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This month’s edition of Healthcare Review – OnlineTM considers Maori health services in New Zealand.
This edition on Maori health services supplements the December 1997 edition of Healthcare Review – Online (Maori Health. Healthcare Review – OnlineTM. 2(4); December 1997) that brought together the opinions of a number of figures in Maori health in New Zealand. Together these contributions helped to identify the issues at that time in providing best care for Maori, to define health priorities for Maori, and to outline the positive and negative impact for Maori health of the Coalition Health Agreement and the shift to centralised purchasing.
The current edition focusses on the role of strategic planning in health services for Maori and approaches to operationalising these plans.
Te Aniwa Tohovaka, General Manager, Maori Health, Te Kaiarahi o Hauora Waitemata (Waitemata Health) considers the approach to date in establishing health services for Maori in Waitemata Health. She reviews the management process through which Waitemata Health has worked to determine the most effective method for the organisation to improve its response and service delivery to Maori.
Key to the approach has been the appointment of a manager to provide leadership and strategic direction in Maori health services development and to build strong relationships with key stakeholders.
Materoa Mar, Kaiwhakahaere/Associate Clinical Leader, Te Whare Marie, Porirua, Capital Coast Health Ltd, focusses on establishment and sustainable development of Maori mental health services. Mar’s experience of assisting with establishing specific kaupapa Maori mental health services has been within the Health and Hospitals Services.
Mar considers examples of effective mechanisms for providing specialist kaupapa Maori services, including the development of identity for staff and clients encompassing te reo (the [Maori] language), tikanga (values and beliefs) and Maori models of practice, and the need for staff, clients and whanau to participate at all levels of mental health service and Maori mental health service development.
She emphasises the crucial influence and direction of kaumatua (elders) and the need to protect their role within Western processes. The korowai (cloak of protection) that the kaumatua provide to each interaction that takes place at all levels of service provision and development is pivotal.
Thomas Maniopoto, Regional Manager of Raukura Hauora O Tainui Ki Tamaki, reviews the approach to provision of health service for Maori taken by this non-profit, indigenous Maori health organisation.
Ownership of health services is seen as an important part of the service delivery process at Raukura Hauora O Tainui Ki Tamaki. By establishing its own health service organisation, Raukura Hauora O Tainui Ki Tamaki believes it can become directly involved in the delivery, management and control of health services. Maniopoto emphasises that this approach is one that many First Nations people have used.
Maniopoto describes the primary care and specialist services provided by Raukura Hauora O Tainui Ki Tamaki. Mental health services provided by Te Rangihaeata, a sub-service of Raukura Hauora O Tainui Ki Tamaki, are seen as distinctive from other community mental health services because they are based on Maori working for Maori, incorporating kaupapa and tikanga Maori standards, protocols and practices in all aspects of service provision. Support services offered by Te Rangihaeata include whanau (family) support, cultural counselling and education in mental health, tikanga (protocols of compliance), rongoa Maori (traditional medicines and practices), access to tohunga (traditional healers), and whakawhanaungatanga (re-unification and consolidation of family and genealogical links).
