Ngā whakāro hauora Māori o te karu: Māori thoughts and considerations surrounding eye health

ABSTRACT

Clinical Relevance

Research highlighting Indigenous patient perspectives is essential in the pursuit of understanding and addressing longstanding health inequities.

Background

Evidence indicates that disparities in ocular health outcomes between Māori and non-Māori are pervasive in the New Zealand health system. Evidence shows the cause of these inequities is often multifactorial; due to factors such as colonisation, ongoing marginalisation, racism, socioeconomic status, poverty and culturally unsafe practice between health professionals and Māori patients.

Methods

This project used kaupapa Māori methodology to identify the perceptions of Māori surrounding ocular healthcare within a Māori context in Aotearoa New Zealand. Three focus groups with Māori community members and three individual interviews with Māori eyecare practitioners were conducted. Participants discussed sub-topics relating to Māori health, ocular health consultations, ocular examination and access to ocular health services in Aotearoa New Zealand. Reflexive thematic analysis was undertaken using NVivo qualitative research software.

Results

Five key themes were derived from the data: (1) the importance of effective clinician-patient communication; (2) historical experiences of patients inform their health attitudes; (3) barriers to access are systemic; (4) Māori health is important to Māori and (5) Te Ao Māori, Tikanga and Tapu are significant cultural concepts for Māori. Overall, Māori patients recognise the value of ocular healthcare and the importance of acknowledging Māori models of health within services.

Conclusion

The key issues Māori patients face within ocular health services resonate strongly with wider concepts intrinsically important to Māori. These are the right to cultural safety within clinical settings, the right to accurate and pertinent communication of information between clinician and patient and the respect of cultural beliefs and acknowledgement of power imbalances within the wider healthcare system. Participant discussions and suggestions raise possible pathways to begin addressing ocular ethnic disparities in healthcare delivery.

KEYWORDS:

• Indigenous eye health
• Kaupapa Māori
• Māori health
• New Zealand
• qualitative research

Acknowledgements

We would like to acknowledge the Health Research Council of New Zealand for generously supporting two Māori Health Summer Student scholarships. We gratefully acknowledge the generous support of Associate Professor Donna Cormack and Dr Sarah-Jane Paine of Te Kupenga Hauora Māori at the University of Auckland, New Zealand in guiding the qualitative and supporting the cultural aspects of the research. We would also to acknowledge our Māori advisors and consultants at Iwi United Engaged Ltd. This valuable mahi (work) would not be possible without the continued partnership with Māori communities, leaders, organisations and researchers – tēnā koutou, tēnā koutou, tēnā koutou katoa (Thank you, thank you, thank you all).

Disclosure statement

The authors have no commercial or proprietary interest in any concept or product described in this article.

Additional information

Funding

This research project was supported by the Health Research Council of New Zealand [Māori Health Research Summer Studentship 22/372 [IS], Māori Health Research Summer Studentship 22/375 [JP]].