He Korowai Oranga - Māori Health Strategy

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Date of Publication: November 2002 It is also available as a PDF file to download or print.
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Te Ara Tuarua - Pathway Two
Māori participation in the health and disability sector


Supporting Māori participation at all levels of the health and disability sector is the second pathway to improving whanau ora. Active participation by Māori in planning, development and delivery of health and disability services will ensure services are appropriate and effective for Māori.

Pathway Two seeks to increase:

• Māori participation in health and disability sector decision-making

• Māori provider development

• Māori workforce development.

Increasing Māori participation in decision-making

Objective 2.1


Partnerships with iwi and Māori communities

Partnership with the Crown is one of the principles of the Treaty of Waitangi. DHBs have the primary responsibility for planning and funding health and disability services and improving Māori health. They are expected to work in partnership with iwi and Māori communities to ensure their decision-making effectively leads to whanau ora improvement and supports the achievement of Māori health aspirations.

They are required to involve iwi and other Māori communities in developing strategies to improve Māori health and to enable them to influence the planning, purchasing, delivery and monitoring of services to build Māori health.

No single partnership model will suit every iwi and DHB. Iwi, Māori communities and DHBs need to work together to develop models that meet their needs.

In addition to developing partnerships with iwi and Māori at the governance and operational levels, DHBs are also expected to consult with Māori communities (as they are with the wider community).


Māori membership of DHB boards

The New Zealand Public Health and Disability Act 2000 requires the participation of Māori on DHBs through at least two Māori members on each board. The Act also requires Māori membership on a range of DHB committees.

All board members – not only Māori members – are required to develop the skills and knowledge necessary to achieve Māori health objectives of both the Government and the DHB, as well as their Treaty obligations.

The Ministry of Health recognises that Māori board members will require further support due to the additional expectations placed on them by whanau, hapu, iwi and Māori communities.



Increasing Māori provider capacity and capability

Objective 2.2


Māori providers are key players in improving access to, and the effectiveness and appropriateness, of health and disability services for whanau. Māori providers are essential to developing services that practise Māori views of health and healing.

Māori providers have developed within hapu, iwi and Māori communities and are particularly well placed to understand and meet the needs of whanau. Their work also contributes to the capacity and capability of Māori communities, and their economic wellbeing.

Moving forward with provider development requires:

• expanding geographical coverage of Māori providers to ensure all Māori populations have access to a choice of a Māori provider for well child, primary, mental, disability support and other community-based services

• consolidating and co-ordinating providers

• continuing quality improvement

• further developing Māori disability providers, Māori models of disability support, and elimination of barriers that may have been created by providers towards disabled Māori

• supporting Māori providers to develop into or participate in primary health organisations responsible for the health of enrolled populations, under the Primary Health Care Strategy

• improving integration between providers.

DHBs have a statutory obligation to continue to foster Māori capacity to participate in the health and disability sector and to provide for their own needs. This will include exploring new provider models, particularly if iwi or Māori communities have identified these as appropriate to their needs.



Developing the Māori health and disability workforce


Objective 2.3


Trained Māori clinicians and other health professionals, managers, community and voluntary workers, and researchers are necessary to strengthen the health and disability sector’s capacity to deliver effective and appropriate services to whanau.

Māori are under-represented in the health and disability workforce in almost every area, holding back both Māori provider development and improvements in mainstream delivery to Māori. Extending workforce development initiatives, such as targeted training programmes and scholarships, is therefore vital.

A number of initiatives are already contributing to Māori workforce development in both the education and health sectors, with the support of the Māori Provider Development Scheme, mental health funding and the Clinical Training Agency. New Māori health worker organisations have emerged in the past five years to sit alongside the more established groups.

Māori workforce development needs acceleration and greater co-ordination.

The Health Workforce Development Advisory Committee will play an important role in identifying the need for Māori health workers and ensuring more systematic ways to develop them.

Māori community health and voluntary workers, many of whom are Māori women, have a pivotal role in improving the health of Māori whanau. This needs to be recognised with the development of mechanisms to encourage community workers, public health workers, and voluntary workers into professional training.

Areas identified in the New Zealand Disability Strategy regarding the care and support of disabled Māori, include:

• increasing the number of trained and qualified Māori Disability Support Service (DSS) workers

• recognising and valuing whanau that support disabled Māori.

To achieve Māori health workforce objectives, the health and disability sector will collaborate with the education sector, Te Puni Ko kiri, the Ministry of Women’s Affairs, iwi and Māori communities to address wider issues affecting Māori participation in education.

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