title: An examination of DHB climate change policy and implementation: Responsiveness to Māori health

authors: Powell, Elisha

abstract: The impacts of climate change have become increasingly evident throughout the world and in Aotearoa. Frequency and intensity of extreme weather events such as flooding, coastal erosion, wildfires, and droughts are notably increasing. Climate-related disasters have devastating effects on human health, as is well documented in literature. These effects include cardiovascular disease, poorer mental health, food insecurity and water borne disease. 

Due to pre-existing health disparities, Māori are particularly vulnerable to the health impacts of climate change. Further, Māori have unique relationships with whenua wherein destruction of the natural environment will have a negative impact on the health of Māori people and communities. The health sector has an obligation to respond to Māori health in a way that honours Māori relationships with the environment and prioritises equitable health outcomes for Māori in climate change policy. 

Although Māori face potentially severe health impacts due to climate change, there is limited literature that considers health sector climate change policy and its responsiveness to Māori health. In an effort to address this gap in literature, this thesis aims to examine whether there is existing District Health Board (DHB) policy focused on implementing institutional responses to climate change. Further, this research seeks to understand the extent to which any identified DHB climate change policy responds to Māori health. 

At the time of study, DHBs were responsible for providing and funding health services throughout Aotearoa. During the late stages of this research, the health sector underwent reform, and two health authorities have replaced DHBs. The implications of this research have important ramifications within the newly established health authorities. A dedicated Māori health authority will provide the health sector with the chance to advance health equity by acting on holistic understandings of health for Māori. These actions would establish health policy that recognises Māori health as fundamentally linked to the environment and therefore uniquely impacted by climate change. 

To achieve the aims of this thesis, two research methods were implemented. Initially, an environmental scan of 17 DHB websites was completed to identify climate change and Māori health policies. This was followed by qualitative interviews with three DHB staff from diverse localities. Additionally, tāngata whenua interviews from the wider research project named Haumanu Hauora, were analysed to ensure Māori understandings of climate change were included in this research (Masters-Awatere et al., 2022). 

Research findings provide insights that point to highly fragmented climate change policies across the health sector. There is a glaring lack of direction in the health sector's response to climate change throughout existing policy. Māori health policies were in place across all DHBs, however, lacked recognition of the interconnection between Māori health and the natural environment, and therefore the impacts of climate change. 

Although policy was fragmented across regions, there is potential to enhance both climate change and Māori health policies by recognising the interconnected nature of Māori health and climate change. This will necessitate a significant change in the health systems policy response to climate change that prioritises mātauranga Māori and addresses the ongoing impacts of colonisation.

text: An examination of DHB climate change policy and implementation: Responsiveness to Māori health The impacts of climate change have become increasingly evident throughout the world and in Aotearoa. Frequency and intensity of extreme weather events such as flooding, coastal erosion, wildfires, and droughts are notably increasing. Climate-related disasters have devastating effects on human health, as is well documented in literature. These effects include cardiovascular disease, poorer mental health, food insecurity and water borne disease. 

Due to pre-existing health disparities, Māori are particularly vulnerable to the health impacts of climate change. Further, Māori have unique relationships with whenua wherein destruction of the natural environment will have a negative impact on the health of Māori people and communities. The health sector has an obligation to respond to Māori health in a way that honours Māori relationships with the environment and prioritises equitable health outcomes for Māori in climate change policy. 

Although Māori face potentially severe health impacts due to climate change, there is limited literature that considers health sector climate change policy and its responsiveness to Māori health. In an effort to address this gap in literature, this thesis aims to examine whether there is existing District Health Board (DHB) policy focused on implementing institutional responses to climate change. Further, this research seeks to understand the extent to which any identified DHB climate change policy responds to Māori health. 

At the time of study, DHBs were responsible for providing and funding health services throughout Aotearoa. During the late stages of this research, the health sector underwent reform, and two health authorities have replaced DHBs. The implications of this research have important ramifications within the newly established health authorities. A dedicated Māori health authority will provide the health sector with the chance to advance health equity by acting on holistic understandings of health for Māori. These actions would establish health policy that recognises Māori health as fundamentally linked to the environment and therefore uniquely impacted by climate change. 

To achieve the aims of this thesis, two research methods were implemented. Initially, an environmental scan of 17 DHB websites was completed to identify climate change and Māori health policies. This was followed by qualitative interviews with three DHB staff from diverse localities. Additionally, tāngata whenua interviews from the wider research project named Haumanu Hauora, were analysed to ensure Māori understandings of climate change were included in this research (Masters-Awatere et al., 2022). 

Research findings provide insights that point to highly fragmented climate change policies across the health sector. There is a glaring lack of direction in the health sector's response to climate change throughout existing policy. Māori health policies were in place across all DHBs, however, lacked recognition of the interconnection between Māori health and the natural environment, and therefore the impacts of climate change. 

