Healthy lifestyles are where some of the greatest challenges face TTH.
Nearly half of Hawke's Bay Maori mothers giving birth are smokers, compared with 11 per cent for non-Maori and non-Pacific mothers.
Smoking during pregnancy can cause miscarriage, stillbirth, premature birth and low birth weight. Exposure to second-hand smoke increases the risk of sudden unexpected death in infancy, asthma attacks, chest infections, and glue ear in children.
Smoking is a major risk factor for heart disease and lip, mouth, throat, bladder, cervical stomach and lung cancers.
More than half of Hawke's Bay Maori adults are obese, compared with less than a third for non-Maori. Obesity is a risk factor for diabetes, heart diseases, asthma, arthritis and cancer.
DHB CEO Kevin Snee said past contracts did not focused enough on improved-health outcomes.
"I recognise that as soon as you've got to focus on the fine print of the contract you've failed," he said.
"So what we're doing with a number of local organisations is making it easier for them to operate, to be able to serve their population better."
TTH general manager Luke Rowe said the change would give greater transparency for both parties and enable health services to match performance frameworks.
"It is all about understanding who is doing what with whom and when," he said.
"These new contracts will be outcomes-based, which means that TTH's healthcare provision to whanau will be assessed on its achievements and what has changed for families."
The broader scope of the new contracts would allow greater efficiency and flexibility, he said.
"Our work and staff will not be compartmentalised by the strict parameters of multiple contracts for individual services. It will mean less time spent on paperwork demonstrating compliance, and more time on the frontline.
"For whanau, it will mean one TTH car in the drive, not three. They will notice a far more co-ordinated approach to their involvement with TTH and easier access to the right support at the right time."
"It is making it very explicit who we are targeting and trying to change the health status for some whanau, because the reality is there are still inequality gaps."
Bill Stirling QSM, the first chairman of TTH who recently passed away, was fondly remembered in both opening and closing comments by Ngati Kahungunu Iwi chairman and DHB deputy chairman Ngahiwi Tomoana.
