![]() 4 Practices associated with colonisation include reduced access to social determinants of health, 5 higher rates of preventable, adverse in-hospital events, 6 and increased likelihood of inappropriate care and follow-up. 3 Inequitable Māori healthcare outcomes are consistent with broader Indigenous experiences of colonisation that include theft of land, degradation of language, racist policies, discrimination and social exclusion. 2 Colonisation fundamentally disrupted these systems, with newly imposed health systems (including hospitals) configured primarily to serve Pākehā (New Zealanders of European descent). Prior to colonisation, Māori had developed health structures and systems tailored to themselves, their environment and collective concepts of health. 1 This form of service provision disadvantages Māori, the Indigenous people of Aotearoa New Zealand. However, this publicly funded health service is designed to privilege individualistic approaches, clinical discourses and acute need. Implications for public health: Public health providers must find ways to ensure that Māori consistently experience positive, high-quality healthcare interactions that support Māori ways of being.Īotearoa New Zealand's publicly funded, universal health system incorporates free inpatient and outpatient public hospital services, subsidies on prescription items, subsidised primary healthcare and a range of support services for people with disabilities in the community. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Facilitators were categorised as the provision of whānau support in the form of practical assistance, emotional care and health system navigation.Ĭonclusions: For many Māori, the existing public health system is experienced as hostile and alienating. We categorised barriers as organisational structures, staff interactions and practical considerations. Results: Māori patients and whānau from the included papers mention both barriers and facilitators to health. ![]() We undertook a qualitative metasynthesis on these papers using a critical community psychology approach. Methods: A systematic search using PRISMA protocols and reflexive typology organised around the categories of Māori, public healthcare and qualitative research identified 14 papers that covered all three categories. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’ Objective: This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system.
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