Provider Perspectives on Heart Healthcare Inequities Among Māori and Pacific Peoples in Aotearoa New Zealand: A Qualitative Study

Abstract

Objective: We explored service providers’ views on evidence–practice gaps and inequities in heart health care for Māori and Pacific peoples, alongside solutions to address these issues. Methods: Employing Kaupapa Māori and Pacific research methodologies, we recruited Māori, Pacific, and non-Māori/Pacific providers, purposively sampled from a range of disciplines. Semi-structured interviews were conducted individually and in focus groups. Differences in perspectives offered by Māori and Pacific providers are compared to those of non-Māori/Pacific providers. Results: Twenty-three providers, identifying as Māori (6), Pacific (5), or non-Māori/Pacific (12), shared their views of the healthcare system, experiences of providing care, and observations of Māori and Pacific patient and whānau experiences. Results were grouped into three themes: Tikanga Māori and Fa'a Pasifika versus non-Māori/Pacific ways; gaps in the health system for Māori and Pacific patients; and solutions. Māori and Pacific providers emphasised structural determinants, systemic failures and workforce inadequacies underlying inequities. Conclusions: There is a critical need for equity-focused, holistic and relational models of heart health care that are co-designed with Māori and Pacific patients and whānau, and delivered by a culturally safe workforce. Implications for Public Health: Adequately resourced services, designed by and for Māori and Pacific peoples, have the potential to achieve equitable heart health care outcomes.