{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T14:16:42Z","timestamp":1769609802106,"version":"3.49.0"},"reference-count":0,"publisher":"Pasifika Medical Association Group","issue":"1628","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NZMJ"],"abstract":"<jats:p>Community-led action is essential for building a more effective and equitable health system. Yet Aotearoa New Zealand\u2019s history of topdown\nstructural reforms has undermined progress toward \u201chealthy futures for all\u201d. We draw on complexity science and system-change\nprinciples to explain why genuine devolution and community engagement are not just ideological preferences but practical necessities\nin a complex adaptive health system. Community agency and locally tailored innovation can drive emergent, system-wide improvements,\nbut only if central structures enable and sustain these relationships. A key step is reframing our mental model of the health system from\na linear machine to a complex system. We discuss how the turbulence of current policy changes fits into long-running patterns and why\na clearer conceptualisation of complexity can guide policymakers toward tangible actions that reorient the system towards patients\nand communities. Finally, we outline some essential ingredients for how New Zealand can transition from rhetoric and good intentions\nto the effective implementation of an equitable, community-centred health system.<\/jats:p>","DOI":"10.26635\/6965.7118","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T01:16:33Z","timestamp":1769562993000},"page":"68-76","source":"Crossref","is-referenced-by-count":0,"title":["Putting communities at the centre for a more effective and equitable health system in Aotearoa New Zealand"],"prefix":"10.26635","volume":"139","author":[{"given":"Anna","family":"Matheson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Reidy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lis","family":"Ellison-Loschmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11177","published-online":{"date-parts":[[2026,1,30]]},"container-title":["New Zealand Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T01:16:35Z","timestamp":1769562995000},"score":1,"resource":{"primary":{"URL":"https:\/\/nzmj.org.nz\/journal\/vol-139-no-1628\/putting-communities-at-the-centre-for-a-more-effective-and-equitable-health-system-in-aotearoa-new-zealand"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":0,"journal-issue":{"issue":"1628","published-online":{"date-parts":[[2026,1,30]]}},"URL":"https:\/\/doi.org\/10.26635\/6965.7118","relation":{},"ISSN":["1175-8716"],"issn-type":[{"value":"1175-8716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}