Tuesday, December 10, 2019

Maori Health

Question: Discuss about theMaori Health. Answer: Introduction: Maori is a group of indigenous people who have settled in New Zealand even before the Europeans colonized at about 1000 years ago (Kinloch Metge, 2014). Since those days, several instances have been reported where racial discriminations have been the basic reason for the various inequities faced by the indigenous peoples. If one needs to focus on the inequities faced by the Maoris, the entire discussion becomes a broad topic because many reasons can be noted that culminates into a number of inequities. This report contains a detailed analysis of the inequities faced by Maori in New Zealand during attaining health services, major health issue of the Maoris and the framework by which the three principles of the Waitangi can be applied in creating a successful health service provision. A Critical Analysis of the Reasons why Maori Suffer Health Inequity/Poorer Health /outcomes: Absence of systematic disparities in the different determinants of health among the different social groups occupying different positions of hierarchy is the sole reason for health inequities among the Maoris (Clark et al., 2014). Of the various causes that lead to inequities among the Maoris in the health care sectors, we can select different factors that would be the topic of the discussion here. Lack of proper access to healthcares often resulted in the increased number of mortality in the Maori. This can be well documented from the statistical records over the years, which have shown that a large proportion of mortality among The Maori can still be found when even the effective health care systems are available in the different health centres of New Zealand. This shows differences in the extent and rate of the health care services that are being provided to the Maori in comparison to that of the non-Maoris. Inaccessibility to health care is not only through limited scopes to avai l the different services from the healthcare providers but also through the quality of the service that is provided which is also compromised (Brannelly, Boulton Hiini, 2013). Racial discrimination has often resulted as major issue while gaining access to healthcare services. An Understanding of the Treaty of Waitangi in Relation to the three Ps: The treaty of Waitangi was signed between the Maoris of New Zealand and the British people in order to finalize the rights that both the groups would share and perform business and agriculture. It aimed to protect the Maori peoples from losing their lands to the colonizing powers and to regulate the British subjects and secure each others commercial interests as well (Orange, 2015). Coming to the main impact that the treaty of Waitangi had on the health concerns on the Maori peoples, three important principles can be pointed that leads to the establishment of the health policy of the Maori peoples (Robson Ellison, 2016). Partnership: This part of the principle was the result of the treaty that was made between the Iwi and Crown to develop the working procedure of the then government and Maori. This principle mainly deals with the maintenance of both the government and the Maori to actively take part in discussions and meetings and contribute their valuable suggestions for the betterment of the livelihood of the indigenous people of New Zealand ("Treaty of Waitangi principles", 2014). They should be included in any healthcare implementation programs allowing them to show their likes and dislikes in various fields like during making and implementation of laws and strategies (Scott, 2013). Participation: This principle of the Treaty of Waitangi mainly concerns the involvement of the Maori in every field of healthcare organisations and encourages the active participation in various arenas for leading a quality life such as decision making, planning, and development and also for proper delivery of services in the health sectors of New Zealand. Proper maintenance of the treaty would help the Maoris to share and receive equal opportunities to receive health services from the hospital service providers. Protection: This principle of the treaty of the Waitangi covers the protection issues of the Maori. This treaty states that the government should be responsible enough to provide same level of protection to the Maori as given to the Non Maori, which implies that no discrimination should be present in terms of the protection provided to both the groups. This principle mainly sates that the Maori should experience equal health outcomes and complete elimination of (health) inequity by protecting their ethical and moral values (Makowharemahihi et al., 2016). Specific Health Issue: A specific health issue that has been seen to affect the Maori in great number is the occurrence of the asthma problems among their populations. Reviews have shown asthma as a critical health issue that often affects Maori and Non Maori children in same number but an astonishing fact is observed here. With the growing age, the prevalence of asthma decreases in Children from non-Maori background but a reciprocal outcome is observed in Maori ("Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide - New Zealand Medical Journal", 2016). With the gradual increase in age of the Maori, the prevalence of asthma increases in the Maori. Statistical data obtained from a review in the year 1989 to 1983 showed that death rate in case of the Maori was 18.9 per 100000 in comparison to the non-Maori, which were only 3.4 per 100000 (Gillies et al., 2013). However, the rate was seen to decrease in the following years as known from the review of 1991 although the rate of the deaths remain higher in the Maori than the Non Maori. Maori people over the age of 25 has increased rate of asthma attacks in comparison to that of the non Maori people mainly because of theory ethnicity and social practises (Radhakrishnan Hew, 2015). There are many reasons out of which one is the environmental exposures to tobacco smoke and lack of proper management. This can be explained as a reason of the decreasing of asthma with age in non-Maori but the increase in attacks in the Maori. Researchers have noted that inappropriate management systems and lack of proper health education are other contributing factors that result in increasing prevalence of asthma among the adults