Tihei Mauri Ora: A Māori response to health disparities

Abstract

Māori bear a disproportionate burden of health problems which, in concert with other factors (e.g. poor housing, low socio-economic status and low education attainment), contribute to and maintain low health status. It is noted that there have been multiple attempts to reduce health inequities – however, such attempts have been largely unsuccessful. Barriers to success include government reticence, restrictions on Māori participation in determining health directions/solutions, current contract paradigms and a reluctance to engage in meaningful partnerships with Māori. Those barriers occur within a cultural framework which defines (and therefore prioritises) the health of an individual over the needs of the collective.

The hypothesis of this research is that Māori health disparities are best addressed via the development and delivery of Māori health models by services which are oriented to kaupapa Māori principles. Utilising a case study approach, this thesis looks at the outcomes generated when a kaupapa Māori service applies key Māori principles to health service delivery. The case study, in tandem with focus group interviews identifies the key elements necessary to developing services which are responsive to the needs of Māori.

This study identified the importance of promoting change (and ultimately improve Māori health status) that encompasses the formation of a framework which considers collective benefit over individualism, encompasses Māori values, acknowledges and accepts Māoricentric clinical interventions. In addition, the thesis asserts that Māori health status will improve once Māori are active participants rather than recipients of health services.