Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Whānau Māori explain how the Harti Hauora Tool assists with better access to health services

Bridgette Masters-Awatere A B and Rebekah Graham A
+ Author Affiliations
- Author Affiliations

A University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand.

B Corresponding author. Email: Bridgette.Masters-Awatere@waikato.ac.nz

Australian Journal of Primary Health 25(5) 471-477 https://doi.org/10.1071/PY19025
Submitted: 31 January 2019  Accepted: 19 June 2019   Published: 16 September 2019

Journal Compilation © La Trobe University 2019 Open Access CC BY-NC-ND

Abstract

In this paper, whānau Māori highlight how a Kaupapa Māori-centred intervention (the Harti Hauora Tamariki tool, hereafter Harti tool) has improved interactions with health services. The Harti tool is undergoing a randomised control trial (RCT) at Waikato Hospital in New Zealand. As part of the RCT, the authors engaged in a series of qualitative interviews with whānau members of tamariki Māori (children aged 0–5 years) admitted to Waikato Hospital’s paediatric ward. Whānau who met at least one criteria for New Zealand’s domains of deprivation were included. Using a Kaupapa Māori approach to the study, participants shared their views on barriers and facilitators to accessing health resources and primary care services. The interviews conducted highlight how the Harti tool, when administered in a culturally appropriate and respectful manner that prioritised relationship-building, enabled better connection to healthcare services. Prevalent in our analysis were connections to wider determinants of health and ways to reduce existing health inequities. To conclude the paper, how the Harti tool has enhanced feelings of being in control of health, with the potential to reduce the likelihood of a hospital readmission, is highlighted.

Additional keywords: Indigenous health, New Zealand, social determinants of health, tertiary health care.


References

Arlidge B, Abel S, Asiasiga L, Milne S, Crengle S, Ameratunga S (2009) Experiences of whānau/families when injured children are admitted to hospital: a multi-ethnic qualitative study from Aotearoa/New Zealand. Ethnicity & Health 14, 169–183.
Experiences of whānau/families when injured children are admitted to hospital: a multi-ethnic qualitative study from Aotearoa/New Zealand.Crossref | GoogleScholarGoogle Scholar |

Blakely T, Ajwani S, Robson B, Tobias M, Bonné M (2004) Decades of disparity: widening ethnic mortality gaps from 1980 to 1999. The New Zealand Medical Journal 117, U995

Bolitho S, Huntington A (2006) Experiences of Maori families accessing health care for their unwell children: a pilot study. Nursing Praxis in New Zealand Inc 22, 23–32.

Came H (2014) Sites of institutional racism in public health policy making in New Zealand. Social Science & Medicine 106, 214–220.
Sites of institutional racism in public health policy making in New Zealand.Crossref | GoogleScholarGoogle Scholar |

Chamberlain K (2000) Methodolatry and qualitative health research. Journal of Health Psychology 5, 285–296.
Methodolatry and qualitative health research.Crossref | GoogleScholarGoogle Scholar | 22049137PubMed |

Chin MH, King PT, Jones RG, Jones B, Ameratunga SN, Muramatsu N, Derrett S (2018) Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health Policy 122, 837–853.
Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States.Crossref | GoogleScholarGoogle Scholar | 29961558PubMed |

Cram F, Smith L, Johnstone W (2003) Mapping the themes of Maori talk about health. The New Zealand Medical Journal 116, 1p following U353

Denzin N, Lincoln Y (2000) ‘Handbook of Qualitative Research.’ (Sage: Thousand Oaks, CA, USA)

Flyvbjerg B (2006) Five misunderstandings about case-study research. Qualitative Inquiry 12, 219–245.
Five misunderstandings about case-study research.Crossref | GoogleScholarGoogle Scholar |

Gifford H, Cvitanovic L, Boulton A, Batten L (2017) Constructing prevention programme with a Māori health service provider view. Kōtuitui: New Zealand Journal of Social Sciences Online 12, 165–178.
Constructing prevention programme with a Māori health service provider view.Crossref | GoogleScholarGoogle Scholar |

