and Dallas Honey. Teina Kake took over the reins in 2003. A number of key staff left to further their careers in specialist areas, reflecting a conundrum for the Forum – interest in workforce development and education is often stronger in specific work streams to the detriment of broad based health promotion and generic training. Dr Alison Blaiklock’s arrival as Executive Director late in 2004 signalled a new era for the Forum. She is a public health physician who has worked in health promotion since 1994. Her special interests are the health of children and young people, the determinants of health, and health and human rights. Alison along with others attended the 6th World Conference (conducted by the World health Organisation) where The Bangkok Charter for Health Promotion in a Globalized World (11 August 2005) was agreed on. This Charter articulated new global approaches to health promotion and pointed new directions for the Forum. Also in 2005 the Forum signalled a shift in strategic direction with the launch of a new tohu (logo) and slogan ‘Hauora – Everyone’s Right’. The new focus on human rights approaches to health promotion and the need to address inequities prioritises resources around groups with least advantage such as Māori, Pacific, refugees and migrants. The report, Closing the Gaps, from the World Health Organisation Commission on Social Determinants of Health released in 2008 sanctions these approaches and gives direction to health promotion for the foreseeable future. Many changes such as the amended Constitution in 2008 and strengthened infrastructure position the Forum to serve the future workforce. Alison now leads a small team of health promoters with expertise in strategy and workforce development, support staff, contractors and consultants. Initiatives include, the expansion of the MIT Certificate of Achievement in Introducing Health Promotion, the support for MIT establishing an undergraduate qualification The Diploma in Health Promotion (Level 6, 120 credits), participation in other tertiary education developments, and the establishment of five reference groups – Māori, Pacific, primary health, academic and South Island – from the senior workforce throughout Aotearoa. A change of newsletter name to Hauora, launch of a new website in 2008 and an e bulletin Rongo Korero o Hauora reflect works in progress as the Forum seeks to keep pace with rapidly changing and expanding electronic communications. Within the Forum strong Māori, strengthening Pacific participation and the growing voice of Asian communities in both governance and service delivery reflect commitment to Te Tiriti o Waitangi, determinants of health and human rights based approaches to health promotion.

During the annual symposium in July 2009 the Forum celebrated 21 years.

Forum Council chairs from inception to 2010

Dr Erihapeti Rehu-Murchie (MWWL) June Mariu (MWWL) Druis Barret (MWWL) Sandra Kirby (ALAC) Andrea McLeod (Otago DHB, Public Health South) Te Herekiekie Herewini (AIDs Foundation) Janferie Bryce-Chapman (Age Concern) Gary Brown (Hapai Te Hauora Tapui) Donna Leatherby incumbent – See more at: http://www.hauora.co.nz/history.html#sthash.EaEskPyW.dpuf