Search

Closed stranger adoption has not commonly been recognised as a tool of Indigenous oppression in Aotearoa New Zealand, yet it was a colonial practice that caused great harm to Māori. This article narrates some of the ways in which adoptees who identify as Māori demonstrate resilience and resistance to the pernicious effects of closed stranger adoption. Using a mana (strengths-based values) enhancing approach, meaning we champion respect and understanding, this research elucidates how Māori adoptees navigate complex social relationships in courageous and creative ways, including when seeking birth kinship, maintaining those relationships, and making broader efforts to (re)connect with things Māori. Māori adoptees want their experiences to be recognised by Māori and non-Māori alike, so that the ongoing harms of closed stranger adoption can be redressed, and the next generations do not continue to live the negative impacts.

No description supplied

In April 2019, educators from around Aotearoa (New Zealand) and Australia came together to share their experiences of teaching Indigenous public health. The inaugural International Indigenous Publi...

Community environmental management (CEM) involves the facilitation of community partnerships, local dialogue, consultation and participative decision-making. This is increasingly seen as a solution to some of the more complex environmental issues faced by regulatory authorities. Anecdotal evidence suggests that CEM programmes have much potential, but the evaluation of them is problematic, and there is a need for more robust evidence of their effectiveness. This paper reports on the development of a new CEM evaluation approach (inspired by soft systems methodology, developmental work research and systemic intervention), which was trialled with a New Zealand regional council. The approach shows promise in addressing common evaluation bottlenecks and helping stakeholders to develop causal narratives that more fully account for the complex relationship between community participation and environmental outcomes. However, while the local participants in the CEM initiative acted on the evaluation findings, they hoped that it would stimulate wider organisational change, and this did not happen. Project reflections, informed by institutional theory, reveal that the logics of ‘participation’ and ‘community’ implicit in the findings were appropriate for local participants, but non-participating regional council stakeholders read the findings with different logics, and therefore the evaluation failed to communicate the necessity for wider change. The reflections highlight a previously unrecognised evaluation bottleneck. While the CEM evaluation methodology has the potential to be adapted for other contexts, if wider organisational change is required, care must be taken to anticipate the different institutional logics of stakeholders who might be unfamiliar with, or even hostile to, CEM.

DNA profiling is just one of many tools available to police in a criminal investigation. However, unlike any other criminal investigative tool, DNA profiling has captured the public imagination. It...

Purposeto provide a bicultural perspective on the views of people who have completed cancer treatment and, of health providers.Design/methodology/approachQualitative study using semi-structured interviews with 29 individuals (people who had recently completed cancer treatment and health providers). General inductive analysis was undertaken with all interview data, and a Kaupapa Māori approach was employed with the data from Māori participants.FindingsThemes for Māori participants are as follows: (1) understanding health information is enhanced by connection and relationship; (2) the “professional” is personal and (3) enduring beyond cancer is “our” responsibility. Themes for non-Māori participants are as follows: (1) from survivorship to living with and beyond cancer; (2) from the hospital to primary care and (3) support for living with and beyond cancer.Practical implicationsPositive relationships, communication and self-determination are important for Māori making the transition from hospital to the community after cancer treatment. Well-coordinated processes and services are vital for supporting transitions from hospital to community for non-Māori living with and beyond cancer.Originality/valueThis research presents the diversity of Māori and non-Māori experiences of living with and beyond cancer, adding to the limited New Zealand literature regarding post-treatment supportive care. This paper is among the first to undertake separate interviews and thematic analyses of Māori and non-Māori experiences, and to report these separately. Determinants of positive survivorship experiences are identified, specifying a central and expanded role for cancer care services.

Increasingly recognized as an educational domain in its own right, Ma-ori health is a central focus of medical and health sciences curricula in Aotearoa/New Zealand. As part of the Bachelor of Health Sciences offered at the University of Canterbury, Ma-ori health content is taught in a compulsory introductory course “Ma-ori Health Issues & Opportunities” (HLTH 106), positioned at the interface of Ma-ori health and public health. The course follows a trajectory through Ma-ori history, the Treaty of Waitangi, colonization, and the emergence of inequities, ending with structural and Ma-ori-led approaches for redress. Much of the content challenges prevailing public discourses relating to Aotearoa/New Zealand’s settlement and status as an egalitarian society, the basis of many students’ preconceptions. A social determinants of health frame has supported the navigation of this “tricky” terrain, and the construction of evidence-based counternarratives. Iterative curriculum development demonstrated the value of taking account not only of learner needs but also the characteristics of public health that may hinder learning.

