Abstract
Introduction: The extent to which tikanga is integrated into clinical practice within hospitals across Aotearoa, New Zealand is scarcely understood. Based on my medical training in hospitals and the experiences from whānau and colleagues, my understanding was that tikanga is largely absent from health care.
Aim: This dissertation aims to explore how tikanga is currently applied within hospitals across Aotearoa, New Zealand.
Methods: This research is guided by kaupapa Māori theory, which allows for this research to be centred within my own worldview, a Māori worldview. A literature review was initially completed to understand what national literature speaks to this topic. Then five interviews were conducted with Māori health professionals’ working in different hospitals across the country (three in the North Island, two in the South Island) to gain insights into their experiences of the application of tikanga. Finally, a content analysis was completed on all of the national District Health Board tikanga guidelines.
Results: Sixty-five articles were included in the literature review. These articles could be split into four main categories: (1) the experience of tikanga within a service; (2) the implementation of a tikanga model centred in te ao Māori; (3) the description of the application of tikanga; and (4) the perspectives and thoughts of people within a health service in relation to tikanga. From the five interviews three themes were identified: (1) the application of tikanga; (2) the trajectory of tikanga application: and (3) system-based limitations. Results from the content analysis of the National DHB guidelines found that every DHB has a form of either a tikanga guideline or a Māori health plan. Half of these guidelines were identical to each other, the only difference being the name of the area the document applied to had changed. Content of the guidelines included a series of instructions health professionals were expected to incorporate into their clinical practice.
Conclusion: Tikanga application is limited within clinical practice due to a lack of education, a lack of Māori health professionals’, and system based limitations. Despite tikanga guidelines being written and provided for hospitals within a district, the guidelines are rarely used. I recommend that Te Whatu Ora re-write the tikanga guidelines, placing them within the context of te ao Māori and working in partnership with local iwi in each region of Aotearoa, New Zealand.