Understanding Mana Whenua's Role in Health Governance
Updated: Sep 15
Mana Whenua i Tamaki Makaurau continue to build on the mahi of our predecessors by a
continuation of meaningful working relationships with the Counties Manukau District Health
Board to progress equitable health and wellbeing outcomes for Whänau Maori.
Whilst our focus is on the future wellbeing of Whanau Maori, we remind ourselves that it is
fitting that the Treaty underpins this revised Hauora plan. The following historical narrative is
crucial if we are to maintain a meaningful Treaty Partnership.
The Treaty has been portrayed as 'the first Maori health strategy,' describing a Maori
population in sharp decline following the impact of unmanaged Colonisation. Busby raised
concerns in 1837 of the miserable condition of the natives' which he reported if left
unchecked would result in the extinction of the Maori race. Whether this was the real
motivation behind Busby's actions still remains contentious today. However, his unease over
the health and welfare of Maori, to which he placed some of the blame on the total
European impact was a factor in persuading the British Colonia: office to propose a Treaty
to Maori.
Such was the contrast to earlier references by the first immigrants that described Maori as
bountiful, healthy and vibrant. The Crown offered protection of land, culture and wellbeing,
resources and the continued ability of the tribes to control their interests in the form of a
Treaty. Despite controversy and debate by the chiefs of the haapu regarding the intent of the
Crown, concerns over Maori health were not insignificant in terms of both shaping and selling the Treaty to Maori.
Much has been debated concerning the history and validity of the principles as applied to the Treaty of Waitangi. This Hauora Plan advances the importance of the articles although it is acknowledged that the principles are the Crown's interpretations of a document yet to be
properly honoured by successive governments. Over time specific strategies based on the
articles will be developed for more detailed planning exercises
In brief the Treaty has three main articles that in contemporary times and through NZ case law have been aligned to the three principles Of protection, partnership and participation. MWiTM recognizes the articles and the intent of the principles within the original
framework.
Article one — Kawanatanga and the obligation to exercise protection by the Crown. The
government and its agencies have a responsibility to protect the rights conferred in articles two and three.
Article two — Tino Rangatiratanga and the right of Mana Whenua i Tamaki Makaurau to enter into partnership with the Crown. Mana Whenua i Tamaki Makaurau maintains this
responsibility, while ensuring those who reside within their geographical areas are supported to exercise their right of participation.
Article three — Oritenga in terms of equitable participation by Mataawaka - Maori and
non- Maori in the provision of services to improve Maori wellbeing. While Mana Whenua i
Tamaki Makaurau supports quality service provision within its rohe, in terms of reciprocity,
Mataawaka participation supports Mana Whenua to exercise their right to rangatiratanga
through the process Of a Treaty partnership.
There should be no further misunderstanding of the position Mana Whenua holds within their rohe. Not to be confused with iwi from other areas, urban Maori communities or service
providers, the framework guides the way forward in terms of Treaty obligations and
relationships with the Crown, its agencies and Mana Whenua i Tamaki Makaurau.
The Importance of Mana Whenua in Health Governance
Health governance in New Zealand is increasingly recognizing the importance of incorporating Mana Whenua perspectives. This shift is essential for several reasons:
Cultural Relevance: Health services that respect and integrate Māori cultural practices are more likely to be accepted and utilized by Māori communities.
Community Empowerment: Involving Mana Whenua in health governance empowers communities to take charge of their health outcomes, leading to more effective and tailored health solutions.
Holistic Approaches: Māori health perspectives often emphasize a holistic view of well-being, which includes physical, mental, spiritual, and social dimensions. This approach can enhance overall health outcomes.
The Historical Context
Understanding the historical context of Mana Whenua is vital for grasping its current role in health governance. The Treaty of Waitangi, signed in 1840 between Māori chiefs and the British Crown, established a framework for recognizing Māori rights and interests. However, the subsequent colonization process led to significant land loss and marginalization of Māori voices in governance.
The Treaty of Waitangi and Health
The Treaty of Waitangi is a foundational document that outlines the relationship between Māori and the Crown. In the context of health governance, it emphasizes:
Partnership: The Crown and Māori must work together to improve health outcomes.
Protection: The Crown has a responsibility to protect Māori health and well-being.
Participation: Māori must be actively involved in decision-making processes regarding health services.
Current Health Governance Framework
New Zealand's health governance framework has evolved to better incorporate Mana Whenua perspectives. Key components include:
Health and Disability System Review
The Health and Disability System Review, conducted in 2020, highlighted the need for a more equitable health system that prioritizes Māori health. Recommendations included:
Establishing Māori Health Authorities to ensure Māori voices are central in health decision-making.
Integrating traditional Māori healing practices alongside conventional medical treatments.
Whānau Ora
Whānau Ora is a holistic approach to health and well-being that focuses on the entire family (whānau) rather than just the individual. This model empowers families to take control of their health and well-being, aligning with the principles of Mana Whenua.
Case Studies: Successful Integration of Mana Whenua in Health Governance
Example 1: Te Whānau o Waipareira
Te Whānau o Waipareira is a Māori health provider in Auckland that exemplifies the integration of Mana Whenua in health governance. They focus on:
Culturally Appropriate Services: Offering health services that are tailored to Māori cultural practices and beliefs.
Community Engagement: Actively involving the community in health service design and delivery.
As a result, they have seen improved health outcomes and increased trust within the community.
Example 2: Ngāti Porou Hauora
Ngāti Porou Hauora is another example of a successful Māori health provider that emphasizes Mana Whenua principles. Their approach includes:
Holistic Health Services: Providing a range of services that address physical, mental, and spiritual health.
Community-Led Initiatives: Empowering local communities to identify their health needs and develop solutions.
This model has led to significant improvements in health metrics for the Ngāti Porou community.
Challenges in Implementing Mana Whenua in Health Governance
Despite the progress made, several challenges remain in fully integrating Mana Whenua into health governance:
Resource Limitations: Many Māori health providers face funding constraints, limiting their ability to deliver comprehensive services.
Systemic Barriers: Institutional racism and biases within the health system can hinder effective collaboration with Māori communities.
Cultural Competency: There is a need for ongoing training and education for health professionals to ensure they understand and respect Māori cultural practices.
The Future of Mana Whenua in Health Governance
Looking ahead, the role of Mana Whenua in health governance is likely to expand further. Key areas for development include:
Strengthening Partnerships
Building stronger partnerships between Māori health providers and government agencies will be essential for improving health outcomes. This includes:
Collaborative Policy Development: Involving Māori in the creation of health policies that affect their communities.
Shared Decision-Making: Ensuring that Māori voices are heard in all levels of health governance.
Emphasizing Research and Data
Investing in research that focuses on Māori health issues will provide valuable insights for policymakers. This includes:
Culturally Relevant Research: Conducting studies that reflect the unique health challenges faced by Māori communities.
Data Collection: Improving data collection methods to ensure accurate representation of Māori health statistics.
Conclusion
Mana Whenua plays a vital role in shaping health governance in New Zealand. By recognizing and integrating Māori perspectives, the health system can become more equitable and effective. As we move forward, it is essential to continue fostering partnerships, investing in research, and empowering Māori communities to take charge of their health outcomes.
The journey towards a more inclusive health governance framework is ongoing, but with the commitment to uphold Mana Whenua principles, we can create a healthier future for all New Zealanders.
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