The Significance of Maori Health Providers to the New Zealand Primary Health System

Abstract

The purpose of this research was to examine the significance of Māori Health Providers, to the New Zealand Primary Health Services. The whakapapa of Health Provider development is germane to the exploratory nature of the research, spanning the decades from the late 1980’s, to 2021. Kaupapa Māori is the cloak under which this research has navigated the elements of Māori values, respectful always to negotiate the framework through the Waka (canoe), of Te Ao Maori, (Māori world view). A qualitative, interpretive research approach was undertaken to capture, and explore, five semi structured participant interviews with experienced Māori and Mainstream Health Leaders, from Te Tai Tokerau, (Northland), and Tāmaki Makaurau, (Auckland). Empirical data captured the resonance, perspectives, and perceptions from the experiences of each participant. The elements of Māuri ora, (Life principles), recognition of Te Taha Wairua, (Spirituality), and Te Taha Hinengaro, (Mind), was inherent to the korero (discussions), offered willingly by most participants, and provided glimpses of philosophical understanding, and political positioning. Braun & Clarke’s (2006), thematic steps provided the analytical framework to explore rich data. Thematic analysis was adopted to analyze the data collected, with conscious scrutiny of all aspect’s, intonations, words spoken, language (both Te Reo and English), meanings and associations, and keeping closely in mind, words of connectivity, to the Treaty of Waitangi obligations, the basis for Māori /mainstream, Health Provider relationships. The context of the insights, of data analysis and interpretation, provides saturation of analysis, to establish that all participants, agree to the problematic, unresolvable liability of the current District Health Boards (DHB) capability and capacity toward meeting the needs of its constituency population, of the unwell. The result of data analysis concerning Māori health status, strongly suggests that the DHB has serious limitations, in appropriate Māori health service provision. Māori Health Providers, are significantly identified, as providing competent, timely, and culturally appropriate, Kaupapa Māori Primary Health Services, both to Maori, and their communities. Participant discussions resonated their view that Māori Health Provider services provided the health response whānau felt comfortable to access. At the time of this research, the Government, Ministry of Health, is in the midst, of what they circulate as a radical, re-setting of the health systems, across the entirety of the health portfolio, primary, secondary, tertiary, and public health. There is a definitive expectation of radical change, blowing across the nation, and Te Tai Tokerau (Northland), is buzzing with intrigue and uncertainty, as the power brokers of health affluence, move into seats of negotiation with the crown emissaries, and I search for the whānau, in this space. Williams (1914), Ka mua, ka muri, (look backwards into the future), agrees that Kaumatua and Kuia have unceasingly, exhorted their people over the echelons of time. Such wisdom surely deserves prescience of consideration, as the waka of new health initiatives, crests the political wave of yet, another change in 2021. There appears to be strong intimation, that the hour of Tino Rangatiratanga, (the principle of self-determination), is to the forefront of Māori intention, concerning the health and wellbeing of the whānau. The waka of Kaupapa Māori suggests that the health environment should change, and it is, time for Māori to determine, and control their own culture, aspirations, and destiny. I conclude this dissertation, with a discussion of findings and themes, which advocates the significance of Māori Health Providers, to the New Zealand Primary Health Services. The themes identified, affirms the reality of racism, assimilation, and Māori and Gender Inequity. The implications of both findings and research limitations are explored, concluding with closing reflections.