Hawke’s Bay District Health Board is today releasing its findings into a 2021 review focussing on cultural responsiveness in its maternity services.

The ‘Hau Te Kura – Nurturing our treasures’ review was commissioned following a focus on the DHB’s maternity services, including reports of institutional racism.

The review, led by a team of nationally recognised cultural experts in partnership with a local expert advisory group, focussed on identifying areas to improve health service delivery, performance, equitable outcomes and Pae Ora (healthy futures) for whānau Māori.

The expert advisory group included Māori researchers, midwives, and Nga Maia o Heretaunga as well as District Health Board cultural advisors and support from the DHB Planning, Funding and Performance Directorate.

“We knew we needed to look at ways to improve the experience of whānau in a safe and caring environment, and where Māori whānau particularly feel respected, listened to, cared for, and supported,” says Karyn Bousfield-Black, DHB Chief Nursing Officer.

Hau Te Kura was conducted, with the agreement of all parties involved, as an individual piece of work unfettered by the past to allow openness, transparency and a desire to move forward.

Midwife and member of the expert advisory group Beverly Te Huia said there will be mixed emotions regarding the review.

“This review will be difficult for some to read and for others, it will come as no surprise. However, what is most important is that the wahine and whānau who shared their stories feel that they are heard and that we will and must do better.

“The recommendations from this review are specific and achievable. I am looking forward to champion this Kaupapa together with Health NZ and Maori Health Authority.”

The report includes stories from the interviewees’ perspective that describe incidents of a lack of cultural awareness and racism, and the DHB has embraced the recommendations from the report. The report also includes comment on the 2019 attempted uplift of a baby by Oranga Tamariki on hospital grounds in 2019.

“Our core values of Akina, Tauwhiro, He Kauanuanu, and Raranga Te Tira were particularly relevent during this review to ensure a high quality of both clinical and cultural responsiveness can be achieved,” says Ms Bousfield-Black.

“These values will be embedded into the process. Health equity is a high priority for the DHB and includes addressing any institutional racism.

“Sustainable and organisational-wide change needs to happen to give assurance that the review’s findings have been heard.”

Acting Director of Midwifery Catherine Overfield said the recommendations will guide the maternity service to continue to improve levels of care. Most notably addressing well documented inequities in maternal and infant health outcomes, as well as providing a greater experience for Māori staff and community.

“We know that the care provided to expectant parents throughout the pregnancy journey can have a profound and lasting effect on māmā, pēpi and whānau.

“We want to acknowledge the many staff and stakeholders involved in this review, including the many voices of whānau who supported and contributed to it, and the committment to improvement shown by participating,” says Ms Overfield.

Stakeholder engagement included an online survey option for Lead Maternity Carers (LMCs) and DHB staff through face-to-face interviews and zoom/phone interviews with 22 whānau who had birthed in DHB facilities in the prior two-year period; 43 DHB governors, Māori Relationship Board partners, managers, and staff, and six external Iwi and community provider participants. A total of 71 interviews were conducted.

The DHB is currently working through the recommendations and developing a work plan to address them in a timely manner.

The background to the report can be found here and the full report here.

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