Harris R, Cormack D, Tobias M, Yeh L-C, Talamaivao N, Minster J, Timutimu R (2012) The pervasive effects of racism: experiences of racial discrimination in New Zealand over time and associations with multiple health domains. Social Science & Medicine 74, 408–415.
The pervasive effects of racism: experiences of racial discrimination in New Zealand over time and associations with multiple health domains.Crossref | GoogleScholarGoogle Scholar |

Hodgetts D, Stolte O (2017) ‘Urban Poverty, Inequality and Health: Critical Perspectives (Critical Approaches to Health).’ (Routledge: London, UK)

Hodgetts D, Chamberlain K, Tankel Y, Groot S (2014) Looking within and beyond the community: lessons learned by researching theorising and acting to address urban poverty and health. Journal of Health Psychology 19, 97–102.
Looking within and beyond the community: lessons learned by researching theorising and acting to address urban poverty and health.Crossref | GoogleScholarGoogle Scholar | 24058112PubMed |

Hodgetts D, Stolte O, Groot S, Drew N (2018) Homelessness, mimesis, and the flânerie. International Perspectives in Psychology: Research, Practice, Consultation 7, 91–106.
Homelessness, mimesis, and the flânerie.Crossref | GoogleScholarGoogle Scholar |

Hodgetts D, King P, Stolte O, Rua M, Groot S (in press) Reproducing the general through the local in research into poverty and homelessness. In ‘Subjectivity and Knowledge: Generalization in the Psychological Study of Everyday Life’. (Eds C Højholt, E Schraube) (Springer: New York, NY, USA)

Jansen P, Bacal K, Buetow S (2011) A comparison of Māori and non-Māori experiences of general practice. The New Zealand Medical Journal (Online) 124, 24–29.

Jones B, Ingham TR, Cram F, Dean S, Davies C (2013) An indigenous approach to explore health-related experiences among Maori parents: the Pukapuka Hauora asthma study. BMC Public Health 13, 228
An indigenous approach to explore health-related experiences among Maori parents: the Pukapuka Hauora asthma study.Crossref | GoogleScholarGoogle Scholar | 23497423PubMed |

Kerr S, Penney L, Moewaka Barnes H, McCreanor T (2010) Kaupapa Maori Action Research to improve heart disease services in Aotearoa, New Zealand. Ethnicity & Health 15, 15–31.
Kaupapa Maori Action Research to improve heart disease services in Aotearoa, New Zealand.Crossref | GoogleScholarGoogle Scholar |

Kidd J, Gibbons V, Kara E, Blundell R, Berryman K (2013) A Whānau Ora journey of Māori men with chronic illness: a Te Korowai analysis. AlterNative: An International Journal of Indigenous Peoples 9, 125–141.
A Whānau Ora journey of Māori men with chronic illness: a Te Korowai analysis.Crossref | GoogleScholarGoogle Scholar |

Kirkeby IM (2011) Transferable knowledge: an interview with Bent Flyvbjerg. Architectural Research Quarterly 15, 9–14.

Masters-Awatere B (2017) A game of slides and ladders: Māori health providers and funders. In ‘Precarity: Uncertain, Insecure and Unequal Lives in Aotearoa New Zealand’. (Eds S Groot, C van Ommen, B Masters-Awatere, N Tassell-Matamua) pp. 147–162. (Massey University Press: Auckland, New Zealand)

Masters-Awatere B, Nikora LW (2017) Indigenous programmes and evaluation: an excluded worldview. Evaluation Matters – He Take Tō Te Araomatawai 3, 40–66.
Indigenous programmes and evaluation: an excluded worldview.Crossref | GoogleScholarGoogle Scholar |

McKinny C (2006) Māori Experiences of Hospital Care in Auckland. Masters of Public Health Thesis (unpublished), University of Auckland, Auckland, New Zealand.

