Realising the rhetoric: refreshing public health providers’ efforts to honour Te Tiriti o Waitangi in New Zealand

Came, Heather; McCreanor, Tim; Doole, Claire; Simpson, Thomas

doi:10.1080/13557858.2016.1196651

Cited by 22 publications

(34 citation statements)

References 20 publications

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“…However, as a result of Māori sovereignty movements that have focused on Treaty rights, there has been some national responsibility at least since the mid-1970s to honor Māori protections in the Treaty. 26 From American historical and ethical perspectives regarding racial and ethnic minority populations, the Aotearoa/NZ experience resonates in different ways from broken U.S. governmental treaties with American Indians and the emphasis on individual rights in the American Civil Rights Act of 1964. 46,72 For example, in his 1963 speech “Report to the American People on Civil Rights,” rather than stressing legal obligations, President John F. Kennedy stated: “We are confronted primarily with a moral issue.…”

Section: Resultsmentioning

confidence: 99%

“…While multiple ethnic groups in Aotearoa/NZ suffer from important health inequities (Pacific peoples and Asians, among others), we will focus on pervasive Māori:non-Māori inequities because te Tiriti o Waitangi (the Māori version of the Treaty of Waitangi) between Māori and the British Crown in 1840 is the contractual relationship on which Aotearoa/NZ is founded. 26 Thus, indigenous rights conferred by the Treaty to monitor government action and inaction around inequities are fundamental to the legal and moral existence and operation of Aotearoa/NZ. We analyze the Aotearoa/NZ system in more detail than the U.S. system because a more extensive literature exists about the latter.…”

Section: Introductionmentioning

confidence: 99%

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Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States

et al. 2018

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Aotearoa/New Zealand (Aotearoa/NZ) and the United States (U.S.) suffer inequities in health outcomes by race/ethnicity and socioeconomic status. This paper compares both countries' approaches to health equity to inform policy efforts. We developed a conceptual model that highlights how government and private policies influence health equity by impacting the healthcare system (access to care, structure and quality of care, payment of care), and integration of healthcare system with social services. These policies are shaped by each country's culture, history, and values. Aotearoa/NZ and U.S. share strong aspirational goals for health equity in their national health strategy documents. Unfortunately, implemented policies are frequently not explicit in how they address health inequities, and often do not align with evidence-based approaches known to improve equity. To authentically commit to achieving health equity, nations should: 1) Explicitly design quality of care and payment policies to achieve equity, holding the healthcare system accountable through public monitoring and evaluation, and supporting with adequate resources; 2) Address all determinants of health for individuals and communities with coordinated approaches, integrated funding streams, and shared accountability metrics across health and social sectors; 3) Share power authentically with racial/ethnic minorities and promote indigenous peoples' self-determination; 4) Have free, frank, and fearless discussions about impacts of structural racism, colonialism, and white privilege, ensuring that policies and programs explicitly address root causes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States

et al. 2018

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“…The ethical decisions made by nurses should ‘reflect the lived reality and experiences of the individuals, whānau, hapū, iwi and communities that make up our society’ (p. 8). 6 The social ethics has three key attributes depicted in the middle circle. The ethical element of promoting social justice and empowerment acknowledges that predominant healthcare contexts are often incongruent with the cultural needs and values of minority groups.…”

Section: Socioethical Model Of Culturally Safe Practicementioning

confidence: 99%

“…12 Abundant evidence demonstrates that indigenous people typically experience alienation and further disenfranchisement when they attempt to use health services. 2,6,13…”

Section: Introductionmentioning

confidence: 99%

Indigenous nurses’ practice realities of cultural safety and socioethical nursing

