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Māori, the indigenous people of Aotearoa New Zealand, experience poorer health than non-Māori across a range of health measures. Interventions focused at an individual level have proved largely ineffective; 'bottom-up' approaches where communities determine their own priorities may be more sustainable than 'top-down' approaches where goals are determined by health authorities. The purpose of this paper is to illustrate an innovative health promotion programme aimed at improving Māori health and to discuss the importance of ownership and control of health initiatives by Māori. Evaluators conducted a comprehensive evaluation of a Healthy Eating Healthy Action programme in six small Māori health agencies, gathering information from programme managers and co-ordinators, participants and wider community members about what changes were occurring at individual, family and community levels. Effective interventions built on cultural values and practices and were delivered by Māori with close connections to the community. Changes in nutrition and physical activity made by participants also benefitted their wider families and community. The changes demonstrated subtle but important shifts in thinking about healthy eating and healthy activity that in the longer term could lead to more measurable change towards improved quality of life for people within communities.

Evidence from health surveys have identified that Māori, the indigenous people of Aotearoa New Zealand, experience a high incidence of obesity with physical and social implications. In 2000, the New Zealand Government introduced a strategy aimed, among other objectives, at improving nutrition, increasing physical activity and reducing obesity through a 'Healthy Eating Health Action' (HEHA) strategy. As part of the HEHA strategy, a Māori primary health organisation (PHO) in a regional centre of Aotearoa, New Zealand, developed a program aimed at improving the health of the local Māori communities. The program, called Project REPLACE, invited participants to gradually change their behaviour by replacing behaviours potentially detrimental to health with a healthier alternative. Between 2009 and 2010 a team of researchers evaluated the program, taking care to use Māori approaches when conducting the research. The findings from the evaluation were that each community was innovative in their approaches to implementing Project REPLACE, drawing on their culture to combine healthy eating with increased exercise activities as well as measurements of achievement. The relationship that each coordinator had with the community was pivotal to the success of the program. Project REPLACE highlighted the importance of Māori ownership and control of health initiatives.