Keeping Up to Date’ aims to increase awareness of the reasons to use evidence in practice, to stimulate debate about evidence, and to encourage the health promotion workforce to contribute to the evidence base by designing, delivering, and evaluating rigorous programmes.
29th & 30th edition -April 2009
This bumper edition of Keeping Up to Date makes up for the 29th and 30th editions of 2008. This paper examines three Māori health models forpromoting the health of Māori. They are applied to a case study, the growing crisis of type 2 diabetes in Māori communities in Aotearoa me Te Wai Pounamu (New Zealand). In the paper indigenous health models are used to reflect on modern health problems of indigenous peoples through the eyes of indigenous peoples.
Firstly, using The Treaty of Waitaki as a model we are able to create the policy framework that will enable the health system to promote appropriate policies and programmes for Māori.
Secondly, using Whare Tapa Wha (the four cornerstones of health) we are able to tease out the cultural, social, psychosocial and physical determinants of health. This model of health enables the development of health promotion programmes that respond to these key health determinants and therefore are more likely to be effective.
Finally, using Mason Durie’s Te Pae Mahutoka (the Southern Cross) we are able to identify and implement the essential elements of an effective health promotion programme that meets the needs of Māori. Using these three models together enables the development of a comprehensive approach to Māori health and health promotion. This will hopefully assist health promoters, service providers, policy makers, researchers and Māori in meeting Māori health needs.
Note: Te reo Māori used in this paper is written in the dialect of the Kai Tahu, Kati Mamoe iwi; ie the letter k replaces the more commonly used ng.
The purpose of this paper is to describe a framework of three Māori models for health that address Māori health needs: the Treaty of Waitaki, Whare Tapa Wha and Te Pae Mahutoka. The framework operates at three different levels providing a holistic approach for addressing any health issue. In this paper the framework is outlined and then its application in health promotion is illustrated by applying it to preventing type 2 diabetes.
In this paper we have outlined three models that can be used together to outline policy responses, the theory of wellness and programme design that enables a comprehensive health promotion response to complex problems, as illustrated by their application to type 2 diabetes. Together these models provide a framework that is consistent with sound health promotion principles as outlined in the Ottawa Charter. These are:
This collective framework comes from a kaupapa Māori worldview but may have universal application for indigenous peoples. Coming from a Māori (Māori knowledge) and demonstrates that the solutions to Māori health issues come from within Māori communities. That Māori can and will determine their own destiny. Coming from a Māori worldview is essential as it validates matauraka Māori (Māori knowledge) and demonstrates that the solutions to Māori health issues come from within Māori communities. That Māori can and will determine their own destiny.
- the principle of partnership between health systems and affected communities in policy development (Treaty of Waitaki);
- the princple of a holistic concept of wellbeing (Whare Tapa Wha); and
- the principle of empowerment of affected communities in programme design and delivery (Te Pae Mahutoka).