Hunter

Cook

2020

Nurs Ethics

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Background: Persistent healthcare emphasis on universal moral philosophy has not advantaged indigenous and marginalised groups. Centralising cultural components of care is vital to provide ethical healthcare services to indigenous people and cultural minorities internationally. Woods’ theoretical explication of how nurses can integrate cultural safety into a socioethical approach signposts ethical practice that reflects culturally congruent relational care and systemic critique. Aim: To demonstrate the empirical utility of Woods’ ethical elements of cultural safety within a socioethical model, through analysis of indigenous nurses’ practice realities in Aotearoa New Zealand. Research design: The study used a qualitative indigenous narrative inquiry. Participants and research context: Participants were recruited nationally. Twelve Māori registered nurses and nurse practitioners were interviewed. All participants provided direct care in either primary or secondary health services. Ethical considerations: Research approval was gained from the Human Ethics Committee of the lead author’s tertiary institution. Participation was voluntary, and written informed consent was obtained. Findings: Analysis highlighted the following: (1) cultural needs, which for Māori were integral to care, were easily subsumed by clinical care being prioritised; (2) ethical care by non-indigenous nurses requires critical reflection about broader equity issues that impact Māori disengagement from healthcare; (3) retention of indigenous nurses was seen as essential because their advocacy and the cultural ‘fit’ for Māori contributed to positive healthcare outcomes; and (4) committed leadership ensured culturally safe care was not eroded through workplace efficiencies. Discussion: The data provide rich representation of Woods’ model. The data indicate that nurses must engage reflexively with a relational ethic of care and social justice dimensions in order to deliver culturally safe care. Conclusion: Woods’ model provides a critical lens for nurses to examine their relational practice and systemic factors that enhance or detract from culturally safe care when caring for members of any indigenous group.

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“…The convergence of the Māori version of the Treaty, and in particular, each Article(s) require an ‘active’, and not ‘passive’ level of engagement, for example: Kāwanatanga (Article 1) seeks to protect the rights of Māori to govern over their own health and wellbeing through the adequate provision of resources, funding and services. Tino Rangatiratanga (Article 2) confers and affirms to Māori absolute sovereignty over their taonga (i.e., treasures or what is deemed previous) – including their health, wellbeing, language, education, fora, flora, forests, rivers, streams, mountains, etc. Oritetan ga (Article 3) refers to equal citizenship and in particular, affirms one's human right to education. Indeed, education – is everyone's right, and an important step in moving Aotearoa New Zealand towards a fair and just society (Came, McCreanor, Doole, & Simpson, 2017). …”

Section: Methodsmentioning

confidence: 99%

Te Whakahōnere ngā Wawata o te Whānau: Honouring the Educational Aspirations of Whānau Māori in two English-Medium Primary Schools in the Otago-Southland regions in Aotearoa New Zealand

Whitinui

2019

AJIE

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This paper reports on the preliminary findings of a study carried out in two English-medium primary (elementary) schools (years 1–6) located in the Otago-Southland regions between 2014 and 2015. The purpose of the study aimed to explore the educational aspirations whānau Māori (i.e., Māori family) want for their children, and to build better relationships for teaching and learning in these two schools. The opportunity to bring whānau Māori together using a school hui (i.e., formal school meeting) process, not only created a culturally safe space for whānau Māori to share their thoughts, ideas and concerns about their children's education, but it also provided an opportunity for constructive feedback, and a greater awareness of the success enablers for whānau Māori and their children. A key finding to emerge, is that, whānau Māori not only see the provision of schooling and education for their children as an extension of who they are as culturally connected learners, but also as a medium for learning more about their own cultural norms, values, beliefs, strengths and attributes.

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Realising the rhetoric: refreshing public health providers’ efforts to honour Te Tiriti o Waitangi in New Zealand

Abstract: Public health has an ethical commitment to reduce health disparities. Advancing Te Tiriti obligations in everyday practice has the potential to address inequalities.

Cited by 22 publications

References 20 publications

Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States

Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States

Indigenous nurses’ practice realities of cultural safety and socioethical nursing

Te Whakahōnere ngā Wawata o te Whānau: Honouring the Educational Aspirations of Whānau Māori in two English-Medium Primary Schools in the Otago-Southland regions in Aotearoa New Zealand

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