A Re p ort to the Ministry of Health HAUORA WAHINE MAORI C RECENT DIRECTIONS FOR MA01U WOMENs HEALTH 1984-1994 a Ii STACK KOTUKU PARTNERS WA OCTOBER, 1994 I 1Oij3j HAW MOH Library 1994 IIIIIIff 101185M * A Report to the •Popul a t ion- H eal th x &a f Ministry of Health HAuoRA WxHiNE MAom RECENT DIRECTIONS FOR MAORI WOMENS HEALTH 1984-1994 KOTUKU PARTNERS OCTOBER, 1994 •mon CiIre & y of iteTh wi^_"I;ion (.k Introduction II It, 3. lO999jc13 This report has been prepared by Kotuku Partners for the Population Health Services Section of the Ministry of Health and the Ministerial Advisory Committee on Womens Health. This report covers hui, writings, consultations with Mãori, and Mãori views on Health and Health Services over the period 1980-1994. This extract specifically covers Mäori Womens Health. Introduction III TABLE OF CONTENTS Table of Contents iii Introduction••••••e••••••••s•••••••s•••s.............................................................. ix Major Themes - 11ãori Women health •••••••e...ss...S..s...................... Xjjj ManaWãhine ...............................................................................................xiii HauoraMãon ...............................................................................................xiv Highlights - Mãori Womens Health Status...................................................xv Leading Causes ofDeath....................................................................xvi Leading Causes of Hospitalisation.....................................................xvi Priority Ranking Diseases and Conditions.........................................xvii Directions - Health Services..........................................................................xviii Directions - Policy ........................................................................................ xx Directions - Research....................................................................................xxiv Directions - Mãori and the Health Reforms...................................................xxv Treatyof Waitangi ......................................................................................... xxvi GovernmentAgencies ................................................................................... xxvii Recent Mãori Affairs Policy Statements .......................................................xxx Part Chapter1 Overview ••.s.....................SS..S.S.S..._..................... .nn. 1 1 .1 Methodology...........................................................................................2 1.2 Reports Analysed ....................................................................................3 A Brief Chronology of Health Among Mãori and Pãkehã................ 6 Chapter Two The Treaty of Waitangi ....................................... 15 English Version of the Treaty of %Saitangi......................................... 16 Mläori 'Version of the Treaty of Waitangi ........................................... 17 L. non CiAre &. ry of Health We.nton Introduction IV 2.1 Recognition of the Treaty of Waitangi.....................................................18 2.2 Principles for Crown Action on the Treaty of Waitangi...........................20 2.3 New Zealand Mãori Council - 10 Implicit Principles...............................21 2.4 The Treaty of Waitangi and Health Care .................................................21 2.5 Tino Rangatiratanga and the Treaty of Waitangi ...................................... 23 Government Agencies 24 2.6 Kawanatanga and the role of Government ............................................... 24 2.7 Ministry of Womens Affairs - Minitatanga mö nga Wãhine .................... 24 TeOhu Whakatupu.............................................................................25 Government Outcomes for Women.....................................................25 2.8 Te ManatU Hauora - Ministry of Health...................................................26 2.9Rangapfl Hauora Tumatanui - Public Health Commission.......................26 Whdia te ora mô te Iwi - Sfrive for the good health of the people................................................................................................27 Government Outcomes for Health ......................................................28 2.10 Te Pum Kökiri - Ministry of Mãon Development ................................... 30 Government Outcomes for Mãori Development: Mdori Health................................................................................................30 Chapter Three Recent Mãori Affairs Policy Statements .............. 31 3.1 Te Urupare RangapU ...............................................................................32 The Development Decade 1984 - 1994...............................................35 3.2KaAwatea ............................................................................................... 36 3.3 Towards 2010 - The Next 3 Years ........................................................... 38 FU ChapterFour Consultation •....................S.............S......U••••••S••••tS 41 4.1 Guidelines for Consulting Women and Mãori Women............................42 4.2 Consultation Guidelines ..........................................................................42 4.3 A Guide for Departments on Consultation with Iwi ................................. 43 Chapter Five Significant Health Hui 1984 - 1994................. 45 5.1 Hui Whakaoranga .................................................................................... 46 Details................................................................................................ 46 Kaupapa............................................................................................. 46 Proceedings/Recommendations .......................................................... 46 5.2 Hui Taumata ............................................................................................ 53 Details................................................................................................ Kaupapa.............................................................................................53 Proceedings.......................................................................................53 5.3 Hui-a-Iwi: Nursing Education and Services............................................ 54 Details.................................................................................................54 Kaupapa.............................................................................................54 Introduction V Proceedings.54 5.4 Cultural Considerations in Health............................................................ 56 Details................................................................................................56 Kaupapa.............................................................................................. 56 Proceedings.......................................................................................56 5.5 Hui - Te Ara Ahu Whakamua.................................................................. 58 Details/Kaupapa .................................................................................58 Proceedings1......................................................................................58 Proceedings2.....................................................................................60 Analysis of Hui Te Ara Ahu Whakamua - Kotuku Report....................60 Chapter Six Significant Health Research.................................. 63 6.1 Rapuora...................................................................................................64 6.2 Hauora: Mãorj Standards of Health: 1970-1984.....................................76 6.3 Te Kohikohinga: A Mãori Health Knowledge Base................................80 Ilauora iIlAori literature Review •••••••S••SSS••••••S••••S•••••.............fl.flflfl... 81 MentalHealth, Hearing and Asthina.............................................. 85 6.4 Mental Health - Nga la o te Oranga Hinengaro Mãori ............................. 85 Details/Kaupapa ................................................................................85 Proceedings.......................................................................................85 6.5 Whakarongo Mai ..................................................................................... 88 Details................................................................................................88 Proceedings........................................................................................88 6.6 He Mate Huango - Mãori Asthma Review ................ ............................... 91 Details................................................................................................91 Proceedings.......................................................................................91 Chapter Seven The Health Reforms and Mãori ....................... 93 7.1 Treaty and the Health Reforms ................................................................ 94 7.2 A Summary of Mãori Concerns ........... ....................................................94 7.3 Core Health & Disability Support Services .............................................. 95 7.4 Guiding Principles...................................................................................96 Introduction A PARTj ••••••••••••••••••••••••• . ......................S... 99 Chapter Eight \\ãhine Pvlãori....................................................