Abstract
Low immunisation rates are likely to result in a greater impact of vaccine preventable diseases within Aotearoa New Zealand. Current immunisation rates have shown us that the Māori and Pacific immunisation uptake is decreasing, increasing the risk of an outbreak in New Zealand, particularly among communities with high morbidities, low socioeconomic status and poor health.
The aim of this thesis is to explore Māori attitudes towards vaccination in a Māori community, focusing on childhood and maternal immunisations attitudes in the Takapūwāhia Pā community in Porirua, Wellington. This is to gain insights as to why Māori are choosing to receive or not receive immunisations, and what factors might be influencing their decision-making on immunisation.
A literature review has been conducted to understand findings and research that has already been conducted both nationally and internationally on this topic, which found key themes including vaccine hesitancy, immunisation knowledge and education, effects of interactions with the health system, delivery of immunisation services, community impact on immunisation decisions and Rongoā Māori.
The research presented in this thesis was of a qualitative nature and conducted within a Kaupapa Māori research methodology, in line with the tikanga of the Ngāti Toa Takapūwāhia Pā community. Nine participants were recruited for the study with the support of Ora Toa Takapūwāhia Medical Centre, where they participated in a semi structured interview process.
Key themes that arose from these interviews included education and information, experiences with the health system, importance of immunisations, systems and processes, Rongoā Māori and community impact.
Some similarities were found with the literature, including vaccine hesitancy and the effect of negative and positive immunisation and health system delivery experiences. However, some new insights were uncovered, such as feeling of community protection and importance of whānau when making decisions on vaccination. Although this is only from a small research cohort within a specific Māori community, these provide an insight into what the views and attitudes of Māori communities are towards immunisation, and how this has evolved.
The health system is currently going through major change, meaning there is now an unique opportunity with a clear Māori health strategic direction in place for positive advances to be made in pursuit of Māori health equity. This thesis makes four recommendations to increase immunisation uptake for Māori. These include increasing community developed and led education and information, increasing hauora Māori providers and delivery models to deliver immunisation services, growing the capacity and capability of the vaccinating workforce to reflect the community it is serving and increasing Māori health monitoring and evaluation of the immunisation system.
Māori solutions have shown to have worked at a community, regional and national level, however more work is needed to support this. Ultimately, immunisation is one of the most effective tools that we have to prevent whānau from suffering from vaccine-preventable disease, which disproportionately affect Māori. It is important that Māori vaccination rates continue so that we are able to continue to pass down Māori tikanga, purakau and way of life so that Māori can thrive for generations to come.