The Coronavirus pandemic of 2019–20 (COVID-19) affected multiple social determinants of health (SDH) across the globe, including in New Zealand, exacerbating health inequities. Understanding these system dynamics can support decision making for the pandemic response and recovery measures. This study combined a scoping review with a causal loop diagram to further understanding of the connections between SDH, pandemic measures, and both short- and long-term outcomes in New Zealand. The causal loop diagram showed the reinforcing nature of structural SDH, such as colonization and socio-economic influences, on health inequities. While balancing actions taken by government eliminated COVID-19, the diagram showed that existing structural SDH inequities could increase health inequities in the longer term, unless the opportunity is taken for socio-economic policies to be reset. Such policy resets would be difficult to implement, as they are at odds with the current socio-economic system. The causal loop diagram highlighted that SDH significantly influenced the dynamics of the COVID-19 impact and response, pointing to a need for purposeful systemic action to disrupt the reinforcing loops which increase health inequities over time. This will require strong systems leadership, and coordination between policy makers and implementation at local level.
Playcentre is a parent cooperative early childhood service where parents are trained and supported as the educators in the service. Once considered a ‘mainstream’ service, policy has increasingly marginalised Playcentres in favour of supporting teacher-led services. This article gives a background of parent cooperative services, and then reviews policies of the fifth National government from 2008, with an emphasis on how these policies have accommodated or excluded Playcentre. This review is presented as an argument for maintaining diversity in the early childhood education and care sector by developing policy which accommodates parent cooperative services.
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