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5. Understanding contemporary Māori demographic fertility patterns and trends in Aotearoa New Zealand

Author

Kukutai, Tahu Hera, Simmonds, Naomi Beth, Jarallah, Yara, Rarere, Moana, Kukutai, Tahu Hera, Simmonds, Naomi Beth, Jarallah, Yara, and Rarere, Moana

Abstract

This thesis re-examines demographic studies of contemporary Māori fertility patterns and trends. Analysing fertility is a core undertaking in demography, and in studies that include Māori fertility, most have been undertaken by non-Māori demographers who instinctively draw on Western-based frameworks to analyse and interpret these trends. Consequently, Māori perspectives are virtually invisible. Incorporating Māori perspectives are needed because despite a convergence of fertility similar to Pākehā, important fertility patterns persist. Notably, Māori women bear their babies earlier and over a longer period. Fertility studies of other Indigenous peoples in settler-colonial states share striking similarities. While demographic and economic factors are important in fertility outcomes, this thesis primarily explores the potential influence of culture, which has received little attention. Hence, this doctoral study asks: To what extent does culture influence contemporary Māori fertility patterns? This thesis draws on Kaupapa Māori and Mana Wahine frameworks, along with the tools of demography, to deploy a mixed methods design of statistical techniques – using secondary data from the 2013 Aotearoa NZ Census and the 1995 New Zealand Women: Family, Employment, and Education Survey – and thematic analysis of interviews with nine Māori women. While acknowledging the limitations of the analyses, the empirical results suggest that ‘cultural identity’ is an important factor in Māori fertility, and that ‘whakapapa’ and ‘whānau’ are at the heart of fertility decisions. These findings broadly imply that taken-for-granted demographic theories and analytical practices need to incorporate Indigenous-centred frameworks and perspectives for a better understanding of Indigenous fertility and population change.

Published
2024

16. He aha te mea nui o te ao? He tāngata!† (What is the most important thing in the world? It is people!).

Author

Masters-Awatere, Bridgette, Rarere, Moana, Gilbert, Rewa, Manuel, Carey, and Scott, Nina

Subjects
*PREVENTION of chronic diseases, *TYPE 2 diabetes prevention, *HEALTH promotion, *INTEGRATED health care delivery, *INTERVIEWING, *MAORI (New Zealand people), *RESEARCH methodology, *PATIENT-professional relations, *MOTIVATION (Psychology), *PREDIABETIC state, *PRIMARY health care, *QUALITY assurance, *STATISTICAL sampling, *SELF-efficacy, *MEDICAL care of indigenous peoples, *JUDGMENT sampling, *HEALTH of indigenous peoples, *FAMILY relations, *PSYCHOSOCIAL factors, *SOCIAL support
Abstract

This paper highlights the importance of people as a central factor in improving health for Māori (Indigenous people of New Zealand). How whānau (family) relationships, connections, values and inspiration are integral to achieving Indigenous health goals is explained. Descriptions of how community researchers, healthcare staff, consumers and academics worked together to design interventions for two health services (in the Waikato and Bay of Plenty regions) is included. Through highlighting the experiences of health consumers, the potential for future interventions to reduce the advancement of pre-diabetes among whānau is described. Evidence from the study interviews reinforces the importance of whānau and whakapapa (heritage) as enabling factors for Indigenous people to improve health. Specifically, the positive effect of whānau enhancing activities that support peoples' aspirations of tino rangatiratanga (self-determination) in their lives when engaging with health care has been observed. This study highlights the many positives that have emerged, and offers an opportunity for taking primary health to the next level by placing whānau alongside Indigenous primary care providers at the centre of change strategies. [ABSTRACT FROM AUTHOR]

Published
2019
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17. Implementation framework for chronic disease intervention effectiveness in Māori and other indigenous communities

Author

Oetzel, John, Scott, Nina, Hudson, Maui, Masters-Awatere, Bridgette, Rarere, Moana, Foote, Jeff, Beaton, Angela, and Ehau, Terry

Subjects
Epidemiology not elsewhere classified, 3. Good health
Abstract

Background: About 40% of all health burden in New Zealand is due to cancer, cardiovascular disease, and type 2 diabetes/obesity. Outcomes for Māori (indigenous people) are significantly worse than non-Maori; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for interventions to prevent and treat chronic conditions for Māori and other indigenous communities.Theoretical framework: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation. All elements have conceptual fit with Kaupapa Māori aspirations (i.e., indigenous knowledge creation, theorizing, and methodology) and all have demonstrated evidence of positive implementation outcomes. Applying the framework: A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities in Australia, Canada, New Zealand, and the United States from a systematic review. Cross-tabulations demonstrated that culture-centeredness (p = .008) and community engagement (p = .009) explained differences in diabetes outcomes and community engagement (p = .098) explained difference in blood pressure outcomes. Implications and conclusions: The He Pikinga Waiora Implementation Framework appears to be well suited to advance implementation science for indigenous communities in general and Māori in particular. The framework has promise as a policy and planning tool to evaluate and design effective interventions for chronic disease prevention in indigenous communities.

18. Implementation framework for chronic disease intervention effectiveness in Māori and other indigenous communities

Author

Oetzel, John, Scott, Nina, Hudson, Maui, Masters-Awatere, Bridgette, Rarere, Moana, Foote, Jeff, Beaton, Angela, and Ehau, Terry

Subjects
Epidemiology not elsewhere classified, 3. Good health
Abstract

Background: About 40% of all health burden in New Zealand is due to cancer, cardiovascular disease, and type 2 diabetes/obesity. Outcomes for Māori (indigenous people) are significantly worse than non-Maori; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for interventions to prevent and treat chronic conditions for Māori and other indigenous communities.Theoretical framework: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation. All elements have conceptual fit with Kaupapa Māori aspirations (i.e., indigenous knowledge creation, theorizing, and methodology) and all have demonstrated evidence of positive implementation outcomes. Applying the framework: A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities in Australia, Canada, New Zealand, and the United States from a systematic review. Cross-tabulations demonstrated that culture-centeredness (p = .008) and community engagement (p = .009) explained differences in diabetes outcomes and community engagement (p = .098) explained difference in blood pressure outcomes. Implications and conclusions: The He Pikinga Waiora Implementation Framework appears to be well suited to advance implementation science for indigenous communities in general and Māori in particular. The framework has promise as a policy and planning tool to evaluate and design effective interventions for chronic disease prevention in indigenous communities.

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