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Māori Clinical Leadership: Driving Improvement in Māori Health

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Thesis(2.89 MB)

Date

2024

Authors

Supervisor

Webster, Karen
Dewar, Jan

Item type

Thesis

Degree name

Doctor of Health Science

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Publisher

Auckland University of Technology

Abstract

Māori leadership in health is essential to expand and retain an Indigenous workforce, improve the experience of Māori receiving healthcare and to achieve Māori health equity and wellbeing. Māori clinical leaders play an important role in the direct provision of care and improvement of services for Māori accessing care in western dominant Crown health organisations. There is growing recognition and prioritisation of Māori leadership in high level health reports, however Māori health workforce numbers remain low. This research utilised kaupapa Māori knowledge and perspectives to investigate how Māori clinical leaders should be supported to thrive in Crown health organisations. Through the pūrākau of Māori clinical leaders this study illuminates the full scope of Māori clinical leadership work and makes recommendations for improvement that will create environments of thriving. Twelve Māori clinical leaders from medical, nursing and allied health professions were purposively recruited. Each participant was invited to share their pūrākau through unstructured kōrero. Data analysis utilised a pūrākau framework to articulate a collective pūrākau. Three main themes were generated: Foundations for leadership, whakamana, and grit and determination. Foundations for leadership, delves into participants' perceptions of how culture influences leadership. Participants emphasised the importance of authenticity and described the ways in which they strengthen their leadership foundations. Whakamana, encompasses the subthemes of awhi and tautoko. It highlights the importance of support and mentoring for and from Māori clinical leaders. Grit and determination, illustrates the resilience of Māori clinical leaders in overcoming obstacles to emerge stronger. This study demonstrates that Māori clinical leaders have power in clinical environments, reinforcing their technical expertise and their ability to affect change in clinical practice and for service delivery. It advocates for viewing Māori clinical leadership broadly across professions to enhance collective influence. Māori clinical leadership strengths include foundations in whakapapa, shared values in te ao Māori, a commitment to creating change, and the integration of cultural practices in clinical settings for the benefit of those accessing care. Recommendations include fostering a sense of self-identity through connection and both cultural and clinical development. Monitoring activity to hold Crown health organisations accountable for the growth of the Māori health workforce should be strengthened by expanding on definitions of leadership in policy. This study provides an evidence base around what constitutes as thriving to tautoko, uplift and illuminate experiences of Māori clinical leaders.

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http://hdl.handle.net/10292/18390

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Doctoral Theses