Dissertation (MHSc--Health Science) -- AUT University, 2008. / Includes bibliographical references. Also held in print (xi, 132 leaves : col. ill. ; 30 cm.) in North Shore Campus Theses Collection (T 362.108999442 PAE)

Thesis (PhD--Anthropology)--University of Auckland, 2007. / Includes bibliographical references (leaves 177-185).

Maori aspirations for a better future are inextricably linked to their health and well-being. Research is a central element of any strategy to ensure that the inequalities of today will not be experienced by Maori children of the future. Kaupapa Maori research has been at the forefront of the indigenous challenge to Western research practices which continue to frame Maori as the 'other' and victim blame by measuring differences to non-Maori and then attribute identified negative differences to Maori deficit. A kaupapa Maori framework validates Maori realities and enables the development of research processes that are based on a Maori worldview and endorse Maori values and beliefs. Proponents of distinctly Maori research methodologies have questioned the appropriateness of ethical review processes that are based on Western concepts of ethics that they contend are incongruent with Maori cultural values and beliefs. Maori ethical issues identified in the literature that arise from this interface have similarities with indigenous ethical themes of respect, control and reciprocity. This qualitative research study was based on a kaupapa Maori approach. The research addressed two main research questions: whether the current system of ethical review in New Zealand is responsive to Maori and how can tikanga Maior inform Maori research ethics. Primary data for this study was drawn from interviews with Maori members of ethics committees and analysed thematically. The major conclusion of this study was that the current ethical review process is limited in its responsiveness to Maori. The research found that Maori values were generally marginalised within ethical review processes that are based on universal ethics derived from a Western value base. A number of key ethical issues for Maori are not addressed appropriately within the current system of ethical review due to the limited parameters, in Maori terms, of the review process. It is essential that Maori issues and concerns be addressed in order for Maori to benefit from the activities of the research sector. Differences exist between Maori and Western concepts of ethics and the inclusion of tikanga Maori within the ethical review process could lead to a more transparent and responsive evaluation and greatly enhance the quality of ethical review of health research in New Zealand. The development of a Maori ethical framework that describes the principles of tikanga Maori and their application within the context of research ethics could provide a culturally appropriate framework for ethical review. Such a framework would address ethical issues of significance for Maori in research. The establishment of a National Maori Ethics Committee and the development of a parallel Maori ethical review pathway would further enhance Maori responsiveness.

Maori aspirations for a better future are inextricably linked to their health and well-being. Research is a central element of any strategy to ensure that the inequalities of today will not be experienced by Maori children of the future. Kaupapa Maori research has been at the forefront of the indigenous challenge to Western research practices which continue to frame Maori as the 'other' and victim blame by measuring differences to non-Maori and then attribute identified negative differences to Maori deficit. A kaupapa Maori framework validates Maori realities and enables the development of research processes that are based on a Maori worldview and endorse Maori values and beliefs. Proponents of distinctly Maori research methodologies have questioned the appropriateness of ethical review processes that are based on Western concepts of ethics that they contend are incongruent with Maori cultural values and beliefs. Maori ethical issues identified in the literature that arise from this interface have similarities with indigenous ethical themes of respect, control and reciprocity. This qualitative research study was based on a kaupapa Maori approach. The research addressed two main research questions: whether the current system of ethical review in New Zealand is responsive to Maori and how can tikanga Maior inform Maori research ethics. Primary data for this study was drawn from interviews with Maori members of ethics committees and analysed thematically. The major conclusion of this study was that the current ethical review process is limited in its responsiveness to Maori. The research found that Maori values were generally marginalised within ethical review processes that are based on universal ethics derived from a Western value base. A number of key ethical issues for Maori are not addressed appropriately within the current system of ethical review due to the limited parameters, in Maori terms, of the review process. It is essential that Maori issues and concerns be addressed in order for Maori to benefit from the activities of the research sector. Differences exist between Maori and Western concepts of ethics and the inclusion of tikanga Maori within the ethical review process could lead to a more transparent and responsive evaluation and greatly enhance the quality of ethical review of health research in New Zealand. The development of a Maori ethical framework that describes the principles of tikanga Maori and their application within the context of research ethics could provide a culturally appropriate framework for ethical review. Such a framework would address ethical issues of significance for Maori in research. The establishment of a National Maori Ethics Committee and the development of a parallel Maori ethical review pathway would further enhance Maori responsiveness.

