Experiences of Senior Māori Public Health Practitioners Working in Public Health Units in Aotearoa New Zealand: Success Factors and Barriers for Māori Working in Public Health Units
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In Aotearoa (New Zealand) the underpinning document that frames the nation’s response to public health is Te Tiriti o Waitangi. Te Tiriti o Waitangi has stood and still stands as the most important document for the pursuit of equity for Māori and other Indigenous groups alongside the United Nations Declaration of Indigenous Peoples (UNDRIP) (United Nations, 2007). Regardless of any ideological understanding of the purpose and execution of the Te Tiriti, there continues to be an imbalance in representation by Māori in influential, leadership and decision-making positions in the health sector, and inequity across Māori and Pacifica populations that could be addressed by transforming the systemic issues that contribute to these inequities. Public health specifically focusses on population health and, more specifically, the prevention of illness by focussing on the social determinants of heath that significantly affect outcomes for Māori. Therefore, public health units (PHUs) are major contributors to the health sector’s responsibility for addressing inequities in health for Māori. This research study is a Kaupapa Māori qualitative investigation into the experiences and observations of senior Māori public health practitioners in mainstream PHUs, particularly in relation to success factors for and barriers to successful practice. Senior Māori staff were defined as those who work or have worked in mainstream PHUs for five years or more. This study found that restrictions on Kaupapa Māori practice and cultural freedom in the PHU workplace was being experienced and/or observed by all the participants. The lack of value placed on mātauranga Māori, Kaupapa Māori practice and te ao Māori worldview was inherent in all the kōrero. Inconsistencies in human resource practices were observed relating to hiring for capacities that required te ao Māori knowledge, where appointments of non-Māori were commonly made based on other ‘knowledges’ and qualifications. Also observed was resourcing for professional development or for Māori projects generally not being prioritised and the existence of institutional barriers or institutional racism within these decisions. The public health sector needs to truly understand the damage that occurs by persisting in operating in a way which allows cultural erosion, seemingly with little desire to implement solutions. In the process of establishing and describing the enablers of and barriers to success for Māori working in public health units in Aotearoa, this study shows a need to actively implement solutions that mitigate the perpetuation of environments less suitable to Māori success or, better yet, create solutions that prevent damaging situations or environments from existing in the first place.