Although policy was fragmented across regions, there is potential to enhance both climate change and Māori health policies by recognising the interconnected nature of Māori health and climate change. This will necessitate a significant change in the health systems policy response to climate change that prioritises mātauranga Māori and addresses the ongoing impacts of colonisation.

year: 2025

title: Developing a kaupapa Māori evaluation model – one size fits all?

authors: Masters-Awatere, Bridgette

subjects: Maori health

abstract: Health statistics in Aotearoa (New Zealand) highlight that Māori, the indigenous people Aotearoa have poorer health than non- Māori. In response to the statistics a number of Māori health providers have established services that address specific areas of need in their regions. Initially there were minimal accountability requirements of providers. However, changes in the health system now mean that groups wanting to establish a new service must provide accountability measures before, during and after the funding has been allocated. As a result providers need to develop a rationale behind their decisions and assess the measure of change that has taken place as a result of the service or programme to ensure continued funding. The requirements reflect the dominant Western paradigm in which health promotion is understood to be about producing specific quantifiable behaviour changes in individuals. Māori health providers on the other hand have tended to take a holistic approach to health. Thus they have found themselves in the position of trying to show change within a paradigm where measurements are not easily taken. This has created frustration amongst Māori providers who face losing their funding because of an inability to report measurable outcomes using a framework that does not apply to their culture.

text: Developing a kaupapa Māori evaluation model – one size fits all? Health statistics in Aotearoa (New Zealand) highlight that Māori, the indigenous people Aotearoa have poorer health than non- Māori. In response to the statistics a number of Māori health providers have established services that address specific areas of need in their regions. Initially there were minimal accountability requirements of providers. However, changes in the health system now mean that groups wanting to establish a new service must provide accountability measures before, during and after the funding has been allocated. As a result providers need to develop a rationale behind their decisions and assess the measure of change that has taken place as a result of the service or programme to ensure continued funding. The requirements reflect the dominant Western paradigm in which health promotion is understood to be about producing specific quantifiable behaviour changes in individuals. Māori health providers on the other hand have tended to take a holistic approach to health. Thus they have found themselves in the position of trying to show change within a paradigm where measurements are not easily taken. This has created frustration amongst Māori providers who face losing their funding because of an inability to report measurable outcomes using a framework that does not apply to their culture.

year: 2002

title: Corporate governance structures and financial performance: A comparative study of publicly listed companies in Singapore and Vietnam

authors: Nguyen, Tuan Van

subjects: Corporate governance

abstract: This study uses a dynamic modelling approach to investigate the relationship between corporate governance structures and financial performance of publicly listed companies in Singapore and Vietnam. The dynamic modelling approach facilitates answering the first research question: whether the relationship between corporate governance structures and firm financial performance persists in the Singaporean and Vietnamese markets when the relationship’s dynamic nature is taken into account. Moreover, by focusing on two different types of national governance systems in the Asian region (well-developed vs. under-developed), this study observes how the relationship between corporate governance structures and firm performance is moderated by each country’s national governance quality. By carrying out this observation, this study answers the second research question: whether the corporate governance–firm performance relationship varies according to the quality of national governance systems in which firms operate.
Two samples – including a total of 379 publicly listed non-financial companies  covering a four-year period from 2008 to 2011– are examined through the use of a two-step system generalised method of moments estimator. This estimation technique allows for potential sources of endogeneity inherent in the corporate governance–firm performance relationship, including dynamic endogeneity, simultaneity, and unobserved time-invariant heterogeneity across firms. 
The results suggest that the performance effect of corporate governance structures persists in both markets even after the dynamic nature of the corporate governance–firm performance relationship is taken into consideration. For the Singaporean market, the results also show that the three corporate governance structures (board diversity, board size and ownership structures) appear to have statistically significant effects on firm performance. For both markets, it is observed that there is a statistically significantly positive relationship between ownership concentration and financial performance. This finding supports the prediction of agency theory regarding the efficient monitoring effect of large shareholders in markets with highly concentrated ownership. 
For the Vietnamese market, the results show that board gender diversity has a positive effect on firm performance. Remaining robust even after the alternative proxies for gender diversity are employed, this finding is consistent with the perspectives of agency theory and resource dependence theory. The number of female directors in the boardroom also matters, supporting the view that if female board representation affects firm outcomes, this effect is more pronounced when the number of female directors increases. However, the marginal positive performance effect of board gender diversity ceases when the percentage of female directors reaches a breakpoint of about 20%. This finding suggests that there is perhaps a potential trade-off between the costs and benefits of board gender diversity.
Importantly, the results indicate that the relationship between the current performance and one-year lagged performance is statistically significantly positive in both markets, and robust when alternative estimation methods and models are employed. In line with Wintoki, Linck, and Netter (2012), among others, this finding suggests that the corporate governance–firm performance relationship should be investigated in a dynamic framework. This means that past firm performance should be considered as an important independent variable to control for potential effects of unobserved historical factors on current corporate governance structures and performance.
Furthermore, the results show that better national governance quality has a positive effect on firm performance, and that the performance effect of ownership concentration is contingent upon national governance quality. The results suggest that ownership concentration appears to have a stronger positive effect on performance of companies in Vietnam where the national governance system is underdeveloped. In contrast, concentrated ownership tends to have a weaker effect on financial performance of firms in Singapore where the national governance system is well-established. This finding is consistent with the argument that ownership concentration is an efficient corporate governance mechanism which can substitute for weak national governance quality. In the absence of effective national governance mechanisms, ownership concentration is likely to be an important corporate governance strategy for Vietnamese firms to control potential agency problems. On the contrary, in Singapore, where national governance quality – such as legal protection of shareholders – is much better, the role of ownership concentration in determining performance seems to be weaker.
This study is novel in that it is the first to explore the corporate governance–firm performance relationship using a dynamic modelling approach for the Vietnamese and Singaporean markets. The findings of this study significantly contribute toward a better understanding of international diversity on corporate governance by providing robust empirical evidence from the emerging and mature markets in the Asian region. This study also extends the corporate governance literature by enriching the understanding of the interaction between corporate-level and national-level governance mechanisms.

