Skip to main content

Responsiveness to Māori

 

Te Whāriki

In response to requests for resources, education materials and advice on education on breastfeeding for Māori, NZBA provides a kete of resources, Te Whāriki, to support health professionals, consumers and others.  Scroll down to find them at the end of this section.

Mauri ora ki a tatau katoa,

Te Rōpu Whakaruruhau, te rōpu Māori tohutohu i a NZBA mo ngā take Māori. I te wā tuatahi nei, i panuitia ana, ko ngā rauemi kua whakawātea mai ā “Te Whāriki”.

 
Ko te Whāriki, he wāhi tirohanga mātauranga Māori, mo te whānau, mo ngā kaimahi hauora, mo te kaupapa whangai ū.
 

Good health to us all, Te Rōpu Whakaruruhau, the Māori advisory group to NZBA wish to bring to the attention of whānau and the health sector "Te Whāriki" a Māori health education resource site supporting breastfeeding.
 

These resources are free to use.  Please provide any feedback, questions and ideas to Carmen Timu-Parata - carmen@nzba.co.nz or 027 773 2233.

Te Tiriti ō Waitangi

The Treaty of Waitangi/Te Tiriti ō Waitangi as the founding document of Aotearoa New Zealand expressed as a partnership between the indigenous Māori people of Aotearoa New Zealand and the Crown.  Māori entered into that agreement with the British to advance their aspirations, affirm their tino rangatiratanga/self-determination and ensure equity (Came and Tudor, 2016).

Article 2 relates to the protection of Māori tāonga/treasures - health is a treasure.

Article 3 outlines that Māori receive the same rights as English subjects - this means health status.

NZBA recognises its obligations with regard to the Treaty of Waitangi/Te Tiriti ō Waitangi and the principles of the Treaty are demonstrated by the way NZBA practises as an effective treaty partner by:

  • Partnership:  Identifying hapū/iwi breastfeeding aspirations and addressing inequities to further improve breastfeeding rates in Aotearoa New Zealand.
  • Participation:  Working alongside Māori with decision making, planning, development and implementation of the Baby Friendly Initiatives.
  • Protection:  Ensuring that Māori traditional breastfeeding practices are protected.

The revision of the Baby Friendly Aotearoa Programme to align the revised Ten Steps to Successful Breastfeeding (2018) has a strong focus on improving breastfeeding rates for Māori.  The audit process incorporates the NZBA's policy on Māori Responsiveness (March 2018).

Karakia

E ngā mana, e ngā reo, E ngā karangatanga maha tena koutou

Whakataka te hau ki te uru

Whakataka te hau ki te tonga

Kia makinakina ki uta

Kia mataratara ki tai

Kia hi ake aua te atakura

He tio he huka he hauhu

Tihei Mauriora

Te iwi e tau nei tenei ra

Tena koutou, tena koutou, tena koutou katoa

Timatanga/Introduction

An important focus for the health and disability sector is to address inequity in Māori health status.  Māori aspirations are to lead and fulfil their potential to participate in our society.  However, the root causes of health inequalities are yet to be fully recognised and rectified.  It is imperative that the health sector is challenged to address Māori health issues and that together we can all play an important role in influencing health policy and practice to better meet the needs of Māori.

NZBA is committed to meeting its responsibilities under the Treaty of Waitangi/Te Tiriti ō Waitangi, and its broader legal obligations in being more responsible and effective for Māori.

Te Whāriki

Indigenous Māori are entitled to enjoy the same health status as all other New Zealanders.  Despite this, the evidence increasingly shows that Māori are disproportionately over represented in low breastfeeding rates.  NZBA has a role within the health system to influence these outcomes and we are committed to our Māori health strategy.  It is within this context of the Māori concept of Whai Wahitanga we offer this Māori cultural education kit.

Its main goals are to:-

  • enhance the cultural competency of staff and associated health professionals to improve breastfeeding outcomes for whānau Māori.
  • increase maternity facility and community services responsiveness to the diverse needs of Māori women and their whānau.

Rāranga: weaving the Māori resource

We have used the metaphor of weaving/raranga to view the knowledge and resources from a Māori perspective.

The development of these resources can be likened to weaving a whāriki (a finely woven traditional mat).  The process of weaving is called rāranga.  Providing Māori resources refers to the weaving together of different strands of knowledge.

Rāranga was a symbol of wellbeing for whānau, hapū and iwi.  Te Ao Māori (the traditional society) was a woven culture.  Local hapū attached great importance to their "pa harakeke" (flax cultivations) for use in the family units.  This fundamental important resource enabled the provision of clothing, shelter and housing materials for successive generations.

According to the metaphor used in this resource, harakeke symbolises the various sources of information gathered.

Te Whāriki is the result of collaborative work undertaken by NZBA and Te Rōpu Whakaruruhau, the Māori advisory board.  The purpose of Te Whāriki is to gather a range of educational material to one point of access.  This includes links to powerpoints, research articles, reflective activity sheets and other Māori resources that can enhance your work.  

Puna Wai Ū

For facilities that complete their fourth Baby Friendly accreditaiton a special kohatu/Ōamaru stone carving is sourced from the Ūkaipo, the bosom of Papatūānuku, or the Earth Mother.   It is named Puna Wai ū and it represents whanau (mother and child).  The white colour Ōamaru of the stone correlates with the white creamy colour of breastmilk.  It demonstrates purity and the rich nutrients that make up the baby’s prime food. 

The two fern fronds entwine with each other. Baby is usually placed on mother’s chest close after birth/kiri ki te kiri, her baby is listening to her heart beat, searching, latching and suckling at the breast for the first feed. The baby has once again become “one” with the environment.

