Pae Ora (Disestablishment of Māori Health Authority) Amendment Act 2024: further Crown breaches of Te Tiriti o Waitangi.

The Waitangi Tribunal in their Wai 2575 Report recommended the establishment of Te Aka Whai Ora (the Māori Health Authority) to remedy some of the contemporary breaches of Te Tiriti o Waitangi (Te Tiriti). Te Aka Whai Ora was the culmination of decades of Māori advocacy for the establishment of independent Māori health leadership, policymaking and commissioning. Under urgency, the new National-led coalition Government passed the Pae Ora (Disestablishment of Māori Health Authority) Amendment Act 2024 in February.

African Hut model of health: a framework for improving African migrant health in Aotearoa/New Zealand.

There is renewed international effort to improve the health and well-being of migrants. For African migrants, theoretical frameworks designed to account for and guide interventions to address the underlying mechanisms that interact to influence health and well-being remain largely underdeveloped. The aim of this study was to address this gap by providing a unique socio-ecological framework with specific entry points for targeted health promotion action aimed at improving the health and well-being of African migrants living in Aotearoa New Zealand.

A critical Tiriti analysis of Te Pae Tata: the Interim New Zealand Health Plan.

The current health reforms in Aotearoa New Zealand are being described as "transformational". Political leaders and Crown officials maintain the reforms embed a commitment to Te Tiriti o Waitangi, address racism and promote health equity. These claims are familiar and have been used to socialise previous health sector reforms.

Global food security, self-sufficiency and the cost of bread to Aotearoa.

Nil.

District health board engagement with the living wage movement: evidence from official information requests.

From a public health perspective, there is strong evidence that income is a major modifiable determinant of health. District health boards (DHBs), who were responsible for providing and/or funding regional health services across Aotearoa, are major employers. International literature suggests implementing a living wage strategy can improve health outcomes, contribute until July 2022 to the reduction of ethnic health inequities, and is ethical and socially responsible business practice.

Re-imagining anti-racist theory for the health sector.

Ethnic health inequities between Māori and other New Zealanders continue to manifest systemically across the health sector. They are unjust, unfair, and are a breach of Te Tiriti o Waitangi. Institutional racism is a key modifiable driver of these disparities.

A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill.

Aim: The Pae Ora (Healthy Futures) Bill is the framework for a reformed health system intended to embed Te Tiriti o Waitangi and centre equity. The Bill is informed by the Wai 2575 Health Kaupapa Waitangi Tribunal Inquiry and the Health and Disability System Review, both of which established an urgent mandate to transform the health sector. This desktop review explores to what extent the proposed Bill is likely to uphold Te Tiriti.

A pūrākau analysis of institutional barriers facing Māori occupational therapy students.

Introduction: Across Aotearoa (New Zealand), there are chronic shortages of qualified Māori (Indigenous peoples of Aotearoa) health practitioners and systemic ethnic health inequities. This study, focussing on the discipline of occupational therapy, explores Māori graduates' recollections of the institutional barriers that impacted on their study in this field over a 25-year period.

Methods: This qualitative study interviewed seven Māori occupational therapy graduates using pūrākau-an innovative Māori narrative inquiry method.

Learnings on Doing Health Research with Muslim Communities in Aotearoa New Zealand from a Study on Health and Ramadan.

The Muslim community is a vibrant part of New Zealand society. As this community grows, researchers will need to strengthen engagement and collaboration to tailor the delivery of services. Given the paucity of the literature, this conceptual paper drawing on a study on health and Ramadan presents an exemplar for doing research with Muslim communities.

A Critical Tiriti Analysis of the recruitment and performance review processes of public sector chief executives in Aotearoa.

Objective: Breaches of Te Tiriti o Waitangi (Te Tiriti) and evidence of institutional racism have been consistently documented within the public sector for decades. Chief executives across the sector have a critical responsibility to lead the implementation of the Crown's Te Tiriti o Waitangi responsibilities. This paper examines the recruitment and performance review processes of public sector chief executives from 2000 to 2020 to ascertain Te Tiriti compliance.

Smashing the patriarchy to address gender health inequities: Past, present and future perspectives from Aotearoa (New Zealand).

The second wave feminist dream of smashing the patriarchy remains a task yet to be completed on a complex to do list. Women, particularly able-bodied cis-gendered white women however do enjoy the privilege of living longer than men. But our longer lives take place within patriarchal-capitalist systems where many women's social and cultural rights continue to be compromised.

Te Tiriti o Waitangi compliance in regulated health practitioner competency documents in Aotearoa.

Within Aotearoa (New Zealand) there are systemic health inequities between Māori (the Indigenous people of Aotearoa) and other New Zealanders. These inequities are enabled in part by the failure of the health providers, policy and practitioners to fulfil treaty obligations to Māori as outlined in our foundational document, te Tiriti o Waitangi (te Tiriti). Regulated health professionals have the potential to play a central role in upholding te Tiriti and addressing inequities.

A critical analysis of te Tiriti o Waitangi application in primary health organisations in Aotearoa New Zealand: Findings from a nationwide survey.

Primary health is at the forefront of efforts to address health inequities. Effective primary health care keeps people well and improves longevity and quality of life. The persistence of health inequities, particularly between Indigenous peoples and non-Indigenous peoples globally, suggests that there is a need to strengthen policy and practise.

Women, Patriarchy and Health Inequalities: The Urgent Need to Reorient Our Systems.

