Table 1 Te Tiriti o Waitangi principles for the Aotearoa NZ health and disability system, their meaning and implications for implementation [59, 60]
Treaty principle | Meaning | Implications for implementation |
|---|---|---|
Tino rangatiratanga | Provision for Māori self-determination and mana motuhake in the design, delivery and monitoring of health and disability services | Opportunities for Māori leadership and self-determination, including alignment to Māori-defined aspirations and priorities, are maximised at each step of the pathway |
Equity | Commitment to achieving equitable health outcomes for Māori | Proactive focus on how Māori health equity has been fully considered and addressed in each step of the pathway |
Active protection | Acting, to the fullest extent practicable, to achieve equitable health outcomes for Māori. This includes ensuring that the Crown, its agents and its Treaty partner under Te Tiriti are well informed on the extent, and nature, of both Māori health outcomes and efforts to achieve Māori health equity | Support Māori community readiness to enable the full and authentic engagement of whānau and communities in the implementation process |
Options | Provision and proper resourcing for kaupapa Māori health and disability services. Furthermore, the Crown is obliged to ensure that all health and disability services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care | Ensure inclusion of Māori expertise to more fully understand Māori health inequity and needs, and enable implementation that is informed by mātauranga Māori (including Māori models of healthcare), conducive to kaupapa Māori approaches, has a decolonisation orientation and is impactful. Ensure organisational readiness, such as cultural safety capacity |
Partnership | Working in partnership with Māori in the governance, design, delivery and monitoring of health and disability services – Māori must be co-designers, with the Crown, of the primary health system for Māori | Work in genuine partnership with Māori throughout the implementation process. Practice co-design with Māori communities |