from their childhood age. Smith Pierce (1980) have already shown that the increased number of deaths like about 30 to 40 % is mainly because of asthma for which effective treatment and health care is available. This proved of the deficiency of proper accessibility to health care services by the Maori in comparison of the non-Maori. A study has shown that Mori are unable to utilise a peak flow meter and does not include any action plan. Moreover, studies also show that 33% of the Maori children do not receive an asthma drugs before 24 hours of admission in hospital, which is only 14% in case of non-Maori. From this information, it is evident that an immediate need of a pro per Maori health policy in order to assess the importance of the health consequences and take necessary steps. Treaty of Waitangi as a Framework for Health Provision: Partnership: The New Zealand government has put forward different projects and initiatives in order to include the the Mori leaderships for proper development of programmes that would include asthma management systems. These involvement and partnership of both the government and Mori leaders would help to provide proper access to asthma care and facilitate wrap around services ("Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide - New Zealand Medical Journal", 2016). Participation: The government should involve active participation of the Maori people including children and adults in health literacy program and asthma education to overcome the lack of knowledge and constraints of ethnicity and save themselves from the effects of asthma. He maramatanga huango: Asthma health literacy for Maori children in New Zealand although proposed by the government taking children in mind but also includes the Maori adults (Davidson Sheikh, 2013). Active participation from the Maori individuals and the governmental heal educators would make this a success. Protection: Asthma providers have sought for clinical audits and programmes handling the quality improvement initiatives. These would help the government to monitor and improve the asthma care and provide best outcomes for the complete protection of the Maori individuals suffering from asthma (Pilchar et al., 2015). They have also provided staffs that would help to develop skills governing cultural competency to protect them and help them to engage them in line with professional requirements. Moreover, the New Zealand Nurses organisations have appointed many nurses to work with Maori thereby protecting them from various associated effects of respiratory problems along with asthma. A sense of helping A very good example is set by the doctor of European origin namely Cath Becker who is loved by a huge number of Maori because of the cultural sensitivity that she exhibits during her treatment. Her knowledge about the way Maori people conducts their duties and rituals with their different sets of eth ics has indeed helped her to handle the sentiments of the Maori patients along with taking care of their health aspects ("WHO | Primary health care the New Zealand way", 2016). Conclusion: This report shows that Leadership quality in the initiator, Knowledge about the ethics and values of the the Maori and also their various types of diseases that affect them and also perfect Communication between the concerned stakeholders and other groups would ultimately help in making lives better for the Maori in coming generation. Asthma issue have become a major concern and the framework supported by the Treaty of Waitangi is required in order to protect the people from further destruction and loss of lives. References: (2016). Retrieved 27 October 2016, from https://www.health.govt.nz/system/files/documents/publications/health-maori-adults-children-summary.pdf Brannelly, T., Boulton, A., te Hiini, A. (2013). A relationship between the ethics of care and M?ori worldviewthe place of relationality and care in Maori mental health service provision.Ethics and Social Welfare,7(4), 410-422. Clark, T. C., Johnson, E. A., Kekus, M., Newman, J., Patel, P. S., Fleming, T., Robinson, E. (2014). Facilitating access to effective and appropriate care for youth with mild to moderate mental health concerns in new zealand.Journal of Child and Adolescent Psychiatric Nursing,27(4), 190-200. Davidson, E., Sheikh, A. (2013). Tackling ethnic variations in asthma outcomes in New Zealand's Mori and Pacific children will need a long-term strategy.Primary Care Respiratory Journal,22, 269-270. Gillies, T. D., Tomlin, A. M., Dovey, S. M., Tilyard, M. W. (2013). Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases.Primary Care Respiratory Journal,22, 312-318. https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2016/vol-129-no-1445-18-november-2016/7068 Keating, G., Jaine, R. (2016). What supports are needed by New Zealand primary care to improve equity and quality?.Journal of Primary Health Care. Kinloch, P., Metge, J. (2014).Talking past each other: problems of cross cultural commu Makowharemahihi, C., Wall, J., Keay, G., Britton, C., McGibbon, M., LeGeyt, P., ... Signal, V. (2016). Quality Improvement: Indigenous Influence in Oral Health Policy, Process, and Practice.Journal of health care for the poor and underserved,27(1), 54-60. Orange, C. (2015).The treaty of Waitangi. Bridget Williams Books. Pilcher, J., Patel, M., Smith, A., Davies, C., Pritchard, A., Travers, J., ... Harwood, M. (2014). Combination budesonide/formoterol inhaler as maintenance and reliever therapy in M?ori with asthma.Respirology,19(6), 842-851. Radhakrishna, N., Hew, M. (2014). Addressing ethnic disparity in asthma trials.Respirology,19(6), 775-776. Robson, B., Ellison?Loschmann, L. (2016). M?ori and cancer care in Aotearoa/New Zealandresponses to disparities.European journal of cancer care,25(2), 214-218. Scott, N. (2013). A M?ori cultural reluctance to present for care, or a systems and quality failure? How we pose the issue, informs our solutions. Treaty of Waitangi principles. (2014). Ministry of Health NZ. Retrieved 22 October 2016, from https://www.health.govt.nz/our-work/populations/maori-health/he-korowai-oranga/strengthening-he-korowai-oranga/treaty-waitangi-principles WHO | Primary health care the New Zealand way. (2016). Who.int. Retrieved 22 October 2016, from https://www.who.int/bulletin/volumes/86/7/08-030708/en/

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