To test the feasibility of surveying bereaved next-of-kin in the South Island about their perceptions of end-of-life care for people over 18 years of age; to report results; and to identify issues for future research.The study used the VOICES (Views of Informal Carers Evaluation of Services) questionnaire from the UK, adapted for use in Aotearoa New Zealand. Identification of next-of-kin for all South Island deaths September-November 2017 was undertaken by a commercial firm specialising in such work. Addresses of next-of-kin were sought from the Electoral Roll, with 1,813 eligible people identified and 272 (15.0%) next-of-kin unable to be traced. Surveys were posted out once only, with options to complete by mail, online, by telephone or with a face-to-face interview.Of the 1,541 surveys distributed, 514 (33.4%) were completed. Results confirmed the suitability of the locally modified VOICES instrument and research process. The quality of care overall was rated most highly in hospice or own home, but only a minority were able to die in these settings. Nevertheless, relatives indicated that most people died 'in the best place'.The VOICES questionnaire is acceptable to respondents and there are viable methods for seeking a population sample. Aspects of the questionnaire require modification before wider use. The information obtained can help district health boards, hospices other healthcare providers, and consumers in planning for end-of-life care.

This city profile provides a transdisciplinary story of Ōtautahi Christchurch, Aotearoa New Zealand. We take a socio-cultural history approach to describe multiple disruptions that have led to the city's current urban form and community resilience, with a specific emphasis on the experiences of Māori since colonisation. Ōtautahi Christchurch is the ancestral home of Ngāi Tahu people who exercise mana whenua - Indigenous sovereignty with respect to land, derived from genealogy and occupation. The area was colonised in the early 1800s and the city's strong colonial English ties are still visible in the city's layout, public spaces, urban representations, and architecture. Te Waipounamu South Island lies in an active fault zone resulting in high seismic activity. The Canterbury Earthquake Sequence 2010-2012 had a significant impact on the health of local communities, infrastructure and economies across the region. Subsequent recovery and long-term regeneration strategies across the region have been developed and partly implemented to date. Citizens embrace collaborative temporary urban projects to bridge the gap between emergency response and urban recovery with a return of Māori influence post-quake. This type of place-making contributes to the re-establishment of a sense of place in Ōtautahi Christchurch and a continuous engagement focused in reconnecting the citizens with the city. With this city profile we contribute to the field of critical geographies by sharing the cultural lessons learnt on indigenous resilience to disasters recovery, which may be of relevance to other cities facing ecological and cultural disruptions.

Objective: To explore the patterns of living arrangements, ethnicity and loneliness amongst older adults (aged 65+ years) living at home. Methods: National interRAI-HC (International Residential Assessment Instrument-Home Care) assessments conducted between 1 September 2012 and 31 January 2016 were analysed. Analysis focused on the associations between loneliness and both ethnic groups and living arrangements. Results: There were 71 859 eligible participants, with average age 82.7 years, comprising Māori (5%), Pasifika (3%), Asian (2%) and European/Other (89%) ethnic identification. Most stated that they were not lonely (79%), but those living alone were more likely to be lonely (29%) than those living with others (14%) (P < 0.05). Amongst those living alone, significant differences in the likelihood of being lonely emerged between ethnic groups (P < 0.05). Conclusions: Ethnic identification and living arrangements were significantly associated with the likelihood of loneliness for those having an interRAI-HC assessment. Efforts to reduce the negative impacts of loneliness need a nuanced approach.

This chapter explores the contribution of rongoā Māori (traditional healing) to Māori wellbeing. Rongoā Māori is a holistic system of healing derived from Māori philosophy and customs. Despite attempts in the early twentieth century to suppress and prohibit rongoā Māori, these traditional healing practices and the underpinning knowledge have endured, albeit in a more limited form perhaps than in the past. Today, rongoā Māori is regarded as a taonga, a treasure, to be safeguarded and protected. However, to achieve this requires the concerted and collaborative efforts of both Māori and the Crown, as partners in the Treaty of Waitangi, the country’s founding document. Drawing on the findings of three studies (The future of Rongoā; Ngā Tohu o te Ora – Traditional Māori healing and wellness outcomes; and Supporting traditional Rongoā practice in contemporary healthcare settings), this chapter traverses the historical and contemporary positioning of rongoā Māori and in doing so, argues that in a contemporary setting there are distinct roles and responsibilities which government, the health sector and tribal authorities (iwi) must play in order to ensure the ongoing vibrancy of the sector. Key principles and actions for adoption by these respective entities are identified, in order that rongoā is sustained as a viable health practice into the future.

