Hauora Māori Guide
Te Whatu Ora Counties Manukau Library resources
Māori Health Clearinghouse: Research, Information and Resources
Selected texts from the Library collection
Hauora Māori (Māori Health)
Te Tiriti o Waitangi
Te Rongoa Māori
Ministry of Health
Māori health models
Whakamaua: Māori Health Action Plan 2020-2025
He Korowai Oranga: New Zealand’s Māori Health Strategy
Wai 2575 Health Services and Outcomes Kaupapa Inquiry
Wai 2575 Māori Health Trends Report data and resources
DHB Māori health profiles and profile summaries
Tatau Kahukura: Māori health statistics
Māori health publications
Te Whatu Ora / Te Aka Whai Ora
Te Pae Tata Interim New Zealand Health Plan
Te Pae Tata outlines the first steps to becoming a health service delivery system that better serves our people and communities. This plan covers a period of reset while the foundations of our health system change. As an initial plan, it outlines what we will do differently to establish the basis of a unified, affordable and sustainable health system. Te Pae Tata replaces 20 different district annual plans. This interim plan is designed to begin transformation while a full-scale New Zealand Health Plan is being worked on.
As part of the health system transformation a range of strategies have been developed to help guide our health system to achieve pae ora, healthy futures. One of those is Pae Tū: Hauora Māori Strategy. It has been produced by Manatū Hauora and Te Aka Whai Ora.
Māori Health Priorities Report
This Māori Health Priorities report draws focus to the biggest contributors to health loss and health inequity for Māori, and also represent the greatest potential for intervention. This report was commissioned by Te Aka Whai Ora to inform our positioning on the priorities for the interim New Zealand Health Plan (iNZHP) for Māori.
Health Quality and Safety Commission
Te ao Māori framework
The aim of the framework is to improve the quality of care afforded to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all.
Māori health models– a selective reading list
One model for understanding Māori health is the concept of ‘te whare tapa whā’ – the four cornerstones (or sides) of Māori health.
Traditional Māori health acknowledges the link between the mind, the spirit, the human connection with whānau, and the physical world in a way that is seamless and uncontrived. Until the introduction of Western medicine there was no division between them.
Te Pae Mahutonga (Southern Cross Star Constellation) brings together elements of modern health promotion.
see also Durie, Mason. "Te Pae Māhutonga: A model for Māori health promotion." Health Promotion Forum of New Zealand Newsletter. Vol. 49. No. 2. 1999.
The Meihana Model: a clinical assessment tool for engaging with Māori.
The Meihana Model has centered whānau at the heart of the assessment and intervention processes. That is an act that is fundamentally Māori; the patient is not an individual but a part of a collective, whether that be whānau, hapū, or iwi and the model challenges GPs to engage with, and use, the wider family or community members as crucial parts of the diagnostic and prescription process.
The Model uses the five cross bars of the waka haurua to create a connection between ‘patient’ and ‘whānau’ (a patient’s support networks). These are:
- Tinana: physical wellbeing
- Hinengaro: consciousness and awareness
- Iwi Katoa: wider support
- Wairua: spiritual wellbeing
- Taiao: environmental wellbeing
see SP, When I. "Meihana model: A clinical assessment framework." New Zealand Journal of Psychology 36.3 (2007): 118.
Kaupapa Māori models of practice
Three models of practice were described by Te Rau Matatini in Indigenous Insight, Inspiring Innovation - Kaupapa Māori Models of Practice Series 1. The aim was to enhance knowledge of Māori models of practice and demonstrate the strengths of Māori in Aotearoa.
The Whānau Rangatiratanga Frameworks: Approaching whānau wellbeing from within Te Ao Māori
The Whānau Rangatiratanga Frameworks provide a platform and a guide – from within a Māori world view – for collecting, analysing and using data about whānau wellbeing. A key aim in developing a framework was to enable us to identify measures of whānau wellbeing for the Families and Whānau Status Reports. We developed this conceptual framework to:
• illustrate that whānau aspirations for wellbeing and empowerment, and whānau definitions of those concepts, are central to our work programme around whānau wellbeing
• show that analysis of data on whānau wellbeing needs to be framed from within Te Ao Māori
• reinforce the view that the Whānau Rangatiratanga Frameworks are a way to inform thinking about Māori wellbeing.
Māori Value reports.
Independent Māori Statutory Board
The reports make up a platform for the Board’s work to support Māori wellbeing outcomes, as set out in the Schedule of Issues of Significance and Māori Plan (2017).
The five value reports each represent a Māori value: Rangatiratanga, Manaakitanga, Kaitiakitanga, Whanaungatanga, Wairuatanga. They measure Māori wellbeing in line with Māori experience and from a strengths-based view.
