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This paper synthesises critique from Māori patients with Bipolar Disorder (BD) and their whānau to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system. A qualitative Kaupapa Māori Research methodology was used. Twenty-four semi-structured interviews were completed with Māori patients with BD and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Three key themes identified the impact of structural features of the New Zealand mental health system on health equity for Māori with BD. Themes involved the accessibility, delivery and scope of the current health system, and described how structural features influenced the quality, utility and availability of BD services for Māori patients and whānau. Structural barriers in the existing design, and potential changes to improve the accessibility, delivery and scope of BD services for Māori, were proposed including a redesign of operational, environmental, staffing, and navigation points (information, transition, fatigue) to better meet the needs of Māori with BD. A commitment to equity when implementing structural change is needed, including ongoing evaluation and refinement. This paper provides specific recommendations that should be considered in health service redesign to ensure the New Zealand mental health system meets the needs of Māori patients with BD and their whānau. [ABSTRACT FROM AUTHOR]

The second wave feminist dream of smashing the patriarchy remains a task yet to be completed on a complex to do list. Women, particularly able-bodied cis-gendered white women however do enjoy the privilege of living longer than men. But our longer lives take place within patriarchal-capitalist systems where many women's social and cultural rights continue to be compromised. How do we ensure that all women can exercise our right to health and wellbeing? In this paper, the authors examine, critique, review and re-vision the dynamics of power and patriarchy over three distinct time periods – 1999, 2019 and 2039. We look to the past to track progress; we look to the present to see what we have achieved and look to the future for what might be. This conceptual paper is informed by the authors' expert knowledge, a review of the literature and the novel use of speculative ethnography. The authors conclude that patriarchy remains not only a negative determinant of women's health that needs to be smashed, but is also a threat to all people and to planetary health. [ABSTRACT FROM AUTHOR]

The cumulation of structural violence and wilful harm perpetuated by the state care system in Aotearoa has created a climate for change and calls for the establishment of a new system of care. Mokopuna Māori who have lived through the care system are being left out of this conversation. For transformational change to occur, there must be a focus on honouring these experiences and upholding mokopuna rights. This article presents Kaupapa Māori research undertaken by a mokopuna Māori with the lived experience of state care, alongside established Kaupapa Māori researchers. Literature containing the voices of care-experienced mokopuna Māori was reviewed to explore what conditions exist and are needed to uphold wellbeing. Mokopuna rights, stability, relationships and identity were determined to be important to wellbeing. A rights-based perspective makes it clear that the Crown must honour the rights and expertise of care-experienced mokopuna if new systems of care are to be successful. [ABSTRACT FROM AUTHOR]

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Moe Kura is a longitudinal study focused on the role of sleep in the health and well-being of mothers and children in Aotearoa New Zealand (NZ). The leadership, design and conduct of the study is informed by Kaupapa Māori research principles and is positioned within a broader rights-based approach to health, recognising that inequities in health must be identified and understood to improve the health of wāhine Māori and tamariki. In late pregnancy 418 Māori women and 768 non-Māori women were recruited and data collected at four waves (35–37 weeks gestation, 4–6 weeks postpartum, 11–13 weeks postpartum and when the Moe Kura child was 3–4 years of age) with linkage to birth records and national administrative datasets and associated qualitative research. Findings demonstrate substantial inequities in sleep health, infant and maternal health, and maternal employment between Māori and non-Māori, along with the important role of sleep in perinatal health and maternal mental health outcomes. The research philosophy that underpins the study, the primary focus on women, and the detailed measurement of sleep during the childbearing years has provided new and important findings that contribute to intervention development and health policy for women and children in NZ. [ABSTRACT FROM AUTHOR]