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The importance of trust in commissioning: balancing national and local needs

Preventing chronic disease is a complex challenge that requires a comprehensive package of partnering for impact, scaling the work of communities, adapting and experimenting while being comfortable working in the grey, leadership at all levels, a skilled workforce and achieving equitable outcomes.

Healthy Families NZ brings community leadership together in a united effort for better health and wellbeing. The journey has been to implement a national initiative that responds to the unique context of each community. This has been achieved by aligning to the guiding principles, being outcome focused and maintaining a high-trust partnership between lead providers and the Healthy Families NZ national team. Underpinning the Healthy Families NZ health prevention movement is a commissioning approach built on trust.

Trust is the thread that holds the systems change approach together. Healthy Families NZ locations are contracted for expectations, and indicators of success (as opposed to outputs). Contracts are designed around guiding principles rather than defined deliverables. With this relational contracting approach, the Healthy Families NZ national team demonstrates the shared trust that has been built throughout the movement and the commitment to walk alongside lead providers in partnership. The Healthy Families NZ Summative Evaluation clearly indicates that this approach has enabled and accelerated collective impact for better health and wellbeing outcomes across Aotearoa.

One of the roles of the Healthy Families NZ national team is the ability to collapse the space between communities, lead providers and government. The national/local partnership approach enables kaimahi in the community to “get on with” what works, whilst providing leadership and guidance.

The health prevention movement created by Healthy Families NZ is changing mindsets and systems, nurturing a strong workforce, embedding and promoting kaupapa Māori principles and filling a gap that no organisation has occupied. Healthy Families NZ is generating sustainable change for better health and wellbeing outcomes where we live, learn, work and play which is having ripple effects beyond the initiative.


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