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ABSTRACT
AIM: A nuanced healthcare framework, Te Hā o Whānau, aims to make the maternal-infant healthcare system more accessible and culturally responsive for Māori following unexpected events that led to the harm or loss of their baby.
METHOD: Te Hā o Whānau was developed from three components. Firstly, it was grounded and informed by Kaupapa Māori qualitative research involving whānau who had experienced the harm or loss of their baby. These learnings were then combined with mātauranga Māori (Māori knowledge) and built on three articles of Te Tiriti o Waitangi: Kāwanatanga, Rangatiratanga and Öritetanga.
RESULTS: Te Hā o Whānau has been developed to specifically guide the maternal-infant healthcare system in providing culturally responsive practice points and guidelines. These practice points and guidelines align with three tikanga Māori (customs): Tikanga manaakitanga, Tikanga rangatiratanga and Tikanga whakawhanaunga.
CONCLUSION: To address the stark health inequities present, we must forge innovative models and strategies, rather than reproducing (less successful) paths that have the less resistance. Te Hā o Whānau is provided with the aim of providing better outcomes for all, not just Māori.
The maternal-infant healthcare system is failing Maori, evident in the maternal and infant health inequities between Māori and non-Māori.1 It is an unwelcome truth that for Māori, (Indigenous people of Aotearoa New Zealand), too many die young, suffer avoidable illnesses and injuries and live in unnecessarily difficult circumstances.2 Māori wāhine (women) and their babies face higher rates of morbidity and mortality than non-Māori.3 In addition to death, Māori babies are more likely to be born preterm (born before 37 weeks gestation),4-5 which is associated with poor health, often requiring intensive medical care at a neonatal intensive care unit (NICU) or special care baby unit (SCBU). The higher rates of morbidity and mortality can be attributed to health inequities faced by Māori wāhine and their babies. For example, it has been found that Māori women often receive suboptimal clinical care during preterm labour.3 These health inequities are a breach of Te Tiriti o Waitangi, the founding document of Aotearoa New Zealand, and a representation of how the maternal-infant healthcare system is failing Māori. This paper purposefully refers to Te Tiriti rather than the Treaty of Waitangi, as both are different documents that carry different meanings, with...