Abstract
Background: Whānau-centredness is core to Māori wellbeing. Western models of health, in contrast, tend to be deficit-framed and individualistic, although a more collective model can be seen in the concept of syndemics: conditions that cluster in populations and are amplified by health inequities. Through the voices of whānau and key informants, we investigated how a whānau-ora approach can inform the management of syndemics of long-term conditions and infectious diseases within primary health care.
Methods: The study team was gifted the Māori name Pūriri [a medicinal tree] by a community leader, enabling the concept of syndemics to be considered in a Te Ao Māori context. We undertook a qualitative kaupapa Māori study, conducting focus groups and interviews with purposively selected participants. We utilised descriptive and inductive thematic analysis.
Results: We identified several themes to guide appropriate management of syndemic conditions in primary care. Participants stressed the importance of whakawhanaungatanga and strengths-based practices when working with whānau; culturally appropriate services that are grounded in Māori worldviews; whānau engagement in care; and whakawhanaungatanga, which is also vital at the Provider level.
Conclusions: This paper reports findings from a Māori-led study, building on existing research focused on whānau-centred care and established approaches to Māori health. Building trusting, respectful connections through whakawhanaungatanga was seen as a central practice for engaging with Māori. Grounded in the symbolism of the Pūriri, these findings highlight pathways for primary health care to partner with whānau and communities in a whānau-ora approach to create enduring and equitable solutions to syndemics.