This paper claims that participatory approaches to water resource management in New Zealand are highly influenced by how institutional and community actors understand and practise democracy, including indigenous Māori rights under the Treaty of Waitangi. Drawing on case study analysis from a six-year research programme in which the aim was to evaluate existing and new methods for participatory decision-making, we highlight how different but co-existing democratic beliefs and practices, referred to as democratic logics can shape relationships between governance/decision-making bodies and affected communities. One particular case is examined in detail to illustrate how the various “logics” were strengthened, extended and challenged through participatory research methodologies. Our key message is that revealing and articulating existing democratic logics for participation can help promote and facilitate new participatory approaches, as well as increase robustness and community buy-in to local government decision-making.

Objective: Since 2012, all community care recipients in New Zealand have undergone a standardised needs assessment using the Home Care International Residential Assessment Instrument (interRAI‐HC). This study describes the national interRAI‐HC population, assesses its data quality and evaluates its ability to be matched. Methods: The interRAI‐HC instrument elicits information on 236 questions over 20 domains; conducted by 1,800+ trained health professionals. Assessments between 1 July 2012 and 30 June 2014 are reported here. Stratified by age, demographic characteristics were compared to 2013 Census estimates and selected health profiles described. Deterministic matching to the Ministry of Health's mortality database was undertaken. Results: Overall, 51,232 interRAI‐HC assessments were conducted, with 47,714 (93.1%) research consent from 47,236 unique individuals; including 2,675 Māori and 1,609 Pacific people. Apart from height and weight, data validity and reliability were high. A 99.8% match to mortality data was achieved. Conclusions: The interRAI‐HC research database is large and ethnically diverse, with high consent rates. Its generally good psychometric properties and ability to be matched enhances its research utility. Implications: This national database provides a remarkable opportunity for researchers to better understand older persons’ health and health care, so as to better sustain older people in their own homes.

As populations around the world age, the challenge of ensuring that transport systems can contribute to the wellbeing of older adults becomes more pertinent. Maintaining wellbeing is particularly challenging for older adults in car-dependent societies who have to stop driving at some point in life. It is widely suggested that automated transport will provide a technological solution to the challenges of reduced accessibility and mobility faced by older adults who can no longer drive. In this position paper, we explore the potential wellbeing implications for an ageing population of a transition to automated vehicles and consequent social and spatial shifts in the context of Aotearoa New Zealand, which is a highly car dependent nation. We discuss the processes through which different levels of automation, and different models of vehicle access, could result in different wellbeing outcomes through changes to travel behaviours and urban form. We conclude by discussing the implications of our findings for transport policy and managerial practice, both in Aotearoa New Zealand and cities globally. Ultimately, we argue that the efficacy of emerging transport technologies for ageing populations depends on the extent to which new technologies are accessible and affordable for older people and how far they can support development of denser, less car reliant urban environments. Achieving this is a challenge for transport management.

Operational researchers and social scientists often make significant claims for the value of systemic problem structuring and other participative methods. However, when they present evidence to support these claims, it is usually based on single case studies of intervention. There have been very few attempts at evaluating across methods and across interventions undertaken by different people. This is because, in any local intervention, contextual factors, the skills of the researcher and the purposes being pursued by stakeholders affect the perceived success or failure of a method. The use of standard criteria for comparing methods is therefore made problematic by the need to consider what is unique in each intervention. So, is it possible to develop a single evaluation approach that can support both locally meaningful evaluations and longer-term comparisons between methods? This paper outlines a methodological framework for the evaluation of systemic problem structuring methods that seeks to do just this.

The phrase ‘for M ā ori, by M ā ori, with M ā ori’, synonymous with Kaupapa M ā ori research, reflects the strong community participatory orientation and aims of this paradigm. Its use has evolved from glib reference and catchphrase, to a ‘checklist’/gauge of how well a research project has enacted community participatory principles, and to what extent M ā ori participation in the research process is meaningful and empowered. Description of research according to this ‘shorthand’ definition, however, can be misleading. This paper will discuss two models of collaborative scientific research, conducted at the Institute of Environmental Health and Research (ESR) in association with M ā ori communities, ‘for, by and with M ā ori’. However, Te Riu o Hokianga and the Rakaipaaka Health and Ancestry Study occupy opposite ends of the shared partnership – researcher-led spectrum, and differ quite significantly in their orientation, application of M ā ori research principles, and approach to achievement of their objectives. If the ‘for, by and with’ mantra does not in itself sufficiently guarantee alignment with Kaupapa M ā ori principles, what other mechanisms exist to ensure that this is so? Is articulating the degree of M ā ori responsiveness for funding and ethics proposals adequate? Where these judgements are largely subjective, who decides when a research project ‘measures up’: Kaupapa M ā ori researchers, participating M ā ori communities, funders, or perhaps ethics committees? The importance of M ā ori focused innovation, development and advancement in research has been indicated within Vote RS&T policy and incorporated into funding/investment opportunities within an existing framework that values research excellence and a track record. Ensuring that research excellence as defined and purchased translates into excellence in practice is one issue. A further and equally important issue is whether the measures and means of achieving excellence therein translate into excellence for research practice with M ā ori communities . In the context of conducting research with M ā ori within a Crown Research Institute, a third issue emerges: that of the alignment (or not) of science excellence indicators and outcomes with those of M ā ori research excellence. With reference to two examples of science research collaboration with M ā ori communities, these three key issues will be considered, with inference for M ā ori research excellence and future directions in collaborative scientific research.

