Study into health disparities for young Māori women & babies
Monday, September 9th 2013
Study into health disparities for young Māori women and their babies from a Kaupapa Māori Research paradigm
The reclamation of academic research by, with and for Māori is the focus of a study into inequalities in the country’s health system undertaken by seven Wellington-based health researchers; Beverley Lawton, Fiona Cram, Charrissa Makowharemahihi, Tina Ngata, Bridget Robson, Selina Brown and Warahi Campbell.
Their paper, entitled ‘Developing a Kaupapa Māori research project to help reduce health disparities experienced by young Māori women and their babies’, backgrounds the Māori reclamation of academic research and provides an overview of the health disparities experienced by young Māori mothers and their offspring. The findings are in the latest issue of AlterNative: An International Journal of Indigenous Peoples, published by Ngā Pae o te Māramatanga, New Zealand’s Indigenous Centre of Research Excellence.
Associate Professor Lawton says “Māori are a young population and maternal and child ill-health affects a significant proportion of our population.” “The differences in infant mortality, respiratory hospitalizations and immunization rates between Māori and non-Māori are part of a larger picture of health inequalities in Aotearoa New Zealand and suggest that there is differential access to health services and health system factors contributing to inequalities. Interventions to reduce these health disparities need to have a comprehensive understanding of the lives of these young women, including the challenges they face, their aspirations, and their support networks.” By looking at the plight of young Māori mothers and their babies, the study claims that the mothers suffer the dual stigma of being Māori and being teenagers, in addition to poorer health outcomes for them and their babies.
The authors, describe a community-up process in which Māori researchers engaged with Māori communities for feedback about, and permission for, a research project looking at the lived experiences of young, pregnant Māori women. “This study highlights the roles of Māori researchers undertaking research that is by Māori, for Māori, and with Māori participants and the importance of research processes that respect relationships and the aspirations that communities have for wellbeing,” said Associate Professor Lawton.
Dr Lawton advises that
consultation with Māori communities and stakeholders is an
essential prerequisite to research being conducted in any
region in Aotearoa New Zealand, and this project was no
different. “These relationships meant we could, in some
sense, get straight down to business within the context of
cultural protocols. The process described in the present
paper is not a prescription for consultation with Māori
about health research. Rather, it is a methodology that sets
out the importance of working with and for people,
highlighting issues/disparities to see if they resonate, and
working out ways in which research might be conducted within
local contexts,” Associate Professor Lawton says.
Dr Fiona Cram states: “This is about consultation as a mechanism to establish an endorsed foundation for the research to build upon and to begin the development of “mutual thinking”—whakawhitiwhiti kōrero—between the researchers and communities to collaboratively support the research throughout its life cycle.”
The consultation was not a one-off moment that had a definite beginning and an end after a time- and project-limited journey. Rather, the consultation occurred within the context of existing and newly established relationships, with the post-project relationship continuing indefinitely. These relationships are about the ability of the researchers and the community to call upon one another. This might mean, for example, convening a consultation opportunity/moment, speaking at one another’s special occasions, or catching-up over morning coffee. In this way, consultation occurs within a web of kinship relationships and mutual obligations that is hard to replicate in a recipe-directed way, but reasonably easy to tell the story in terms of the values and principles that it embodies.
“In the past,
Māori academics have written at length about seven
community-up research practices that originate from a
Kaupapa Māori Research paradigm. These practices are: Aroha
ki te tangata—a love for the people; He kanohi
kitea—being a face that is seen; Titiro, whakarongo …
kōrero—looking and listening well before speaking;
Manaaki ki te tangata—sharing, hosting, being generous;
Kia tūpato—being careful; Kaua e takahia te mana o te
tangata—not trampling on the dignity of people; Kia
The community-up research practices have become an example of the sorts of things Māori communities might think about rather than strict guidance that must be adhered to in order for the research or evaluation to be considered Kaupapa Māori. The current project sought to embody these principles through a commitment to stakeholder engagement and ongoing consultation, built upon a foundation of pre-existing as well as newly formed respectful and accountable relationships.
“It is no longer appropriate to just count or describe disparities. We must develop effective programmes that can help to improve health outcomes. The emergent findings from this study and the related quantitative cohort study will inform policy and provide essential information for the design of a protocol for an intervention based on whānau ora, just as in the present study consultative discussions will be a key component of the development of an intervention. On the basis of permissions being sought and given we will proceed to seek funding for this next stage in our research commitment to reducing the health disparities experienced by young Māori women and their babies.” said Associate Professor Lawton.
Ngā Pae o te Māramatanga (NPM) is a Centre of Research Excellence consisting of 16 participating research entities and hosted by The University of Auckland. NPM conducts research of relevance to Māori communities and is an important vehicle by which New Zealand continues to be a key player in global indigenous research and affairs. Its research is underpinned by the vision to realise the creative potential of Māori communities and to bring about positive change and transformation in the nation and wider world. Visit www.maramatanga.ac.nz