Māori hauora ā-iwi competencies Māori public health competencies

Abstract

Abstract Background: In Aotearoa New Zealand there are persisting health inequities between Māori and non-Māori. Equity is a fundamental component of public health practice, however a review of public health courses at the University of Otago found that, aside from dedicated content, the focus on Māori health was lacking. The Māori haurora ā-iwi/public health competency project sought to address this, initially in defining a set of core competencies for teaching purposes. This paper focusses on the subsequent phase of the project, which expanded on the core competencies to enable their use in workplaces, adding progression across multiple levels. Methods: The research was completed using kaupapa Māori methodology in four stages which included: the development of draft levels of competence for the core competencies identified during phase one, consultation hui to acquire feedback, analysis of the feedback and redrafting of the competencies including their associated levels, and respondent validation. Results: Key themes emerging from the consultation process addressed both the content of competencies and their associated skills, knowledge and attitudes, as well as the application and presentation of the competency framework as a whole. Increasing expectations were identified in relation to language and tikanga (correct practice and protocol), and participants highlighted the importance of strength-based approaches and self-determination. There were recommendations to emphasise context, contemporary needs and action, as well as individual responsibility in order to decolonise public health practice. Reflective practice was deemed a fundamental cross-cutting competency and there were proposals to include planetary health and political ideologies as additional socio-political determinants of health impacting equity. In terms of application and presentation, participants emphasised cultural safety and careful navigation of worldviews, while also ensuring that all public health practitioners would feel ‘seen’ in the competencies. The final competency document has been published under a Creative Commons licence. Conclusions: The process of drafting a set of Māori public health competencies has elicited key themes that could be relevant for promoting health equity in other countries. It has also resulted in a tool for universities and workplaces to help drive forward progress in Aotearoa New Zealan