Indigenous health

Building strength-based, community co-designed solutions to health inequities.

Our challenge

Beginning with pregnancy, the first years of life are critical to achieving excellent health outcomes for children and setting them on a successful path as adolescents and into adulthood.

Māori women experience higher rates of preterm delivery, stillbirth, and neonatal death than non-Māori women. Each year approximately 1,200 Māori babies arrive too early. Māori babies are more likely to be born preterm (8.1 percent, compared to an overall rate of 7.4 percent) and they are more likely to have a preterm death. When a preterm baby survives, they are more likely to experience illness or disease that may last a lifetime.

Our research

Whānau Manaaki is a Kaupapa Māori (by Māori, with Māori, for Māori) research programme that puts women and children at the centre. The programme’s goal is to improve maternity and child care for Māori communities, resulting in better whānau health and wellbeing.

Whānau Manaaki explores the health care delivery system and the structural determinants of health – including housing, racism, transport, income, and education – that impact the wellbeing of Māori women, babies, and whānau. Launched through a grant from the Health Research Council of New Zealand, Whānau Manaaki currently encompasses three research projects:

• He Korowai Manaaki: This community intervention integrates maternal and child clinical services into one care pathway, using a comprehensive wraparound approach to pregnancy. The project’s approach is based on the rationale that early, evidence-based care and more support from maternity through to childhood will lead to improved health and long-term wellbeing for wāhine (women) and tamariki (children), and potentially for their whole whānau.
• Tamariki Kokoti Tau – Tackling Preterm Quantitative Study: This quantitative statistical analysis project examines the rates of preterm babies and the clinical care pathway for babies born prematurely in New Zealand in order to determine how care and the health status of these babies can be improved.
• Tamariki Kokoti Tau – Tackling Preterm Qualitative Study: This Kaupapa Māori qualitative longitudinal study examines the experiences of whānau as they journey along the preterm care pathway until one year after the baby’s delivery. It examines the experiences, barriers, and facilitators faced by whānau, and will inform researchers of structural and clinical issues that can be addressed to reduce the burden of disability and the harm of preterm birth.

Our impact

The He Korowai Manaaki research partnership between Te Tātai Hauora o Hine—National Centre for Women’s Health Research Aotearoa and the Ngāti Pāhauwera Development Trust received the award for excellence in the use of knowledge to deliver innovative solutions in the Hawke's Bay Health Awards 2019.

Findings from Tamariki Kokoti Tau – Tackling Preterm Quantitative Study highlighted barriers and facilitators to health and wellbeing for whānau. These barriers included poor communication, issues in access to transport/accommodation, and isolation. Facilitators included trust in medical care, prompt/proactive support for whānau, and empathetic care. These results can inform service improvement to be more responsive to Māori whānau, ultimately improving long term whānau health and wellbeing.