In systemic intervention, boundary critique is important. This means explicitly exploring the inclusion, exclusion and marginalization of both people and issues. Most of the practitioner's attention in boundary critique is usually focused on relationships between stakeholders (i.e. the participants in the intervention and those who might be affected by it). A significant focus is also the remit of the intervention: those things that need to be directly addressed or bracketed out in order to make a difference that is meaningful to a broad range of stakeholders. What is often less visible during boundary critique is the personal and/or professional identity of the practitioner, and the impact this may have on both relationships with others and the construction of people's understanding of the issues they are grappling with. This paper reflects on a project promoting environmental health through Māori community development that reveals the importance of personal and professional identity to systemic intervention. It is argued that it is impossible for practitioners to set aside their identities and become ‘neutral’ modellers or process facilitators. When this appears to happen it is because the practitioner's identity has been (often invisibly) constructed to legitimate his or her activities, and these activities do not transgress the expectations of participants that flow from their understanding of the practitioner's identity and role. Nevertheless, even though practitioner identities inevitably impact on the trajectory of interventions, at least some of their implications can be explicitly acknowledged and managed as part of systemic intervention. Some examples of management strategies are provided. Copyright © 2007 John Wiley & Sons, Ltd.

Whakapapa is the foundation of traditional Māori social structure and it perpetuates a value base that locates people through their relationships to the physical and spiritual worlds. As part of a new envirogenomics research programme, researchers at the Institute of Environmental Science and Research (ESR) are developing a study with an iwi (tribe) to identify combinations of genetic and environmental factors that may contribute to current health status. A major objective of this study is to utilise whakapapa (genealogical information) to explore patterns of genetic variation unique to the iwi and to correlate these with potential disease or ill health. Genetic testing and screening raises numerous ethical issues, particularly when indigenous peoples are the subjects. This paper will outline ESR’s strategy for addressing indigenous concerns about genetic testing and how whakapapa forms an integral part of the envirogenomics research programme.

Rongoā Māori practitioners make a valuable contribution towards Māori health outcomes, albeit with limited resourcing or formal training. This paper reports on a survey of healers/healing practices-specifically healers' aspirations for professional development and training-and considers the implications for healing practice and future training undertakings.Healers in seven districts around the country were surveyed about rongoā practice and service delivery during 2013. Consenting healers completed surveys either in person, via phone, or returned them via post, according to their preference and convenience. Resulting data were analysed and reported according to frequency of responses.Thirty-eight healers/rongoā clinics completed the survey--a 79% response rate. Respondents were primarily Māori (88%), female (69%), aged 50 years or older (60%), and worked as volunteers. Informal training modes focused on te reo, mātauranga and tikanga were the most common means of skill/ knowledge acquisition, and preferred modes for further training.The survey highlights the pressing need for expansion of the rongoā Māori workforce and training/service funding, to sustain rongoā practice. The findings add to what little is known about the training pathways and aspirations of practising healers, identified targets of the Māori Health Workforce Development Plan 2006.

INTRODUCTION: The influence of indigeneity is widely recognised as a health determinant; however the impact of the utilisation of the indigenous language on health care has not been closely examined. AIM: To explore the Maori language (te reo) as a determinant of health from a Maori patient’s perspective. METHODS: Maori patients were recruited through Maori health networks and the snowballing technique. Thirty participants participated in one of three focus group interviews. A semi-structured interview explored the utilisation of health services, comfortability with service delivery and perceptions of general practice surgeries’ cultural competency. Thematic analysis was utilised to interpret the data. RESULTS: Te reo was recognised as an important cultural competency, noted by participants as contributing to the development of appropriate doctor–patient relationships and their feelings of being valued within a practice. Patient-led use of te reo was identified as most appropriate, an indicator of quality of care. DISCUSSION: The training of primary care staff in te reo should be encouraged. Developed as a competency, this will see primary care settings better able to respond to Maori patients and in turn support Maori health gains. KEYWORDS: Maori health; Maori language; family practice; quality health indicators