Barrett Nikki M, Burrows Lisette, Atatoa-Carr Polly, Smith Linda T
Te Ngira: Institute for Population Research, University of Waikato, Hamilton, New Zealand.
Te Whare Wānanga O Awanuiārangi, Whakatāne, New Zealand.
J Racial Ethn Health Disparities. 2025 Apr 22. doi: 10.1007/s40615-025-02419-4.
Despite universal provision of maternity care, Māori (Indigenous peoples of Aotearoa/New Zealand) experience significant maternal and infant health disparities compared to their dominant Pākehā (non-Māori) counterparts. This paper examined the lived realities of postnatal Māori māmā (mothers) engaging with health and social services. Enablers and barriers were identified to better understand what is required to strengthen health services' responsiveness to Māori māmā health needs and aspirations.
Underpinned by Kaupapa Māori research principles, which are grounded in Māori cultural values, emphasising self-determination, and Māori aspirations, a small cohort of 17 expectant Māori māmā were recruited from a Māori childbirth education programme to participate in a three-phase study. Phase three, the focus of this paper, involved seven semi-structured, open-ended telephone interviews with Māori māmā. A thematic analysis, underpinned by a mana wahine (authority inherent in Māori women) theoretical perspective amplified these experiences.
Five themes were identified that encapsulated participants' engagement and interactions with health and social services. These themes were as follows: (1) right to enact tino rangatiratanga (autonomy) and self-achievement; (2) responsiveness of services; (3) service and system issues; (4) need for greater choice and opportunity; and (5) impact of COVID-19.
This study privileged the voices of Māori wāhine, highlighting their experiences with a complex and often unresponsive health system. Participants valued services that enabled them to exercise tino rangatiratanga. Echoing the experiences of other Indigenous Peoples, incorporating culturally relevant practices into perinatal health services is crucial for achieving health equity and addressing disparities.
尽管提供了普遍的孕产妇护理，但与占主导地位的非毛利人（帕克哈人）相比，毛利人（新西兰原住民）在母婴健康方面存在显著差距。本文研究了产后毛利母亲与健康和社会服务机构接触的实际情况。确定了促进因素和障碍，以更好地了解需要采取哪些措施来增强卫生服务机构对毛利母亲健康需求和愿望的响应能力。
以毛利研究原则为基础，该原则植根于毛利文化价值观，强调自决和毛利人的愿望，从一个毛利分娩教育项目中招募了一小群17名待产毛利母亲，参与一项分为三个阶段的研究。本文关注的第三阶段，包括对毛利母亲进行七次半结构化、开放式电话访谈。以mana wahine（毛利女性固有的权威）理论视角为基础的主题分析，强化了这些经历。
确定了五个主题，概括了参与者与健康和社会服务机构的接触和互动。这些主题如下：（1）行使tino rangatiratanga（自主权）和自我成就的权利；（2）服务的响应能力；（3）服务和系统问题；（4）需要更多选择和机会；（5）新冠疫情的影响。
本研究重视毛利女性的声音，突出了她们在复杂且往往反应迟钝的卫生系统中的经历。参与者重视能让她们行使tino rangatiratanga的服务。与其他原住民的经历相呼应，将与文化相关的做法纳入围产期卫生服务对于实现健康公平和消除差距至关重要。