Literature Review to Inform the Development of a Culturally Appropriate Assessment Model for Māori (2022)
Francis+ Health
The purpose of this literature review is to inform the development of a culturally appropriate assessment model that meets the need of Māori and whānau and will enable a holistic assessment of needs and inform the provision of care and support services. Capturing relevant findings from the literature will ensure that the processes undertaken to develop a culturally appropriate model are evidence based. The findings of the review are intended to assist the Francis Health project team and wider steering group in how best to approach this work. The wider project is underpinned by a kaupapa Māori approach, one framework being utilised is the Te Pā Harakeke Framework. This literature review as an input contributes to Te Puawai in the framework. Te Puawai references the flower head of the harakeke plant and refers to the processes used within each function to give effect to the strategy of the kaupapa. Largely, it seeks to inform ways to weave Kaupapa Māori approaches with interRAI assessment to enable positive outcomes for Māori. The literature review is one of many information streams that is feeding into the project.
The scope of the literature review includes:
− Approaches undertaken to make established assessment tools culturally appropriate
− Approaches undertaken to develop assessment tools that are compliant with Te Ao Māori
− How to implement relational Māori models of health within an assessment tool
Wilson, Denise, et al. "Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health." Journal of Clinical Nursing 30.23-24 (2021): 3539-3555.
This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).
He oranga mo Aotearoa: Māori wellbeing for all
Deloitte. 2018
We consider various Māori wellbeing frameworks and measurements, the barriers to Māori wellbeing and the drivers and changes that could improve it.
Pitama, S., Huria, T., & Lacey, C. (2014). Improving Māori health through clinical assessment: Waikare o te Waka o Meihana. New Zealand Medical Journal, 127(1393), 107-119.
Provides an overview of the Meihana model and its components. The Meihana model builds on the work of other Māori health models and is specifically designed to support health practitioners to gain a fuller understanding of the presenting complaint and the context of the patient and whānau.
Te Moemoea, Te Pou. "He rongoā kei te kōrero. Talking therapies for Māori. Wise practice guide for mental health and addiction services." (2010).
A guide for healthcare practitioners working with Māori. The introduction discusses Māori cultural worldviews and Māori models of health and practices including Te Whare Tapa Whā, Te Wheke and the Meihana model.
Māori health : structural inequity, racism and Te Titirit o Waitangi – a selective reading list
'HAUORA: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry'
Waitangi Tribunal. 2023
Our stage one report addresses claims concerning the way the primary health care system in New Zealand has been legislated, administered, funded, and monitored by the Crown since the passing of the New Zealand Public Health and Disability Act 2000 (‘the Act’) Statistics. In our report we explore whether the persistent inequitable health outcomes suffered by Māori are indicators of Treaty breach. In doing so, we ask whether a cause of the inequitable health statistics suffered by Māori is the legislative and policy framework of the primary health care system itself. In approaching our task, we identified four main thematic issues to focus on for this stage of the inquiry : the Treaty-compliance of the Act and framework ; funding arrangements for primary health care ; accountability arrangements for primary health care ; and the nature of Treaty partnership arrangements in the primary health care sector.
Selak, Vanessa, et al. "Acknowledging and acting on racism in the health sector in Aotearoa New Zealand." The New Zealand Medical Journal (Online) 133.1521 (2020): 7-13.
The purpose of our editorial is twofold. First we will highlight some of the false beliefs that persist, and contribute to, ongoing racism within the health sector in Aotearoa New Zealand. Such racism, albeit often unconscious, has been identifi ed in recent studies of New Zealand medical students. We will use examples of false beliefs we have encountered through the academic peer review process, as Māori (MH) and Pākehā (VS, RJ) researchers exploring and addressing differences in cardiovascular disease (CVD) risk factors and outcomes by ethnicity. This work builds on a paper by Reid, Robson and Jones, that explored and debunked common myths regarding disparities in health 20 years ago, and draws on the excellent articles high[1]lighting ethnic inequities in this issue of the NZMJ. Second we recommend some appropriate ways for the NZMJ and Pākehā health professionals/researchers to contribute to research and peer review that will support culturally safe research and equitable outcomes for Māori and other groups experiencing inequities.
Graham, Rebekah, and Bridgette Masters‐Awatere. "Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research." Australian and New Zealand Journal of Public Health 44.3 (2020): 193-200.
For many Māori, the existing public health system is experienced as hostile and alienating. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Public health providers must find ways to ensure that Māori consistently experience positive, high-quality healthcare interactions that support Māori ways of being.
Durie, M. (2003). Ngā kāhui pou: Launching Māori futures. Wellington, New Zealand: Huia Publishers.
