Indigenous Wellbeing: Collaborative decision-making for Māori health gain: A case study in Taranaki, Aotearoa, New Zealand

This paper tells the story of a case study of Māori Health Service Provider involvement in interpreting and utilising childhood immunisation data within the Taranaki region of Aotearoa, New Zealand, between 2017 and 2019. This Kaupapa Māori (Māori approach) qualitative research was led by a community researcher with longstanding relationships with the health organisations in this region.

Data included key informant interviews with individuals from the Taranaki District Health Board (TDHB), which funds the regional immunisation programme, and leaders from the three Māori Health Service Providers in the region. Interview data were supplemented by insightful observations of relevant meetings and a review of key documents provided.

Early in the study, there was genuine engagement between TDHB and Māori Health Service Providers with regard to reviewing and interpreting Māori childhood immunisation data. A quarterly data review cycle, which had been put in place as part of a multi-provider single alliance contract for Māori health, provided a platform for this engagement. When the alliance contract ended, so did the collaborative immunisation data and services review between TDHB and the Māori Health Service Providers.

This paper reflects on some of the general challenges for Māori Health Service Providers in working with District Health Boards. A partnership between providers and the funder requires long-term commitment, which supports wider whānau ora (family wellbeing) and not simply conventional outcome indicators. It requires the Crown to trust mātauranga Māori (Māori knowledge), structures and processes, and to provide resources over a longer timeframe if meaningful outcomes are to be achieved. This case study demonstrates the fragility of initiatives designed to improve health equity for Māori.

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