"Going the Extra Mile": A descriptive exploratory study of Primary Health Services based on the experiences of Pacific Primary Health Organisation Service managers and providers


  • Margaret Pack ANZASW




primary health care, pacific providers, social work, evaluation


INTRODUCTION: This exploratory study is part of a larger evaluation of the primary health care strategy (PHCS) in Aotearoa New Zealand, using a mixed methods research approach. The aims of this qualitative arm of the research were to explore the extent of use and satisfaction with the PHCS through the operation of Pacific-led Primary Health Organisations (PHOs) in relation to service provision and delivery from the service providers’ and managers’ perspectives.

METHOD: The exploratory study was conducted using a case study design and in-depth interviews with service managers and health providers at six Pacific-led PHOs. A review of the literature on primary healthcare was conducted prior to undertaking the research. In this literature review, several themes were noted from the review of policy documents providing background to the development of primary healthcare in New Zealand. 

CONCLUSION: The themes from interviews suggest a core tension between the business model, Ministry reporting requirements, and more altruistic values of both managers and service providers in their delivery of services. Overall, there was a positive response to the lowered cost of healthcare from the providers and managers interviewed in the Pacific-led primary health services, mirroring the findings of the larger evaluation report of PHOs (Cumming et al., 2005). The availability of wrap-around, holistically based, accessible services delivered by culturally responsive health providers who were considered to “go the extra mile” for their clients was the predominant theme accounting for an increased uptake and use of the services. The implications for health social work are discussed.


Agnew, F., Pulotu-Endemann, F. K., Robinson, G., Suaalii-Sauni, T., Warren, H., Wheeler, A.,… Schmidt-Sopoaga, H. (2004). Pacific models of mental health service delivery in New Zealand (“PMMHSD”) project. Auckland, NZ: Waitemata District Health Board.

Anderson, I., Crengle, S., Kamaka M., Chen, T. H., Palafox, N., & Jackson-Pulver, L. (2006). Indigenous health in Australia, New Zealand, and the Pacific. Lancet, 27, 367(9524), 1775–1185.

Barnett, R., & Barnett, P. (2004). Primary healthcare in New Zealand: Problems and policy approaches. Social Policy Journal of New Zealand, 21, 49–66.

Barnett, P., Smith J., & Cumming, J. (2009). The roles and functions of primary health organisations. Wellington, NZ: Health Services Research Centre, Victoria University of Wellington. Retrieved from https://www.victoria.ac.nz/health/centres/health-services-research-centre/docs/reports/Roles-and-Functions-of-PHOs.pdf

Barwick, H. (2000). Improving access to primary care for Māori and Pacific peoples: A literature review. Wellington, NZ: Health Funding Authority.

Beddoe, L., & Deeney, C. (2012). Discovering health social work in New Zealand in its published work: Implications for the profession. Aotearoa New Zealand Social Work, 24(1), 41–55.

Cumming, J., & Mays, N. (2011). New Zealand's Primary Health Care Strategy: Early effects of the new financing and payment system for general practice and future challenges. Health Economics, Policy and Law, 6(1), 1–21. doi:10.1017/S1744133109990260

Cumming, J., Raymont A., Gribben B., Horsburgh M., Kent B., McDonald J.,… Smith, J. (2005). Evaluation of the implementation and intermediate outcomes of the Primary Health Care Strategy. Wellington, NZ: Health Services Research Centre, Victoria University of Wellington. Retrieved from https://www.victoria.ac.nz/health/centres/health-services-research-centre/docs/reports/downloads/FINAL-Overview-27-May.pdf

Döbl, S., Beddoe, L., & Huggard, P. (2017). Primary health care social work in Aotearoa New Zealand: An exploratory investigation. Aotearoa New Zealand Social Work, 29(2), 119–130.

Gauld, R., & Mays, N. (2006). Are New Zealand’s new primary health organisations fit for purpose? British Medical Journal, 333, 1216–1218.

