Indigenising Photovoice: Putting Māori Cultural Values Into a Research Method

In this article, we discuss Indigenous epistemology that ensures research is inclusive of Māori cultural values, such as collectivity and storytelling. We explain an adapted photovoice methodology used in research investigating Māori (the Indigenous peoples of Aotearoa/New Zealand) patient's perspectives on rongoā Māori (traditional Māori healing) and primary health care. Traditional photovoice theoretical frameworks and methodology were modified to allow Māori participants to document and communicate their experiences of health and the health services they utilised. Moreover, we describe the necessity for cultural adaptation of the theoretical framework and methodology of photovoice to highlight culturally appropriate research practice for Māori.In diesem Artikel diskutieren wir, wie Forschung durch den Einbezug einer indigenen Epistemologie inklusiv für kulturelle Maori-Werte wie Kollektivität und mündliche Überlieferung konzipiert werden kann. Wir veranschaulichen dies am Beispiel der Adaption von Photovoice zur Erforschung von Maori-Patient/innenperspektiven auf traditionelle Maori-Heilverfahren und Gesundheitsversorgung. Der herkömmliche Photovoice-Ansatz wurde dabei so modifiziert, dass Maori ihre Erfahrungen mit Gesundheit bzw. dem Gesundheitssystem dokumentieren und kommunizieren konnten. Wir versuchen so auf die Notwendigkeit der kulturellen Adaption theoretischer und methodologischer Vorannahmen zu verweisen, um zu kulturell sensitiven Forschungspraktiken zu kommen

Digital and data sovereignty - Guest editorial

Journal of Indigenous Wellbeing: Te Mauri – Pimatisiwin editorial board member Dr Amohia Boulton introduces the Digital and Data Special Issue, Volume 4, Issue 1

Rongoā Māori is Not a Complementary and Alternative Medicine: Rongoā Māori Is A Way Of Life

Rongoā Māori (RM), traditional Māori healing, encompasses Māori values, customs and healing practices that have existed in Aotearoa/New Zealand for more than a thousand years. Increasing global interest in commercialization of Indigenous knowledge, has resulted in misuse, misrepresentation, and misunderstanding of this Indigenous knowledge. Amalgamation of RM practices under the umbrella of Complementary and Alternative Medicine (CAM) for ease of classification and categorization displaces RM from its place as a culturally appropriate healing treatment for Māori. This community-based commentary premises the right of Indigenous peoples to maintain the cultural integrity of their healing practices, separate from CAM, and that recognises Indigenous healing practices as integral to a culturally appropriate way of life

Making Health Data Work for Maori: attitudes and current challenges

This article explores the experience of health services decision makers using Mäori health data to inform decision making. It draws on selected findings from the second phase of a three-year Health Research Council-funded study and discusses how Mäori health data identification, data analysis and data interpretation processes are being used by decision makers to help to identify the most promising strategies to improve Mäori health. Data is critical to monitoring inequity and has the potential to drive health service change. However, improvement is needed at all steps in the decisionmaking process to better facilitate utilising data to leverage change in Mäori health outcomes

Delivering on Outcomes: the experience of Maori health service providers

This article explores the service delivery experience of Mäori health service providers within the context of contracting. It draws on selected findings from a three-year Health Research Councilfunded study and discusses how Mäori health service providers are evidencing that their service delivery is contributing to positive outcomes for whänau. Although generally outcomes contracting appears to be fraught for providers, the foundations of a policy platform for effective outcomes contracting ‘by Mäori for Mäori’ has been established through the Whänau Ora policy,\

