Research highlights strengths and weaknesses in Māori providers

1 January 2009

The significance of Maori nurses in the “leadership, development and maintenance” of Maori health providers cannot be underestimated, a research report states.

The report on successful strategies by Māori providers also raised concern about the lack of clinical data about the effectiveness of cardiovascular disease and diabetes interventions.The Te Toi-Hauora-Nui research report, commissioned by the Ministry of Health, found Maori nurses “at the forefront of primary health care”. “Through this study we met a number of Māori nurses working at the coalface – inspiring, being persistent and empowering others to make life style changes.”

The Mauriora-ki-te-Ao (MKTA) research team did a literature review and studied models of practice by nine established Maori health service providers. It found that Māori providers had achieved a “great deal in a short amount of time” and despite complex and changing policy environments had established credible services that offered Māori and others a genuine alternative.

The research said while nurse services were often provided to complement GP intervention, for some providers, rural in particular, nurses were often the first (and possibly the only) point of contact for many patients.

Of the nine providers studied, two of the urban and two of the rural providers had nurse-led general practice services.

The study found unique features among Māori health services including being kaupapa Māori-inspired; being culturally authentic and responsive; dedicated to supporting Māori families achieve whanau ora – maximum health and well-being; taking a holistic approach to treating patients and their whanau; deploying multidisciplinary teams and having community buy-in.

But they also found a significant gap in the lack of clinical data and information about cardiovascular disease (CVD) and diabetes.

Only two organisations could present CVD patient figures, and four were able to do so for diabetes. Apart from one large provider, the team was unable to obtain statistical and medical information about the effectiveness of some interventions and, where data existed, there was limited expertise to collate and provide meaningful analysis. The research report said this gap “required immediate attention”.

Other issues included the need for sustainable funding and appropriate performance indicators, and ongoing recruitment and retention problems for clinical staff.