Bevin Nina, Eggleton Kyle, Herbert Sarah
Public health registrar, School of Population Health, The University of Auckland, New Zealand.
Associate Dean, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
N Z Med J. 2023 Aug 4;136(1580):40-47. doi: 10.26635/6965.6040.
Over recent decades, a body of research has established the presence of pervasive health inequities experienced by Māori. Work to identify the root causes of inequities has focused on the unequal distribution of the determinants of good health, access to healthcare, and racism. This study contributes to a small but growing field of work which engages with Te Tiriti o Waitangi to critique key health documents, focusing on district health boards' (DHBs) annual plans.
A qualitative, directed content analytical approach was used to investigate whether DHBs' 2019/2020 annual plans were consistent with the principles of Te Tiriti o Waitangi, as identified by the Wai 2575 Waitangi Tribunal inquiry.
While annual plans contained actions that aligned with the principles of active protection and equity, comparatively few related to the principles of options, partnership, and tino rangatiratanga. Overall, DHB actions operated to constrain options available to Māori and efforts to exercise the Tiriti-guaranteed right of tino rangatiratanga in the provision of health services.
While DHBs' annual plans expressed commitment to Te Tiriti o Waitangi, their content did not give effect to these commitments. Significant shifts are necessary if future New Zealand Health Plans are Tiriti-responsive documents that deliver Tiriti-responsive health services.
在最近几十年里，一系列研究证实了毛利人普遍存在健康不平等的情况。确定不平等根源的工作聚焦于健康良好决定因素的不平等分配、获得医疗保健的机会以及种族主义。本研究为一个规模虽小但不断发展的工作领域做出了贡献，该领域运用《怀唐伊条约》来批判关键的健康文件，重点关注地区卫生委员会（DHBs）的年度计划。
采用定性的、定向内容分析方法，调查DHBs 2019/2020年度计划是否符合怀唐伊法庭调查Wai 2575所确定的《怀唐伊条约》原则。
虽然年度计划包含了与积极保护和平等原则相符的行动，但与选择权、伙伴关系和自决权原则相关的行动相对较少。总体而言，DHB的行动限制了毛利人可选择的方案，以及在提供卫生服务时行使《条约》保障的自决权的努力。
虽然DHBs的年度计划表达了对《怀唐伊条约》的承诺，但其内容并未落实这些承诺。如果未来的新西兰健康计划要成为符合《条约》要求的文件并提供符合《条约》要求的卫生服务，就需要进行重大转变。
