Activating Hauora Kaupapa: Realising Māori Aspirations and Disrupting Racism through Māori Health Workforce Transformation

Abstract

The mobilisation of mana motuhake – the autonomous authority inherent to whānau, hapū, Māori, and their communities to determine their destiny, is at the heart of this thesis. Grounded in te ao Māori – the world of Māori, this study offers hauora kaupapa as a foundational concept for realising Māori health and wellbeing aspirations. Within this study I argue that it is a pathway to asserting aspirations and disrupting racism through Māori health workforce transformation. Severe health inequities experienced by Māori, the Indigenous peoples of Aotearoa – New Zealand, are a consequence of institutional racism entrenched in Western-dominated health and health education systems. The Crown continues to compound these inequities with ongoing breaches of te Tiriti o Waitangi. Importantly, with regard to this thesis, advocacy for developing the Māori health workforce has been ongoing since the 1880s. In the last three decades, research has further highlighted the continued critical importance of such advocacy. This study employed kaupapa Māori methodology to explore the visions and values of Māori for health workforce development while simultaneously addressing racism that hinders its progress. Within this rangahau – Māori-led research, I worked alongside a rōpū rangahau – comprising of Māori and Pākehā researchers as critical allies who were committed to developing a Māori-specific theory of anti-racism within the health sector. Within this qualitative study, I completed secondary analysis of data comprising seventeen Māori health professionals with known expertise in transformative praxis and disrupting racism. This study provides insights into how to challenge and interrupt systems which entrench inequities, advocating for the assertions of Māori and Indigenous-led solutions. This rangahau affirms the whakapapa of hauora – embedded in te ao Māori, honouring the inseparable connections between tāngata, whenua, taiao (people, land, environment), and the celestial realms to the health and wellbeing of an individual. These relationships are key to developing the Māori health workforce while empowering the leadership of whānau, hapū, Māori, and communities. This rangahau asserts hauora and the critical intent of kaupapa Māori, alongside critical allyship, as key solutions to strengthening workforce development for transformative change.