What is the experience of whānau Māori caring for their pēpi in a neonatal setting?

Abstract

The motivator for this research are the inequities faced every day in neonatal units around Aotearoa New Zealand. Māori pēpi (babies) have the highest rates of preterm births and proportionally higher mortality rates. The whānau (families) and their extended whānau struggle with the western model that governs Aotearoa’s neonatal units. Our pēpi in Aotearoa sadly go on to be disproportionately represented experiencing poorer health outcomes than their non-Māori contemporaries. This research aimed to investigate the experiences of whānau Māori caring for their pēpi in Aotearoa’s neonatal units. A descriptive Māori-centered methodology was used to obtain Māori knowledge. Eight whānau Māori were interviewed kanohi ki te kanohi (face to face) either in person or by Zoom. The hui process used established whakawhanaungatanga (making connections) and was essential for the research to succeed. By using Braun et al., (2018) six-step reflexive thematic analysis, five superordinate themes were identified. Results showed that when healthcare practitioners took time to listen and connect respectfully, the whānau saw this as a positive experience. Conversely, without these actions, whānau felt loneliness and subsequently disengaged. Powerful stories were told by whānau highlighting a system which failed to provide culturally safe care. The symbiotic relationship between pēpi and whānau supports the need for culturally appropriate care systems. Within a westernised model of health care, the barriers created organisationally and by healthcare staff, perpetuate the cycle of inequity and poor health outcomes. This research shows the immense need for a paradigm shift from the neonatal unit floor through hospital leadership and management to government policy makers.