Navigating the space between co-design and mahitahi: Building bridges between knowledge systems on behalf of communities.

AIMS: To provide knowledge and recommendations for researchers, health professionals and policymakers on navigating between science and matauranga (knowledge) Maori when using co-design methodologies. CONTEXT: It is well known that the health system in Aotearoa/New Zealand does not provide culturally responsive services, programmes or approaches. Indigenous, remote and vulnerable populations that are not well served by medical and scientific models would be better served by the underlying premise of co-design methodology. However, co-design is a Western methodology. Mahitahi is presented here as a culturally responsive method of co-design that builds approaches by utilising the worldview of the people that the health system most needs to have impact upon. Co-design and mahitahi have synergies, and working at the interface between Western and Maori knowledge systems can provide innovative solutions that draw on the strengths of both approaches. APPROACH: Authors will outline the benefit co-design processes have for improving health outcomes for remote and vulnerable populations. Mahitahi will be described and the synergies with co-design emphasised with important distinctions also highlighted. The use of Indigenous knowledge systems, using Maori as the case example, will be outlined. CONCLUSION: Recommendations will be provided to guide researchers, health professionals and policy makers when planning a co-design approach with remote and vulnerable communities.

Cultural context in New Zealand: incorporating kaupapa Maori values in clinical research and practice.

We examined the importance of understanding and incorporating cultural context within Aotearoa/New Zealand when engaging in clinical research and practice. This paper reports on the qualitative findings of a mixed methods study aimed at determining what effect a cardiac risk reduction exercise and lifestyle management programme, embedded within a kaupapa Maori methodological approach, had on Maori participants. This methodology saw participants able to redevelop a western model cardiac risk reduction programme by introducing a Maori worldview. Our study revealed how the kaupapa Maori approach empowered participants to examine and evaluate not only their own health and lifestyle choices, but those of family and the wider community. Combining biomedical and kaupapa Maori components into the programme was found to benefit participants' mental, physical, spiritual and family well-being.