Delivering on diversity: The challenges of commissioning for Whānau Ora

As the populations of Western, so-called “first-world” countries grow; so too do the pressures for the funding, purchasing, and provision of high-quality health care for their citizens.  The drive to purchase and monitor outcomes, as opposed to simply accounting for outputs, has grown in strength in New Zealand and elsewhere, as a means of ensuring greater accountability for spending and ensuring every dollar invested in health care has some positive, downstream impact. This paper, based on a small qualitative research study, explores a specific model of purchasing for outcomes, namely the Te Pou Matakana (TPM) model of Whānau Ora commissioning. We explore how commissioning as a particular model for purchasing services has fared in terms of delivering for Whānau Ora. The paper provides a brief history of Māori health provider development, as a means of establishing the roots of the TPM commissioning approach. We then explore in greater detail the commissioning approach unique to this case study site before presenting the study itself, our data collection methods, results, and analysis of those results. The paper concludes that in the New Zealand context, commissioning as a purchasing model has benefited from alignment with Whānau Ora principles, to the extent that an Indigenous model of commissioning is apparent in the TPM commissioning approach

Indigenous Peoples’ Health Care: New approaches to contracting and accountability at the public administration frontier

© 2013 The Author(s). Published by Taylor & Francis. This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted.This article analyses reforms to contracting and accountability for indigenous primary health care organizations in Canada, New Zealand, and Australia. The reforms are presented as comparative case studies, the common reform features identified and their implications analysed. The reforms share important characteristics. Each proceeds from implicit recognition that indigenous organizations are ‘co-principals’ rather than simply agents in their relationship with government funders and regulators. There is a common tendency towards more relational forms of contracting; and tentative attempts to reconceptualize accountability. These ‘frontier’ cases have broad implications for social service contracting

Assessing the capacity of the health services research community in Australia and New Zealand

BACKGROUND: In order to profile the health services research community in Australia and New Zealand and describe its capacity, a web-based survey was administered to members of the Health Services Research Association of Australia and New Zealand (HSRAANZ) and delegates of the HSRAANZ's Third Health Services Research and Policy Conference. RESULTS: Responses were received from 191 individuals (68%). The responses of the 165 (86%) who conducted or managed health services research indicated that the health services research community in Australia and New Zealand is characterised by highly qualified professionals who have come to health services research via a range of academic and professional routes (including clinical backgrounds), the majority of whom are women aged between 35 and 54 who have mid- to senior- level appointments. They are primarily employed in universities and, to a lesser extent, government departments and health services. Although most are employed in full time positions, many are only able to devote part of their time to health services research, often juggling this with other professional roles. They rely heavily on external funding, as only half have core funding from their employing institution and around one third have employment contracts of one year or less. Many view issues around building the capacity of the health services research community and addressing funding deficits as crucial if health services research is to be translated into policy and practice. Despite the difficulties they face, most are positive about the support and advice available from peers in their work settings, and many are actively contributing to knowledge through academic and other written outputs. CONCLUSION: If health services research is to achieve its potential in Australia and New Zealand, policy-makers and funders must take the concerns of the health services research community seriously, foster its development, and contribute to maximising its capacity through a sustainable approach to funding. There is a clear need for a strategic approach, where the health services research community collaborates with competitive granting bodies and government departments to define and fund a research agenda that balances priority-driven and investigator-driven research and which provides support for training and career development

Public administration reform for Aboriginal affairs: an institutionalist analysis

Persistent underperformance of public policy and program implementation in Aboriginal affairs is widely recognised. We analysed the results of two case studies of attempted reforms in public administration of Aboriginal primary health care in the Northern Territory, using a framework based on the institutionalist and systemic racism literatures, with the aim of better understanding the sources of implementation failure. Implementation of the agreed reforms was unsuccessful. Contributing factors were as follows: strong recognition of the need for change was not sustained; the seeds of change, present in the form of alternative practices, were not built on; there was a notable absence of sustained political/bureaucratic authorisation; and, interacting with all of these, systemic racism had important consequences and implications. Our framework was useful for making sense of the results. It is clear that reforms in Aboriginal affairs will require government authorities to engage with organisations and communities. We conclude that there are four requirements for improved implementation success: clear recognition of the need for change in 'business as usual'; sustainable commitment and authorisation; the building of alternative structures and methods to enable effective power sharing (consistent with the requirements of parliamentary democracy); and addressing the impact of systemic racism on decision-making, relationships, and risk management