This Special Issue is entitled "Women, patriarchy, and health inequalities: an unresolved issue" [...

The Simpson-led health sector review: a failure to uphold te Tiriti o Waitangi.

The Health and Disability System Review (the 'Simpson Review') was an opportunity for health sector transformation, particularly in light of the recent damning WAI 2575 Waitangi Tribunal report released during the review process. There appears to have been a concerted effort to engage with the sector, an impressive Māori Expert Advisory Group and an extensive body of available scholarship documenting where improvements could be made. In this viewpoint, the authors, tangata whenua (Indigenous people of the land) and tangata Tiriti (people of te Tiriti) and health scholars and leaders undertook a high-level review of the Simpson Review report and analysed it against key elements of te Tiriti o Waitangi.

Addressing Structural Racism Through Constitutional Transformation and Decolonization: Insights for the New Zealand Health Sector.

In colonial states and settings, constitutional arrangements are often forged within contexts that serve to maintain structural racism against Indigenous people. In 2013 the New Zealand government initiated national conversations about the constitutional arrangements in Aotearoa. Māori (Indigenous) leadership preceded this, initiating a comprehensive engagement process among Māori in 2010, which resulted in a report by Matike Mai Aotearoa which articulated a collective Māori vision of a written constitution congruent with te Tiriti o Waitangi (the founding document of the colonial state of New Zealand) by 2040.

From gorse to ngahere: an emerging allegory for decolonising the New Zealand health system.

Prior to colonisation, Māori had a well-developed holistic health system based on maintaining balance between people, place and spirit. The colonial imposition of British economic, religious, educational, legal, health and governance, through warfare, immigration, legislation and social coercion had a devastating effect on Māori health outcomes. With the release of the WAI 2575 Waitangi Tribunal report exposing the failings of our health system in relation to Māori health, the need to decolonise our health system becomes more pressing.

The Waitangi Tribunal's WAI 2575 Report: Implications for Decolonizing Health Systems.

, a treaty negotiated between Māori (the Indigenous peoples of Aotearoa) and the British Crown, affirmed Māori sovereignty and guaranteed the protection of (health). The Waitangi Tribunal, established in 1975 to investigate alleged breaches of the agreement, released a major report in 2019 (registered as WAI 2575) about breaches of within the health sector in relation to primary care, legislation, and health policy. This article explores the implications of this report for the New Zealand health sector and the decolonial transformation of health systems.

Resisting ethnic inequities in advanced breast cancer: a call to action.

Māori women with advanced breast cancer are less than half as likely as their Pākehā counterparts to reach the five-year survival mark. We argue that this inequity is unacceptable. We trace the inequity back to i) inadequate screening and risk assessment, ii) lack of support for patient navigation, iii) failure to offer accessible state-of-the-art treatments, and iv) delays in receiving life-prolonging care.

Upholding Te Tiriti, ending institutional racism and Crown inaction on health equity.

Upholding te Tiriti o Waitangi should eliminate institutional racism against Māori and contribute to the achievement of health equity. Given the Waitangi Tribunal is investigating health-related breaches of te Tiriti o Waitangi, we argue institutional racism, a key determinant of health inequalities, needs to be acknowledged and addressed within the health sector. Historically the Crown response can be characterised by denial and inaction.

The whole and inclusive university: a critical review of health promoting universities from Aotearoa New Zealand.

As well as serving as a critic and conscience for societies, universities are elite sites of privilege which, at a surface level, are unlikely locations for health promotion interventions. This paper provides a critical review of the existing health promoting universities (HPU) approaches which is informed by health promotion values. It explores the silence in the global literature around issues of structural discrimination such as the sexism, homophobia and institutional racism that can thrive within university settings.

Shades of competence? A critical analysis of the cultural competencies of the regulated-health workforce in Aotearoa New Zealand.

Objective: To critically examine, within the New Zealand context, the regulated-health practitioners' cultural competencies, their readiness to deliver culturally responsive health services to Māori (Indigenous peoples) and identify areas for development.

Design: A mixed methods critical analysis of the regulatory bodies' cultural competency standards for health practitioners from their websites.

Setting: The New Zealand regulated-health workforce, legislated by the Health Practitioners' Competency Assurance Act 2003 and the Medical Practitioners Act 2007, requires practitioners to regularly demonstrate cultural competence.

Treaty of Waitangi in New Zealand public health strategies and plans 2006-2016.

Aim: This study examines how public health policy in New Zealand has represented the Treaty of Waitangi (the English version) and te Tiriti o Waitangi (the Māori text) between 2006 to 2016.

Method: A dataset of 49 public health strategies and plans, published between 2006 and 2016, were secured from the New Zealand Ministry of Health database. A thematic analysis using Braun and Clarke's process was undertaken and then the findings were reviewed against the Māori text of te Tiriti.

Unravelling the whāriki of Crown Māori health infrastructure.

New Zealand's central government, and more specifically the Ministry of Health, consistently acknowledges their special relationship with Māori and the strategic importance of Māori health, and certainly, strengthening Māori health is critical to addressing systemic health inequities. This paper, framed in terms of the Crown principles attributed to the Treaty of Waitangi, ie, participation, protection and partnership, examines three structural decisions that threaten to unravel the whāriki (foundational mat) of Crown Māori health policy infrastructure. These include the disestablishment of the Ministry of Health's policy team, Te Kete Hauora, revoking mandatory district health boards' (DHB) Māori health plans and reporting, and downscaling the requirements of DHBs to consult.