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Te Pae Mahutonga: A model for Maori health promotion
Abstract
Original Reference Source: Durie, Mason (1999), 'Te Pae Mahutonga: a model for Mäori health promotion', Health Promotion Forum of New Zealand Newsletter 49, 2-5 December 1999. Introduction 1999 is an important milestone, not only for the obvious reason that it concludes the century and indeed the millennium, but also because it marks an important milestone in New Zealand's history and especially in the advancement of Mäori health. Next year, apart from the celebration of the new millennium in 2000, there will also be an opportunity to recognise the centennial of the Department of Public Health, the forerunner of what is now the Ministry of Health. But an important preliminary step had actually occurred in 1899. It was the graduation of Maui Pomare as the first Mäori medical practitioner. Almost immediately after returning to New Zealand, and following a brief internship at Cook County Hospital in Chicago, Pomare was appointed to the new Department of Public Health in 1901 as the first Mäori Medical Officer, at the age of twenty-five years. His duties included 'visiting the natives in their villages; inquiring and investigating into their general health; the conditions of water supply; and the enlightening of the native mind by means of lectures on all points concerning sanitation and hygiene and any social questions materially affecting the welfare of the race.' It was a prescription for a major health promotion programme. Over the next eight years Pomare adopted a five point health promotional plan. The first point was about health leadership. Pomare drew on two types of leadership. There was of course his own example and his combined accomplishments. To the extent that his years as Medical Officer to Mäori contributed to gains in health, his credibility lay equally with qualifications in medicine and with being Mäori. Without either, the impact of his leadership would have been less. And even if at times being a doctor seemed to clash with being a Mäori, more often than not the one augmented the other.
... We present our study outcomes under the framework of a Māori model of health promotion to approximate the holistic nature of Te Ao Māori (Māori worldview) conceptualizations of health and wellbeing. Te Pae Māhutonga (the Southern Cross star constellation), a culturally and historically significant Māori model of health developed by Sir Mason Durie [16], guides health initiatives by reflecting six elements applicable to Māori and broader NZ: ...
... Mauriora: Access to Te Ao Māori Mauriora, the flourishing of Māori identity, is essential for wellbeing. Embracing and strengthening Māori identity promotes positive health outcomes, highlighting the importance of cultural revitalization for overall wellbeing [16]. In this domain, we include various aspects of cultural identity such as cultural knowledge, practices, and language. ...
... Good health depends on many factors, but among indigenous peoples the world over, cultural identity is considered to be a critical prerequisite". (Durie 1999) [16] p. 2 ...
Māori, the Indigenous people of Aotearoa New Zealand, experience wide-ranging inequities compared with non-Māori. This survey aimed to explore the holistic health, wellbeing, and disability experiences of New Zealand’s Indigenous Māori population from a Māori worldview, addressing gaps in culturally relevant data often overlooked by standard health surveys. A robust cross-sectional survey was conducted with 7359 participants of Māori descent using Kaupapa Māori Research principles. Data were analysed using the Te Pae Māhutonga framework, a Māori health promotion model. Participants demonstrated strong cultural identity, with 32.3% understanding spoken Māori fairly well and 97.3% defining a broad non-nuclear concept of whānau (family). While over half reported high life satisfaction, 58.4% experienced discrimination, mainly based on ethnicity and appearance. Access to healthcare revealed that 32.6% were unable to contact a general practitioner due to cost. Socioeconomic challenges were prevalent; nearly a quarter borrowed from family or friends to meet daily living costs, and over a third economized on fresh produce to save money. This study reveals significant gaps in mainstream health data and demonstrates that a culturally aligned, methodological approach is feasible and crucial for informing policies that address the needs and rights of Māori, as guaranteed under Te Tiriti o Waitangi. These results could inform global, indigenous research addressing culturally relevant health, wellbeing and disability inequities.
... When designed effectively, these tests offer participants a more positive and comprehensive preventative experience during a single screening session (Bernstein et al., 2021). A whole-person, holistic, approach aligns with a number of Indigenous health models by recognising that health is multi-faceted and not condition specific (Durie, 1994(Durie, , 1999Pere et al., 1991;Williams and Ragg, 2023;Pulotu-Endemann, 2009). In Aotearoa New Zealand, Māori (Indigenous people) led community health provider approaches are founded in Māori understanding of health and incorporate a range of services (Rolleston et al., 2022), however it is not a usual model for more siloed, single-issue national screening or European-centric health delivery (Eggleton et al., 2022;Reweti, 2023). ...
