Seeing the unseen: evidence of kaupapa Māori health interventions

Abstract

Māori in Aotearoa have higher incidence, prevalence and mortality from chronic disease. The dominant narrative in Aotearoa about the reasons for Māori ill health neglects to acknowledge the history of colonisation and failures of the health system, alongside the holistic view of health taken by Māori focusing on collective, whānau-based outcomes. In this article, we review health interventions for chronic disease that have a kaupapa Māori philosophical basis. Our findings demonstrate that there is no clear process in health service design, delivery, research and funding that values and understands mātauranga Māori. Western knowledge systems are inadequate for collecting and presenting Māori knowledge. Overall, we highlight that the tension between acknowledging that a “by Māori, for Māori” approach is best, and the difficulty in defining appropriate evidence collection methodology and outcome measures when funders and policy makers continue to require Western-centric interventions is an obstacle to improving Māori health outcomes.