A critical examination of the effectiveness of Te Tiriti o Waitangi and Treaty of Waitangi training programmes in health services

Abstract

The overall aim of this study was to critically examine the effectiveness of te Tiriti o Waitangi and Treaty of Waitangi based training in the publicly funded health system in Aotearoa as a tool for addressing health inequities, and to contribute to the broader Kaupapa of improving Māori health through systems that honour te Tiriti partnership. The research was conducted during a period of significant restructuring of the health system, a result of reforms that were framed as opportunities to strengthen Māori voices in health decision-making and to uphold te Tiriti o Waitangi obligations. However, the reforms and subsequent amendments have also been marked by contestation over the place of tino rangatiratanga and the privileging of Treaty principles over the text of te Tiriti. This study set out to examine the role of Tiriti o Waitangi training within the publicly funded health system, exploring how training currently, or could, more effectively respond to legislative change, address inequities, and position health professionals and organisations in relation to their Tiriti responsibilities. Three training programmes were examined; an online e-Learning module, a kanohi-ki-te-kanohi cultural awareness workshop that included Tiriti o Waitangi and Treaty of Waitangi learning, and a Critical Tiriti Analysis workshop delivered as part of a wider scaffolded training programme by a Public Health and Rautaki team at Te Whatu Ora, Waikato. A mixed-method approach was selected to capture learning across groups. The research framework for this study integrated Kaupapa Māori philosophy, te Tiriti o Waitangi and Critical Tiriti Analysis to guide the research. In Chapter 4, post training surveys of the e-Learning module were analysed covering two separate periods – between July 2021 and August 2023. This is followed by an analysis of post training surveys over four different periods between May 2021 to March 2023. Interviews were conducted with 15 participants made up of staff in training at Te Whatu Ora and training providers of the two kanohi-ki-te-kanohi programmes. The use of multiple data sources enabled methodological triangulation and strengthened the credibility of findings. The study makes a significant contribution to scholarship on Tiriti training, Kaupapa Māori research, and evaluation in public health. It demonstrates that while training is a necessary process in addressing inequities, it is insufficient for transformation to occur. Enduring progress toward health equity for Māori requires systems that honour te Tiriti, not only in learning spaces, but in governance, policy, and everyday institutional practice.