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This paper will argue that the Treaty of Waitangi, signed on 6 February 1840 by Māori and the Crown, has a made significant contribution to informing and advancing Māori health practices in Aotearoa New Zealand. A key focus of this paper relates to (re)validating the Treaty to improve Māori health outcomes and providing a strategy for evaluating the current health status of Māori. There is a growing concern among Māori that the health sector continues to perpetuate notions of ?treating? Māori health more so than empowering M?ori to control their own processes for being healthy. Moreover, a major shift constitutionally (that is, self-determining the right to be healthy) as well as institutionally (that is, developing approaches to greater access to health provision) is required to enable Māori to achieve better health outcomes moving forward. Finally, a number of important culturally innovative, responsive and inclusive perspectives are shared to enhance our engagement with the Treaty and Māori health from a socio-cultural perspective.
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Māori and Pasifika populations in New Zealand experience poorer health outcomes than other New Zealanders. These inequalities are a deeply entrenched injustice. This qualitative study explores the experiences of six Māori and Pasifika leaders on health policy-making advisory committees. All had extensive experience in the health system. They were recruited, provided semi-structured interviews, the data coded, and a thematic analysis undertaken. Our findings show that inequalities in the health system are reproduced in advisory committees. Participants noted their knowledge and interests were devalued and they experienced racism and tokenistic engagement. Some indicated it took considerable effort to establish credibility, be heard, have impact, and navigate advisory meetings, but even then their inputs were marginalised. Health policy advisory committees need deeper engagement and more genuine recognition of Māori and Pasifika knowledge. Māori and Pasifika leaders have constructive solutions for eliminating health inequities that could benefit all New Zealanders.
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Obesity among Māori is of growing concern in New Zealand with rates for Māori being one-and-a-half times that of the total population. The New Zealand government's Healthy Eating Healthy Action: Oranga Kai Oranga Pumau (HEHA) Strategy has, in the past seven years, been a significant policy mechanism through which the health sector has been able to address the increasing prevalence of obesity and associated chronic diseases.
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In Canada and New Zealand, policies support Indigenous participation in the planning and delivery of community-based primary health services. However, these services represent only a fraction of the health services accessed by Indigenous peoples. In New Zealand, legislation enacted in 2000 introduced mechanisms to ensure that Māori have a voice in the decisions made by health boards. In Canada, neither policies nor legislation currently ensure that Aboriginal communities are represented in provincial health systems or regional health boards. The New Zealand experience shows that adding mechanisms of participation to legislation and policies creates opportunities for Māori and health boards to engage in discussions about how to best allocate resources to reduce disparities between Māori and non-Māori health outcomes. In Canada, this dialogue may not occur. Requiring that such mechanisms be created in all Canadian jurisdictions would establish meeting places for dialogue, and assist in closing policy and access gaps that remain.
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This article explores the tensions one research team has faced in securing appropriate governance or stewardship (which we refer to as kaitiakitanga) of research data. Whilst ethical and regulatory frameworks exist which provide a minimum standard for researchers to meet when working with Maori, what our experience has highlighted is there is currently a “governance” gap in terms of who should hold stewardship of research data collected from Maori individuals or collectives. In the case of a project undertaken in the traditional healing space, the organisation best placed to fulfil this governance role receives no funding or support to take on such a responsibility; consequently by default, this role is being borne by the research team until such time as capacity can be built and adequate resourcing secured. In addition, we have realised that the tensions played out in this research project have implications for the broader issue of how we protect traditional knowledge in a modern intellectual property law context, and once again how we adequately support those, often community-based organisations, who work at the interface between Indigenous knowledge and the Western world.
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Colonization has resulted in Maori occupying a vulnerable position in New Zealand society. Comparatively poor health, along with complex social and economic problems, is a reflection of this fundamental insecurity. This article aims to put forward a historical and developmental perspective for understanding some of the current health disparities experienced by Maori, by exploring the concepts of historical trauma, loss of land, and alternative theories of development from post-development theory.