Building a systems-thinking community workforce to scale action on determinants of health in New Zealand

Abstract

This article describes findings from the evaluation of Healthy Families New Zealand (HFNZ), an equity-driven, place-based community health initiative. Implemented in nine diverse communities across Aotearoa New Zealand, HFNZ aims to strengthen the systems that improve health and well-being. Findings highlight local priorities and the social mechanisms important for reorienting health and policy systems towards place-based communities. Lessons include the importance of local experience in putting evidence into practice; the strength of acting with systems in mind; the need for relational, learning, intentional, and well-resourced community organisation; examples of how to foster place-based ‘community-up’ leadership; and how to enable responsiveness between communities and the policy system. A reconceptualisation of scaling is offered, which recognises that relationships in social systems are salient, and that ‘communities’ are nested and relative to each other.