Moorfield JC (2011) ‘Te Aka Māori-English, English-Māori Dictionary and Index, 3rd ed.’ (Longman Pearson: Auckland, New Zealand)

Nikora LW, Masters-Awatere B, Te Awekotuku N (2012) Final arrangements following death: Maori indigenous decision making and tangi. Journal of Community & Applied Social Psychology 22, 400–413.
Final arrangements following death: Maori indigenous decision making and tangi.Crossref | GoogleScholarGoogle Scholar |

Olsen B (2003) Material culture after text: re-membering things. Norwegian Archaeological Review 36, 87–104.

Patton MQ (2002) ‘Qualitative Research & Evaluation Methods.’ (Sage Publications: Thousand Oaks, CA, USA)

Pihama L, Reynolds P, Smith C, Reid J, Smith LT, Te Nana R (2014) Positioning historical trauma theory within Aotearoa New Zealand. AlterNative: An International Journal of Indigenous Peoples 10, 248–262.
Positioning historical trauma theory within Aotearoa New Zealand.Crossref | GoogleScholarGoogle Scholar |

Pitama S, Ahuriri-Driscoll A, Huria T, Lacey C, Robertson P (2011) The value of te reo in primary care. Journal of Primary Health Care 3, 123–127.
The value of te reo in primary care.Crossref | GoogleScholarGoogle Scholar | 21625660PubMed |

Radley A, Billig M (1996) Accounts of health and illness: dilemmas and representation. Sociology of Health & Illness 18, 220–240.
Accounts of health and illness: dilemmas and representation.Crossref | GoogleScholarGoogle Scholar |

Radley A, Chamberlain K (2001) Health psychology and the study of the case: from method to analytic concern. Social Science & Medicine 53, 321–332.
Health psychology and the study of the case: from method to analytic concern.Crossref | GoogleScholarGoogle Scholar |

Reinfeld M, Pihama L (2007) Matarākau: Ngā kōrero mō ngā rongoā o Taranaki. Foundation for research, science and technology, Taranaki, NZ. (Karangaora Incorporated: New Plymouth, Taranaki, New Zealand) Available at http://www.tutamawahine.org.nz/matarakau [Verified 10 February 2017]

Rogers M (2012) Contextualizing theories and practices of bricolage research. The Qualitative Report 17, 1–17.

Ruddin LP (2006) You can generalize stupid! Social scientists, Bent Flyvbjerg, and case study methology. Qualitative Inquiry 12, 797–812.
You can generalize stupid! Social scientists, Bent Flyvbjerg, and case study methology.Crossref | GoogleScholarGoogle Scholar |

Salmond C, Crampton P, King P, Waldegrave C (2006) NZiDep: a New Zealand index of socioeconomic deprivation for individuals. Social Science & Medicine 62, 1474–1485.
NZiDep: a New Zealand index of socioeconomic deprivation for individuals.Crossref | GoogleScholarGoogle Scholar |

Stevenson K, Filoche S, Cram F, Lawton B (2016) Lived realities: birthing experiences of Māori women under 20 years of age. AlterNative: An International Journal of Indigenous Peoples 12, 124–137.
Lived realities: birthing experiences of Māori women under 20 years of age.Crossref | GoogleScholarGoogle Scholar |

Stewart MJ, Makwarimba E, Reutter LI, Venstra G, Raphael D, Love R (2009) Poverty, sense of belonging and experiences of social isolation. Journal of Poverty 13, 173–195.
Poverty, sense of belonging and experiences of social isolation.Crossref | GoogleScholarGoogle Scholar |

Walker R (2014) ‘The Shame of Poverty.’ (Oxford University Press: Oxford, UK)

Walker T, Signal L, Russell M, Smiler K, Tuhiwai-Ruru R, Otaki Community Health Centre Te Wakahuia Hauora Te Aitanga a Hauiti Hauora Turanga Health (2008) The road we travel: Maori experience of cancer. The New Zealand Medical Journal (Online) 121, 27–35.

Westbrooke I, Baxter J, Hogan J (2001) Are Māori under-served for cardiac interventions? The New Zealand Medical Journal 114, 484–487.