In the traditional Māori creation story Hine-ahu-one is the first woman and is the placenta of Papatuanuku/Mother Earth. She is seen as the sacred house of people and of ALL nations. 

Her silver hair is the pinnacle and represents the encyclopaedia of knowledge.  She provides shelter and she is an educator of ALL future generations. She is the fountain of life giving BREASTMILK Wai U. A nutritional spring source that will never run dry!

 Kia U, Kia Mau, Kia ita – Grasp onto all that is good!

Watch Carmen Timu-Parata and Henare Edwards explain the significance of the kohatu/Ōamaru stone carving.

Watch a video (English) | Watch a video (Te Reo)

Te Whāriki Resources

1.  Māori perspective on health; Māori models of health; Māori women and breastfeeding

 

2.  Breastfeeding: A Māori world view

Breastfeeding: A Māori world view worksheet

Breastfeeding: A Māori world view certificate

For a set of model answers please contact NZBA - info@nzba.co.nz

3.  Returning to our unsettled dust: Non Māori systems, policies and people impact on Māori health outcomes and how this affects breastfeeding

This video was presented at the BFHI training day by Kelly Dorgan

  • What are the three learnings that you can identify from viewing this presentation that you could use to improve Māori whānau experiences in your workplace
  • Ask a peer to give some feedback on your engagement with Māori women and their whānau
  • Identify and reflect on three aspects that can be improved in your approach to working with Māori

Returning to our unsettled dust Certificate

 

4.  Cultural Safety and the birth culture of Māori

Cultural safety and birth culture of Māori worksheet

Cultural safety and birth culture of Māori certificate

For a set of model answers please contact NZBA - info@nzba.co.nz

5.  Bicultural praxis: the relevance of Te Tiriti o Waitangi to health promotion internationally

  • Reflect on five barriers that would need to be overcome in your work area if you were to implement Māori responsiveness
  • Develop five strategies to overcome the barriers
  • Share your findings with a peer

 

6.  Communicating with Māori in a health setting (equates to 30 - 40 minutes education)

Communicating with Māori in a health setting worksheet

 

7. How can we make health more equitable? Kiri Rikihana, Health and Safety Commission

Kiri Rikihana talks about how collaboration is helping improve health equity in a new Ministry of Health video.

8. National SUDI Prevention Online Training

Seven training modules that take approximately 45-60 minutes to complete.  The training is free and covers:

  • An introduction to SUDI prevention 
  • Connecting and engagement with whānau 
  • Consistent health messaging
  • Accumulation of risk factors for SUDI

9. Implicit Bias Module Series, Kirwan Institute for the Study of Race and Ethnicity

The Kirwan Institute at The Ohio State University is committed to the creation of a just and inclusive society, where all people and communities have the opportunity to succeed. Their commitment to this mission is why they work so hard to understand and overcome barriers that prevent access to opportunity in our society, such as implicit bias and racial disparities in the education system.

This course will introduce you to insights about how our minds operate and help you understand the origins of implicit associations. You will also uncover some of your own biases and learn strategies for addressing them. Each module is divided into a short series of lessons, many taking less than 10 minutes to complete. That way, even if you’re pressed for time, you can complete the lessons and modules at your convenience.

10. He Kākano i Ruia Mai i Rangiātea: Māori Whānau Stories of Neonatal Intensive Care Units

This research focuses on the korero of whānau Māori and their experiences of hospital neonatal intensive units.

11. Briefing on: Waitangi Tribunal Health Kaupapa Report - WAI 2575 (stage one)

Initiated in November 2016, the Waitangi Tribunal Health Services and Outcomes Inquiry (Wai 2575) will hear all claims concerning grievances relating to health services and outcomes of national significance.  As of October 2018, there are 205 claims seeking to participate in the inquiry. The claims are historical and contemporary covering a range of issues relating to the health system, specific health services and outcomes, including health equity, primary care, disability services and Māori health providers.  This PowerPoint provides a summary of stage one, inquiring into aspects of primary care (with hearings from October to December 2018).

12. Goodfellow MedTalks: Health and wellbeing for Māori

Developing strong relationships with your patients and their families leads to greater accuracy in diagnosis, improved treatment plans and greater continuity of care.

This is particularly important when you are working with Māori patients and their wider whānau, where genuine relationships and connection to culture are vital to care outcomes. With Māori patients especially, the therapeutic relationship you develop with them needs to be built on trust and collaboration. Without a good foundation in these relationships, Māori patients are likely to feel alienated by the therapeutic process, making it even harder for them to engage with you.

This series of interviews was recorded in 2018 with Tāmati Kruger. Tāmati is a kaumātua, a respected elder, of Ngāi Tūhoe, and was the chief negotiator in Tūhoe’s settlement process with the Crown.  

Ko tēnei te mihi maioha ki a koe e Tāmati, i tōu ngākau marae, i āu korero mārama, i tāu tohatoha mātauranga.  He iti nā Tūhoe ka mārama te Pō.

13. Levels of Racism: A Theoretic Framework and a Gardener's Tale

The author presents a theoretic framework for understanding racism on 3 levels: institutionalized, personally mediated, and internalized. This framework is useful for raising new hypotheses about the basis of race-associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences. She then presents an allegory about a gardener with 2 flower boxes, rich and poor soil, and red and pink flowers. This allegory illustrates the relationship between the 3 levels of racism and may guide our thinking about how to intervene to mitigate the impacts of racism on health. It may also serve as a tool for starting a national conversation on racism. (Am J Public Health. 2000;90: 1212–1215)

14. Māori Responsiveness Reference List