2. The principles of kawanatanga and tinorangatiratanga and its impact on the delivery of effective healthcare services.
a.) tino rangatiratanga and Maori self-determination over health
Since the signing of the Treaty of Waitangi in 1840, there have been problems within the Maori community. For instance, majority of the Maori chiefs were deprived of sustaining the power to rule community. With this big issue, it influences the delivery of effective healthcare services to the Maori people.
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There were Maori people who became a health practitioner during the early years. Some of them became a doctor. One of the Maori pioneers in the promotion of health is Maui Pomare. He became a successful doctor and a good example of a health leader. During his time, he vigilantly promote health by sharing his knowledge to his people. He gave suggestions and ideas to his native people so they can have a better way of healthy living. For example, he promoted proper hygiene and good sanitation. He also encouraged them to improve and maintain a good environment and safe water supply.
Maori self-determination over health is an excellent way on how they really want to improve their way of living. It is basically a way of how to deal independently with tough situations so they can survive with the ever changing world. They promote a good and effective system that will suit to their needs of their native people (Maori). One good example is during 2010, a group of Maori health practitioner (nurses) who made an initiative in providing health care support to a community of native Maori and became successful due to the assistance that they received from the government.
As mentioned above, the Treaty of Waitangi has a big impact on how the government deals with the Maori people. The Tino rangatiratanga, which means full authority of the Maori chieftains over their lands, villages and treasured things, has been a big issue until now. For the past years, the Maori people received less support from the government. Their cry for reforms were neglected. In terms of receiving effective healthcare services, the Maori people receive less. Aside from that, there are more Maori people who are poor, less educated, receive low salary, and a lower life expectancy than the non-Maori.
In my opinion, the delivery of effective healthcare services will be attained if the government will allow the Maori people to participate in the decision making and planning of healthcare services for the Maori people. It will be good if they will be able to find a way to solve the issues relating to the Tino rangatiratanga of the Maori people. In addition, it will be helpful if the non-Maori will support activities and plan to help the Maori community receives a better healthcare services.
b.) impact of Maori identity, beliefs, values and practices on healthcare practice
The Maori identity changes as the years go by. Since their first interaction with the Europeans during 19th century until the present day, they continue to adapt to the system headed by the crown. During the early years, Maori people experienced prejudice. They were not treated fairly by the government. There are few educated Maori due to lack of support system from the government. During 1960s, there were Maori who were against the government. Many activist was formed in order to get the attention of the government. In the 1970s, they started to gain attention from the government, and there was a gradual progress of health care practice in Maori community. Despite the improvement in health care, until now the Maori has a poor healthcare practice. One of the contributing factors for this is their low educational attainment. A good evidence of this is that they have the highest death rate among other people living in New Zealand. In addition, for the Maori, a tattoo on a face is important for them. It is a part of their identity. By understanding and respecting them, they can be given a better health care management.
Maori belief has a huge impact on healthcare practice. Majority of the Maori people believe on many gods. They worship idols and other non-living things. Maori believes that if they were sick, the gods are punishing them. Instead of seeking help from a doctor they will go to their religious leaders. As a result, there is high death rate among Maori people than the non-Maori.
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Maori values and practices are associated with status (mana), restriction/protection (tapu), and revenge/ maintenance of balance (utu). This values and practices affect the healthcare practice by causing some conflicts and misunderstanding with the healthcare provider. As a result, Maori people tends to break the treatment plan created by the healthcare provider which leads to poor treatment outcome.
It is vital to recognize the identity, beliefs, values and practices of the Maori in the aspect of healthcare practice. Recognition by the healthcare provider of Maori identity, beliefs, values and practices has a big impact on healthcare practice. Government actions on fulfilling the principles of the Treaty of Waitangi will help to initiate improvements on healthcare practice for Maori people.
c.) impact of healthcare provider’s own culture, history, attitudes and life experiences on Maori consumers
The healthcare provider’s own culture, history, attitudes and life experiences has a big impact on Maori consumers. This is evident on the studies conducted by various groups of the past years that focused on Maori health issues. According to the different health statistics, Maori has the highest rate of death among the different people living in New Zealand. The causes are related to misunderstanding, discrimination, mistrust, and non-recognition of identity of Maori. This is basically due to the differences between the groups of people that have lived together, the Maori and the non-Maori.
Different programs have been implemented by the government to aid the Maori people to receive a good quality of health service from various healthcare providers. Some health sectors, like the Nursing Council of New Zealand, have made guidelines for nursing education for giving the nurses a view and knowledge on identifying barriers that must be eliminated in giving care for the Maori consumers.
Non Maori (pakeha) healthcare provider’s culture, history, attitudes and life experiences are different from the Maori. The populace of New Zealand composed of people who come from different parts of the globe and they can have different beliefs and traditions. Because of their differences, it can be difficult to give proper healthcare needs of consumers. It is necessary for the healthcare provider (pakeha) to recognize that the Maori consumers are diverse. If not recognized, healthcare provider will give a poor healthcare service to the Maori consumers. An example is, if a Non Maori received a bad experience from a healthcare provider, the next time he wishes to seek help from a healthcare provider, he will still seek help to the same healthcare provider. On the other hand, many Maori consumers, if they received a news that one of them have a bad experience from a certain healthcare provider, they will be discouraged and instead of seeking help for their poor health condition, they will just go to their elders for help. Recognizing that the Maori consumers are diverse will also help promote understanding, trust, and respect that are necessary for building a good relationship.
All in all, understanding the Maori people is necessary to become a good healthcare provider. Health support programs must continue to strive and work hand in hand with the Maori to achieve a successful outcome.
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