RESUMO
In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.
Assuntos
Acessibilidade aos Serviços de Saúde , Serviços de Saúde do Indígena , Direitos Sexuais e Reprodutivos , Austrália , Colonialismo , Feminino , Humanos , Tocologia , Nova Zelândia , Direitos do Paciente , Gravidez , Estados UnidosRESUMO
AIM: A nuanced healthcare framework, Te Ha o Whanau, aims to make the maternal-infant healthcare system more accessible and culturally responsive for Maori following unexpected events that led to the harm or loss of their baby. METHOD: Te Ha o Whanau was developed from three components. Firstly, it was grounded and informed by Kaupapa Maori qualitative research involving whanau who had experienced the harm or loss of their baby. These learnings were then combined with matauranga Maori (Maori knowledge) and built on three articles of Te Tiriti o Waitangi: Kawanatanga, Rangatiratanga and Oritetanga. RESULTS: Te Ha o Whanau has been developed to specifically guide the maternal-infant healthcare system in providing culturally responsive practice points and guidelines. These practice points and guidelines align with three tikanga Maori (customs): Tikanga manaakitanga, Tikanga rangatiratanga and Tikanga whakawhanaunga. CONCLUSION: To address the stark health inequities present, we must forge innovative models and strategies, rather than reproducing (less successful) paths that have the less resistance. Te Ha o Whanau is provided with the aim of providing better outcomes for all, not just Maori.
Assuntos
Serviços de Saúde do Indígena/organização & administração , Serviços de Saúde Materna/organização & administração , Havaiano Nativo ou Outro Ilhéu do Pacífico , Saúde Pública , Pesquisa Qualitativa , Feminino , Humanos , Nova ZelândiaAssuntos
Efeitos Psicossociais da Doença , Política de Saúde , Povos Indígenas/estatística & dados numéricos , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Feminino , Serviços de Saúde do Indígena/legislação & jurisprudência , Serviços de Saúde do Indígena/estatística & dados numéricos , Disparidades em Assistência à Saúde/legislação & jurisprudência , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Internacionalidade , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Saúde Pública/legislação & jurisprudência , Neoplasias do Colo do Útero/virologiaRESUMO
A research partnership between Iwi (tribal group) Ngati Pahauwera and a university-based research centre specialising in Kaupapa Maori (by Maori, for Maori) research was formed in response to an invitation from Ngati Pahauwera. The initial partnership goal was to address health inequities experienced by Maori women and infants in Te Wairoa (the home place of the Iwi), a predominantly Maori, rural region in Aotearoa (New Zealand). The research developed by the partnership is an example of a culturally responsive research methodology. Key features include: being Iwi-initiated; community identification of strengths and assets; guidance by a community steering group; contribution to local Maori research capacity; and the development of a community-led augmented maternity care pathway that is now being delivered through primary care. These features have strengthened the engagement of the Iwi, researchers and community, and provided opportunities for transformative change.