... It communicates value from a te ao Māori perspective, in terms of what an initiative contributes to the mauri (life force) of a place. • Te Pae Mahutonga, a public health framework developed by Tā/Sir Mason Durie that lays out a set of public health conditions, including physical environments, needed for holistic Māori health and more broadly for health in Aotearoa New Zealand (Durie 1999). It communicates value in terms of whether and how something contributes to public health, informed by Māori cultural values but applicable more widely. ...
For scholars in academic institutions, the process of research usually begins with a question often gleaned from academic literature, progresses through some methods and results, then ends in writing and dissemination of the findings. ‘Impact’ is identified by trying to see if anyone takes up the research and uses it to inform policy or action outside of academia – with contemporary impact databases measuring this by whether it has been cited in policy documents. But this way of understanding impact is fundamentally at odds with researching community-led activism, where impact is already happening, and researchers engage with communities to document and evaluate the impact in ways that support the work. For activists out in the community, research and learning are happening all the time and have impact without anyone writing it up at all. This article reflects on a research project in the city of Ōtautahi Christchurch in Aotearoa New Zealand, where researchers and community activists began with ‘impact’ and ‘dissemination’. From there, we developed frameworks and methods, developed evidence, then ended with asking wider theoretical questions relevant to academic literature. Effectively, we reversed the order that research projects usually follow. In order to recognise this ‘reversed’ order, our article utilises a reversed structure, using the concept of thinking infrastructures to understand what academic research adds to the knowledges already produced in community impact.
... Tā Mason Durie's Te Whare Tapa Whā model of wellbeing (Durie 1985(Durie , 1999(Durie , 2023 was initially used in this study as an analytical framework to interpret and understand Māori informal caregivers' experiences of caregiving during the pandemic and the challenges, (cultural) needs and opportunities that they faced. This model conceptualises health and wellbeing as a whare (house) with four walls, each representing a dimension of Māori health and wellbeing. ...
Drawing upon Tā Mason Durie's Te Whare Tapa Whā model, this research explores the impact of the COVID-19 pandemic on the health and wellbeing of older Māori informal caregivers in Aotearoa New Zealand. Utilising information from 35 in-depth interviews conducted with Māori informal/whānau caregivers, this study identifies that the pandemic impacted the physical and mental health of Māori informal caregivers, facing challenges due to lockdown measures, limited access to support services and increased care responsibilities. However, the study predominantly highlights a range of positive aspects of informal caregiving during the pandemic, such as a sense of purpose and fulfilment in their role, enhanced appreciation for loved ones, and increased hononga and whanaungatanga. The study underscores the importance of cultural values and practices in maintaining the wellbeing of Māori informal caregivers and suggests the need for larger social changes to address structural injustices as well as inequalities. Overall, the study provides insights into the experiences of Māori informal caregivers and highlights the significance of recognising and addressing their health and wellbeing during times of crisis. ARTICLE HISTORY
... A rights-based approach to health is multidimensional and supports Māori concepts of health extending beyond physical interpretations. Indigenous worldviews often hold holistic perspectives of health that combines physical, intellectual, social, emotional, and spiritual dimensions which extends to natural environment (23). A rights-based approach ensures that the ultimate goal of health policy, strategy and programme delivery advance the realisation of the right to health and other health-related human rights as affirmed by national and international human rights legislation. ...
... Whānau may serve as guardians for family members with ocular conditions, representing a significant support system. 36,37 Including the opportunity for whānau to be included within the care journey of each patient is important, seeking to understand their role in the life of the patient, encouraging their questions and their involvement in the formulation of management/care plans, as appropriate. 17,20,21,34 This framework can be contextualised among existing Māori health frameworks such as Te Whare Tapa Whā, the Meihana model, the Hui process, and more, each of which has been developed to portray Māori health principles in an attempt to enhance Indigenous health equity. ...
Clinical relevance:
Development of an Indigenous eye health framework could offer the opportunity for eye health professionals to enhance engagement with Indigenous populations.
