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Academics Call for More Responsiveness to Māori Health Needs

A group of University of Auckland Māori health academics are calling for all health researchers in Aotearoa New Zealand to be accountable under the Treaty of Waitangi and be able to act and respond to Māori health needs.

They say this will help ensure Māori are not left behind in the health system, and will ensure current researchers and those still in training will be ‘future proofed’ to ensure responsiveness to Māori is achieved.

The academics, Associate Professor Papaarangi Reid, Dr Sarah-Jane Paine, Dr Elana Curtis, Dr Rhys Jones, Dr Anneka Anderson, Dr Esther Willing, and Dr Matire Harwood, have written Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research, as the Viewpoint in the latest issue of the New Zealand Medical Journal.

The academics are all part of Te Kupenga Hauora Māori, in the University’s Faculty of Medical and Health Sciences.

The paper outlines how, as recipients of government funding, researchers are increasingly required to demonstrate an understanding of their delegated responsibilities to undertake research that has the potential to address Māori health needs and priorities. These requirements form the basis of responsiveness to Māori in health research, and several research institutions have implemented systems to support their organisation’s approach to this endeavour.

“However, many health researchers have a narrow view of responsiveness to Māori and how it might be relevant to their work,” says lead author Papaarangi Reid.

The paper outlines an overview of existing frameworks that can be used to develop thinking and positioning in relation to the Treaty of Waitangi and responsiveness to Māori.

An equity-based approach encourages health researchers to consider responsiveness to Māori in relation to four main areas: relevance to Māori; protecting Māori as participants; promoting Māori voice; and managing contentious issues around human tissue.

“Responsiveness to Māori in research is not new, and many institutions have implemented systems to support their organisational approach,” says Dr Reid.

“Other systems promote health equity as a starting point for responsiveness to Māori as this focus requires researchers to consider Māori health priorities based on inequities, develop appropriate relationships with Māori and commit to undertaking research that mitigates rather than extends health inequities.”

In relevance to Māori, researchers need to establish whether the topic is important for Māori health and/or whether inequities exist. Opportunities to enhance relevance to Māori include: consultation with Māori, dissemination to a broader Māori audience, enabling relationships with Māori individuals and communities, Māori health research workforce development, including taking opportunities to contribute to Māori health research workforce development by actively recruiting Māori students, researchers and support staff, and taking into consideration the theoretical space of the research.

In the second area, protecting Māori as participants, health researchers should familiarise themselves with the concepts of Māori ethnicity, ancestry or descent and consider the relative strengths and limitations of each variable in relation to their particular research question.

Thirdly, in promoting Māori voice, the Treaty guarantees that the Crown will act in such a way that Māori will not be disadvantaged, and if disadvantage is demonstrated, the Crown will take measures to correct the imbalance. The Māori population is 16 percent of the total New Zealand population, and few researchers think about the impact of a numerically minority voice on policy and programmes generated from research, especially the impact on further inequity and marginalisation. A random population sample will often contain fewer than 16 percent Māori, so the dominant ‘voice’ generated largely tells the ‘story’ of non-Māori: their strengths, risks, needs and preferred ways of being. The Māori ‘story’ could be very different. Researchers should be aware of this in the construction of their research. Promoting Māori voice is relevant to both qualitative and quantitative studies.

In the area of managing contentious issues around human tissue, Māori, and indeed many New Zealanders, consider human tissue to be tapu, meaning it comes with a set of restrictions. There is already a growing interest in obtaining whānau consent instead of, or in addition to individual consent.

The academics say all health researchers should be accountable to our delegated responsibilities under the Treaty of Waitangi and be able to enact issues of responsiveness to Māori.

“In addition, researchers will need to consider what the standards of excellent practice will be in the future, especially as they train junior and emerging researchers and gather data, tissue and genetic samples. We encourage all researchers to engage in the work of ‘future proofing’ health research to ensure that responsiveness to Māori is achieved.”

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