Hawley, N. L., & McGarvey, S. T. (2015). Obesity and diabetes in Pacific Islanders: The current burden and the need for urgent action. Current Diabetes Reports, 15(5), 29-39. doi: 10.1007/s11892-015-0594-5.

Hogg, W., Rowan, M., Russell, G., Geneau, R., & Muldoon, L. (2008). Framework for primary care organisations: The importance of a structural domain. International Journal for Quality in Healthcare, 20(5), 308–313. doi.org/10.1093/intqhc/mzm054

Jantrana, S., & Crampton P. (2009). Primary health care in New Zealand: Who has access? Health Policy, 93(1), 1–10. doi:10.1016/j.healthpol.2009.05.006

Keating, G., & Jaine, R. (2016). What supports are needed by New Zealand primary care to improve equity and quality? Journal of Primary Health Care, 8(4), 312–315. doi:10.1071/HC16020

King, A. (2001). The primary health care strategy. Wellington, NZ: Ministry of Health.

Minister of Health & Minister of Pacific Island Affairs. (2010). Ala Mo’ui’: Pathways to Pacific health and well-being 2010-2014. Wellington, New Zealand: Author. Retrieved from https://www.health.govt.nz/system/files/documents/publications/ala-moui-pathways-to-pacific-health-wellbeing2010-2014.pdf

Pack, M. (2008). An innovation in primary mental health services: The MidValley Well-being Service. Aotearoa New Zealand Social Work Review, 20(3), 25–33.

Pack, M., Minister, J., Churchward, M., & Fa’asalele Tanuvasa, A. (2013). Evaluation of the implementation and immediate outcomes of the Primary Health Care Strategy: The experiences of Pacific PHOs and Pacific populations. Wellington, NZ: Health Services Research Centre, Victoria University of Wellington. Retrieved from https://www.victoria.ac.nz/health/centres/health-services-research-centre/our-publications/reports/pacific-phcs-report.pdf

Pockett, R., & Beddoe, L. (2017). Social work in health care: An international perspective. International Social Work, 60(1), 126–139.

Pulotu-Endemann, F. K. & Faleafa, M. (2017). Developing a culturally competent workforce that meets the needs of Pacific people living in New Zealand. In M. Smith & A. Jury (Eds.), Workforce development theory and practice in the mental health sector (pp. 165–180). doi:10.4018/978-1-5225-1874-7.ch008

Southwick, M., Kenealy, T., & Ryan, D. (2012). Primary care for Pacific people: A Pacific and health systems approach. Report to the Health Research Council and the Ministry of Health. Retrieved from www.pacificperspective.co.nz

Statistics New Zealand. (2013). Quick Stats about culture and identity. Wellington, NZ: Author. Retrieved from http://archive.stats.govt.nz/Census/2013-census/profile-and-summary-reports/quickstats-culture-identity/pacific-peoples.aspx

Suaalii-Sauni, T., Wheeler, A., Saafi, E., Robinson, G., Agnew, F., Warren, H., Erick, M., & Hingano, T. (2009). Exploration of Pacific perspectives of Pacific models of mental health service delivery in New Zealand. Pacific Health Dialog, 15(1), 18–27.

Tamasese, K., Peteru, C., Waldegrave, C., & Bush, A. (2005). Ole taeao afua [the new morning]: A qualitative investigation into Samoan perspectives on mental health and culturally appropriate services. Australian and New Zealand Journal of Psychiatry, 39(4), 300–309.

Yin, R. (2009). Case study research: Design and methods (4th ed.). Thousand Oaks, CA: Sage.




How to Cite

Pack, M. (2018). "Going the Extra Mile": A descriptive exploratory study of Primary Health Services based on the experiences of Pacific Primary Health Organisation Service managers and providers. Aotearoa New Zealand Social Work, 30(2), 57–67. https://doi.org/10.11157/anzswj-vol30iss2id482



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