Background:
Indigenous populations globally experience disproportionately poorer eye health outcomes than non-Indigenous peoples. Incorporating Māori perspectives of eye care and pre-existing Indigenous models of health offers potential to enhance Māori experience and engagement with eye health services. This study seeks to develop and refine a practical framework for eye health care that incorporates nine established Indigenous health principles.
Methods:
Qualitative methodology, guided by Indigenous Māori research principles, was used to evaluate interviews with five leading senior Māori academics surrounding the ongoing development and refinement of a Kaupapa Māori (Māori worldview centric) framework for eye care in Aotearoa New Zealand, created following Māori health consumer consultation. Interviews were semi-structured and analysed using reflexive thematic analysis.
Results:
Seven key themes arose in relation to the development of a Kaupapa Māori framework for eye care in Aotearoa New Zealand: 1) vision is critical to Māori well-being, 2) cultural safety is important, 3) Māori health beliefs must be upheld, 4) achieving pae ora (healthy futures) is important, 5) key concepts and focus of the framework must be clear, 6) pūrākau (traditional Indigenous stories) are valuable resources in developing health frameworks and 7) embedding Matariki (fundamental Māori) principles is valuable.
Conclusions:
Using Kaupapa Māori principles allowed development and refinement of a framework that encourages clinicians to consider Indigenous health principles when engaging with Māori patients who seek eye care. Application of this framework may contribute to enhancing cultural safety and responsiveness of eye care for Māori.
... Comprising 17 percent of the total population, Māori have argued for greater autonomy to manage and deliver their own programs to overcome disparities. Central to this agenda is the recognition of the centrality of culture, identity and socio-economic factors to Māori health and well-being (Durie, 1999), and the institutional role of the Waitangi Tribunal. The tribunal operates in a semi-judicial role assessing whether actions by the Crown are in accordance with the principles of Te Tiriti o Waitangi. ...
"Te mā o te wai e rite ana, kia kite i nga tapuwae a te koura - The quality of the water is such that you can see the footsteps of the koura." Te Tuapapa Cultural Values Framework-Te Arawa Lakes Trust, 2015.
Waikōura (freshwater crayfish - Paranephrops planifrons), is a tāonga (treasure) and mahinga kai (traditional food and food gathering) species inhabiting Lake Rotorua that is of high cultural value to Te Arawa people. The research investigates how waikōura, as a lake mahinga kai species, is recognised and provided for in lake management decision processes. The Waikōura framework describes mātauranga Māori and scientific factors contributing to lake health including key measures: koura CPUE (catch-per-unit-effort), a measure of mahinga kai abundance, a cultural measure for lake health and lake TLI (trophic level index), an environmental measure for lake health.
1. The Waikōura framework is based on the Tuapapa - Te Arawa’s cultural values for the Rotorua lakes.
2. The Eco-Cultural Lake Systems model takes the two cultural and environmental lake health outcome measures and models them against current lake water quality management options to test the impact of each management option against each lake health outcomes. The Eco-Cultural Lake Systems model applies a System Dynamics Modelling approach and includes previously published research on waikōura in Lake Rotorua (Kusabs, 2015);
3. For cultural lake health, the multi-use and alum dosing option had negative impacts culturally, with decreasing waikōura abundance impacting on Te Arawa cultural values;
4. For environmental lake health, the multi-use and alum dosing options were effective at reaching the 4.2 TLI target in the 50-year modelled timeframe, increasing lake environmental health. Neither land use change or wetland options on their own achieved the TLI target.
5. The costs of implementing each water quality management option have been reported for nutrient removal but not for waikōura abundance. Further work is required to explore how the economic concepts are used to value waikōura abundance in future research.
6. Grounding research findings and aligning them with the Waikōura Framework provides a holistic view of lake health for Rotorua that is culturally grounded, environmentally accurate and economically focused in the services it provides locally and to New Zealand on a broader scale while ensuring multiple values and uses are sustainable now and into the future for Lake Rotorua.
This empirical research generates bicultural concepts and models to test the effects of lake water quality management options against cultural and environmental measures. Future work is required on the cost-effectiveness of water quality management options to achieve bicultural lake health outcomes and to ensure tāngata whenua freshwater cultural values are recognised and provided for to improve freshwater decision-making.
ResearchGate has not been able to resolve any references for this publication.