Waitangi Treaty
The Treaty of Waitangi, specifically the principle of participation, is foundational to addressing healthcare inequities between Māori and non-Māori in New Zealand. It emphasizes the need for Māori involvement at all levels of healthcare decision-making, planning, development, and service delivery. This means ensuring Māori have a meaningful voice and are actively engaged in shaping their own health and well-being.
Elaboration:
The Treaty of Waitangi, signed in 1840, established a framework for the relationship between the British Crown and Māori. It's not just a historical document, but a living framework that continues to shape New Zealand society, including the healthcare system. The Waitangi Tribunal, established to investigate Treaty claims, has highlighted the ongoing impact of colonization on Māori health and the need for redress.
Key aspects of participation in healthcare:
Active Involvement:
Māori should not just be consulted, but actively participate in the design, delivery, and evaluation of healthcare services.
Co-design:
Māori should be co-designers with the Crown in the development of healthcare systems, particularly those focused on Māori.
Cultural Responsiveness:
Services need to be culturally appropriate and responsive to Māori needs, values, and aspirations, reflecting the principles of hauora Māori (Māori models of health).
Hauora Māori
Hauora Māori refers to the Māori philosophy and models of health, emphasizing a holistic view that encompasses physical, mental, social, and spiritual well-being. These models highlight the interconnectedness of these aspects and their influence on individual and collective well-being. Key models include Te Whare Tapa Whā, Te Wheke, and Te Pae Mahutonga.
Key Concepts and Models:
Holistic View:
Hauora Māori emphasizes that health is not just the absence of illness but a state of overall well-being, encompassing all aspects of a person's life.
Interconnectedness:
The different dimensions of health are seen as interconnected and interdependent. For example, strong family relationships (whānau) can positively impact mental and spiritual health.
Te Whare Tapa Whā:
This model, developed by Sir Mason Durie, likens health to a meeting house with four walls:
Taha tinana (physical health): Capacity for physical growth and development.
Taha hinengaro (mental and emotional health): Capacity for communication, thought, and emotional well-being.
Taha whānau (family health): Capacity to belong, care, and share within the family.
Taha wairua (spiritual health): Capacity for faith, connection to ancestors, and a sense of purpose.
Te Wheke:
This model uses the octopus as a metaphor, with the head representing family (whānau), the eyes representing overall well-being (waiora), and the tentacles representing different dimensions of health, according to health promotions forum.
Te Pae Mahutonga:
This framework outlines key elements of Māori health promotion, including te oranga (physical health), nga manukura (leadership), te hauora (mental and spiritual wellbeing), and nga whanau (family).
Importance:
Cultural Relevance:
Hauora Māori models are culturally relevant and specific to the Māori world view, promoting culturally safe and effective healthcare practices.
Improved Health Outcomes:
By understanding and incorporating these models, healthcare providers can better address the holistic needs of Māori patients and work towards improved health outcomes.
Equity in Health:
Hauora Māori is crucial for addressing health inequities and promoting equitable health outcomes for Māori.
Empowerment:
Participation aims to empower Māori to take control of their health and well-being, fostering self-determination and tino rangatiratanga (Māori authority over their own affairs).
Equitable Outcomes:
The ultimate goal is to achieve equitable health outcomes for Māori, ensuring they have at least the same level of health as non-Māori.
Examples of Participation in Practice:
Māori health providers:
Many Māori-led health providers play a crucial role in delivering culturally appropriate care and advocating for Māori health needs.
Māori representation on boards and committees:
Ensuring Māori representation on health boards and committees ensures that Māori voices are heard at all levels of decision-making.
Community engagement:
Actively engaging with Māori communities to understand their health needs and preferences is vital for effective service delivery.
The principle of participation is intertwined with the other Treaty principles:
Partnership: Requires collaboration and working together between the Crown and Māori.
Protection: Requires the Crown to protect Māori health and well-being and safeguard Māori cultural values and practices.
By upholding the principle of participation, New Zealand can work towards a more equitable and culturally responsive healthcare system for all.