text: Corporate governance structures and financial performance: A comparative study of publicly listed companies in Singapore and Vietnam This study uses a dynamic modelling approach to investigate the relationship between corporate governance structures and financial performance of publicly listed companies in Singapore and Vietnam. The dynamic modelling approach facilitates answering the first research question: whether the relationship between corporate governance structures and firm financial performance persists in the Singaporean and Vietnamese markets when the relationship’s dynamic nature is taken into account. Moreover, by focusing on two different types of national governance systems in the Asian region (well-developed vs. under-developed), this study observes how the relationship between corporate governance structures and firm performance is moderated by each country’s national governance quality. By carrying out this observation, this study answers the second research question: whether the corporate governance–firm performance relationship varies according to the quality of national governance systems in which firms operate.
Two samples – including a total of 379 publicly listed non-financial companies  covering a four-year period from 2008 to 2011– are examined through the use of a two-step system generalised method of moments estimator. This estimation technique allows for potential sources of endogeneity inherent in the corporate governance–firm performance relationship, including dynamic endogeneity, simultaneity, and unobserved time-invariant heterogeneity across firms. 
The results suggest that the performance effect of corporate governance structures persists in both markets even after the dynamic nature of the corporate governance–firm performance relationship is taken into consideration. For the Singaporean market, the results also show that the three corporate governance structures (board diversity, board size and ownership structures) appear to have statistically significant effects on firm performance. For both markets, it is observed that there is a statistically significantly positive relationship between ownership concentration and financial performance. This finding supports the prediction of agency theory regarding the efficient monitoring effect of large shareholders in markets with highly concentrated ownership. 
For the Vietnamese market, the results show that board gender diversity has a positive effect on firm performance. Remaining robust even after the alternative proxies for gender diversity are employed, this finding is consistent with the perspectives of agency theory and resource dependence theory. The number of female directors in the boardroom also matters, supporting the view that if female board representation affects firm outcomes, this effect is more pronounced when the number of female directors increases. However, the marginal positive performance effect of board gender diversity ceases when the percentage of female directors reaches a breakpoint of about 20%. This finding suggests that there is perhaps a potential trade-off between the costs and benefits of board gender diversity.
Importantly, the results indicate that the relationship between the current performance and one-year lagged performance is statistically significantly positive in both markets, and robust when alternative estimation methods and models are employed. In line with Wintoki, Linck, and Netter (2012), among others, this finding suggests that the corporate governance–firm performance relationship should be investigated in a dynamic framework. This means that past firm performance should be considered as an important independent variable to control for potential effects of unobserved historical factors on current corporate governance structures and performance.
Furthermore, the results show that better national governance quality has a positive effect on firm performance, and that the performance effect of ownership concentration is contingent upon national governance quality. The results suggest that ownership concentration appears to have a stronger positive effect on performance of companies in Vietnam where the national governance system is underdeveloped. In contrast, concentrated ownership tends to have a weaker effect on financial performance of firms in Singapore where the national governance system is well-established. This finding is consistent with the argument that ownership concentration is an efficient corporate governance mechanism which can substitute for weak national governance quality. In the absence of effective national governance mechanisms, ownership concentration is likely to be an important corporate governance strategy for Vietnamese firms to control potential agency problems. On the contrary, in Singapore, where national governance quality – such as legal protection of shareholders – is much better, the role of ownership concentration in determining performance seems to be weaker.
This study is novel in that it is the first to explore the corporate governance–firm performance relationship using a dynamic modelling approach for the Vietnamese and Singaporean markets. The findings of this study significantly contribute toward a better understanding of international diversity on corporate governance by providing robust empirical evidence from the emerging and mature markets in the Asian region. This study also extends the corporate governance literature by enriching the understanding of the interaction between corporate-level and national-level governance mechanisms.

year: 2015