Health chapters:
- Chapter 2: Maui Pomare: First Māori doctor
- Chapter 9: Te pae māhutonga: Mental health promotion for young Māori
- Chapter 10: Māori health: Key determinants for the next Twenty-five years
Durie, M. (2001). Mauri ora: The dynamics of Māori health. Auckland, New Zealand: Oxford University Press.
- Examines the relationship between culture, identity, and socioeconomic factors to Māori health outcomes.
Durie, M. (1998). Whaiora: Māori health development (2nd. ed.). Auckland, New Zealand: Oxford University Press.
- Provides an overview of Māori perspectives on health and Māori public health. The Treaty of Waitangi, Māori health inequalities and health priorities are discussed.
- Chapter 18: Indigeneity: Challenges for indigenous doctors
Research
Māori Health Research Review
This Review features key medical articles from global journals with commentary from Associate Professor Matire Harwood. The Review covers topics such as māori health policy, health inequalities, indigenous health outcomes, obesity, diabetes, immunisation, and smoking cessation.
Te Hiringa Hauora Research Framework ( e Hiringa Hauora. Health Promotions Agency)
The Te Hiringa Hauora Research Framework is designed to guide and enable shared understanding of what best practice health promotion research in Aotearoa New Zealand is and what it seeks to achieve. This Framework presents a way of working at the interface of mātauranga Māori and Western science, using both knowledge systems to generate new knowledge and evidence that contribute towards healthy and decolonising futures for Māori, Pacific peoples, and all New Zealanders.” Source: Te Hiringa Hauora
Health Research Council. 'Māori Health Advancement Guidelines' (2019)
Alignment with the Māori Health Advancement criterion as well as other assessment criteria will strengthen an application to the Health Research Council. Importantly, the new approach will give applicants clearer guidance and a framework in which they can contribute to improving Māori health, while enabling the HRC to clearly evaluate the degree to which its investment delivers on this objective. These guidelines support health researchers in describing how their proposed research fits within the criterion.
Te Ara Tika - Guidelines for Maaori Research Ethics
The evaluation hikoi: a Māori overview of programme evaluation ( Te Ropu Whariki, 2009)
This book aims to:
• Provide the reader with an overview of the issues surrounding public health programme evaluation by and for Māori
• Give examples of the range of approaches that might be useful
• Highlight areas that evaluators may need to consider. There are many different models and frameworks that can be used to guide indigenous researchers. Our approach has been to grapple with what it means, as Māori, to carry out formative, process and impact evaluation.
Creating a Māori Indigenous Model of Evaluation Founded on Māori Indigenous Values
PhD Thesis: Māori Indigenous Evaluation, 2023
Abstract
Values and evaluation inform and influence all aspects of our lives. However, what is evaluation, and how do evaluation methodologies influence outcomes? This research examines how evaluation systems express and reflect their designers' and developers' values, ideologies, social mores, and political worldviews. Māori values are known as ‘taonga’, cultural treasures that formed the basis of their evaluation approaches across all elements of societal life, including health, education, justice, and the economy. Over the last two hundred years, Māori evaluation systems have been denigrated and discredited through the process of colonisation. Eurocentric evaluation systems have been used as political tools to assess, measure, define, and control Māori and Indigenous communities worldwide. Regardless of such methods, Māori and Indigenous communities continue to bear the brunt of intergenerational trauma and suffer the burden of sociocultural, economic, and ecological inequities. We must then ask how Māori and Indigenous values and worldviews can improve evaluation.
Why are Māori Indigenous values-centred models of evaluation needed today? How can we gather and honour Mātauranga Māori to create a cohesive model of evaluation? Informed by Kaupapa Māori philosophies and praxis, this research spans the hinengaro/psyche, whānau/families, hapu/communities, iwi/nations, and Te Ao/global systems are integrated with the experiential knowledge of Māori and Indigenous evaluation specialists. The creation of Pou Kapua, the largest totem in Aotearoa, provided a unique Mātauranga Māori methodology to support the design of the Pou Mārama model of evaluation. Pou Mārama is a Māori values-centric approach that honours Te Tiriti o Waitangi and the kaingākau of Taha Wairua (spiritual and ethical harmony), Aroha (care and compassion), Mana (heartfelt commitment), Tiaki (protection and preservation), and Ora (intergenerational well-being). Through the Pou Mārama methodology, the principles of Whānaungatanga support respectful and collaborative relationships, and Manaakitanga encourages a complex adaptive systems approach. Kaitiakitanga translates interdisciplinary knowledge into creative and transformative solutions. Finally, Rangatiratanga focuses on demonstrating courageous leadership, supporting authentic measures of well-being, and achieving transformational outcomes - for our people and our planet.