Thesis (PhD) -- Auckland University of Technology, 2005. / Also held in print (240 leaves ; 30 cm.) in City Campus Theses Collection. (T 362.208999442 MCN)

There is a requirement for all services within the New Zealand health system to be accredited with an established quality organisation and to demonstrate an ability to provide a measurable quality service to consumers. For Māori these requirements must make sense in Māori terms. This thesis is based on the view that, for Māori, the concept of health is more effectively expressed as hauora - optimal health and wellbeing for Māori. This thesis makes five contributions to Māori health and Māori health research. First, it identifies a responsive approach to engaging kaumātua effectively in the process of qualitative research. Second, it identifies a fundamental underlying conceptual framework – kaupapa hauora Māori as a means of understanding hauora – expressed in terms derived from kaumātua in Taranaki and Kahungunu. Third, it adapts this conceptual framework into an analytical research framework and then applies it to allow kaupapa hauora Māori (described in terms of worldview, values and ethics) to be identified from a range of data. Fourth, it critically analyses popular models of Māori health – Te Whare Tapa Whā, Te Wheke and Ngā Pou Mana. Finally, it proposes and details post-doctoral research that will translate kaupapa hauora Māori into a quality services framework/tool. “Kaupapa Hauora Māori” is a conceptual framework articulated by kaumātua, and has its origins in te ao Māori, from which the aronga or worldview is developed. The aronga is composed of the kaupapa or values and tikanga or ethics that provide kaumātua with the values base of hauora. These components have been identified by kaumātua and not only inform the concept of KHM but also inform the analytical research framework that is applied to the data. The values have been identified as a core set of values comprising whakapapa, wairua, whenua, whānau, tikanga te reo Māori, tinana, and hinengaro, and the associated tikanga is expressed as behaviour or ethics. These, together, influence the perception and understanding individuals have of their world and of hauora.

Thesis (M.A.)--University of Canterbury, 2007. / Typescript (photocopy). Includes bibliographical references (leaves 80-84). Also available via the World Wide Web.

In New Zealand Māori are under-represented in the workforce across multiple sectors. This thesis explores this incongruity with regard to Māori health. A Māori perspective and philosophical foundation formed the basis of the methodological approach, utilising a case study research design to inform the study. This provided the opportunity to explore Māori health workforce development initiatives and their potential to contribute to improvements and gains in Māori health. It was important that this work take into account social and economic factors and their impact on health, as well as the varying political climates of market oriented reform and a fiscal policy focus, because it has not only challenged Māori health development but also provided opportunities for increased Māori involvement and participation in health and New Zealand society. Therefore the thesis, while focused on health takes cognisance of and, coincides with the capacity and capability building efforts that have been a feature of overall Māori development, progress and advancement. In the context of this thesis Māori health workers are seen as leaders within their whānau, hapū, iwi, and Māori communities. Consequently a potential workforce that is strong and powerful can lead to anticipated gains in Māori health alongside other Māori movements for advancement. The potential cannot be under-estimated. This thesis argues that there are critical success factors, specific determinants, influencing Māori health workforce potential, and that these success factors have wider application. Therefore, as this thesis suggests Māori workforce development, especially in relationship to the health workforce, is dependent on effective Māori leadership, the application of Māori values to workplace practices, levels of resourcing that are compatible with training and development, critical mass, and targeted policies and programmes.

A whanau is a social construct of Maori society in Aotearoa/New Zealand that is likened to an extended family. This thesis describes principles and practice that whanau utilise in decision processes from the findings of a retrospective qualitative case study of three whanau, who decided to participate in genetic research into a medical condition affecting their health. Four elements of whanau decision processes emerged from the data. Hui, rangatiratanga, manaakitanga and kotahitanga are Maori constructs that emphasise the collective nature of whanau decision making, and substantiate philosophical, theoretical and anecdotal evidence that Maori have distinctive ways of reaching decisions, underpinned by unique philosophical conventions. The results of this research place greater significance on the process of decision making than actual decisions, an incidental finding that has not been articulated by previous studies of Maori health and whanau. Contrary to western theoretical knowledge of decision making, whanau decision processes are collective activities. Individual decision making is closely linked to and depends on the collective, because individual identity manifests from the collective, and individual wellbeing is closely linked to that of the collective. When decision processes are familiar to members of a whanau, they are more likely to engage in decision making because they have a greater sense of knowledge and thus control of the processes, and they feel more able to contribute meaningfully to achieving aspirations for their own health. This thesis provides evidence that the New Zealand health sector, health legislation and policies are largely unfavourable for guaranteeing whanau engagement in decision processes. Yet, whanau decision making is an overall objective of the Government’s Maori Health Strategy: He Korowai Oranga, to address inequalities in health between Maori and other New Zealanders that have unacceptably become the norm.