A tertiary approach to improving equity in health: quantitative analysis of the Māori and Pacific Admission Scheme (MAPAS) process, 2008–2012

International Journal for Equity in Health

Research

Yannan Jiang¹  Louise McMillan¹  Erena Wikaire²  Papaarangi Reid²  Elana Curtis²  Rob Loto² 

[1]Department of Statistics, Faculty of Science, University of Auckland, Private Bag 92015, Auckland, New Zealand

[2]Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92015, Auckland, New Zealand

关键词: Māori;    Pacific;    Indigenous;    Ethnic minority;    Health workforce development;    Tertiary admission;    Multiple mini interview;    Widening participation;    Secondary education;   

DOI  :  10.1186/s12939-015-0133-7

 received in 2014-09-12, accepted in 2015-01-06,  发布年份 2015

来源: Springer

【 摘 要 】

IntroductionAchieving health equity for indigenous and ethnic minority populations requires the development of an ethnically diverse health workforce. This study explores a tertiary admission programme targeting Māori and Pacific applicants to nursing, pharmacy and health sciences (a precursor to medicine) at the University of Auckland (UoA), Aotearoa New Zealand (NZ). Application of cognitive and non-cognitive selection tools, including a Multiple Mini Interview (MMI), are examined.MethodsIndigenous Kaupapa Māori methodology guided analysis of the Māori and Pacific Admission Scheme (MAPAS) for the years 2008–2012. Multiple logistic regression models were used to identify the predicted effect of admission variables on the final MAPAS recommendation of best starting point for success in health professional study i.e. ‘CertHSc’ (Certificate in Health Sciences, bridging/foundation), ‘Bachelor’ (degree-level) or ‘Not FMHS’ (Faculty of Medical and Health Sciences). Regression analyses controlled for interview year, gender and ancestry.ResultsOf the 918 MAPAS interviewees: 35% (319) were Māori, 58% (530) Pacific, 7% (68) Māori/Pacific; 71% (653) school leavers; 72% (662) females. The average rank score was 167/320, 40–80 credits below guaranteed FMHS degree offers. Just under half of all interviewees were recommended ‘CertHSc’ 47% (428), 13% (117) ‘Bachelor’ and 38% (332) ‘Not FMHS’ as the best starting point. Strong associations were identified between Bachelor recommendation and exposure to Any 2 Sciences (OR:7.897, CI:3.855-16.175; p < 0.0001), higher rank score (OR:1.043, CI:1.034-1.052; p < 0.0001) and higher scores on MAPAS mathematics test (OR:1.043, CI:1.028-1.059; p < 0.0001). MMI stations had mixed associations, with academic preparation and career aspirations more consistently associated with recommendations.ConclusionsOur findings raise concerns about the ability of the secondary education sector to prepare Māori and Pacific students adequately for health professional study. A comprehensive tertiary admissions process using multiple tools for selection (cognitive and non-cognitive) and the provision of alternative entry pathways are recommended for indigenous and ethnic minority health workforce development. The application of the MMI within an equity and indigenous cultural context can support a holistic assessment of an applicant’s potential to succeed within tertiary study. The new MAPAS admissions process may provide an exemplar for other tertiary institutions looking to widen participation via equity-targeted admission processes.

【 授权许可】

CC BY   
© Curtis et al.; licensee BioMed Central. 2015