Abstract
Infectious diseases cause a considerable burden on health in Aotearoa New Zealand. Antimicrobial resistance (AMR) is an increasing threat to public health that affects the ability to treat existing and emerging infectious diseases. Māori suffer disproportionately worse health outcomes of infectious diseases in part due to AMR. Past research has applied a ‘One Health’ approach, which incorporates understandings of human, animal and environmental health together to understand and tackle the complexities of AMR, but the relevance of this approach within Te Ao Māori requires further study.
The aim of this study was to develop insight into Māori experts’ perspectives on AMR using a One Health approach to human, animal, and environmental health and within the current cultural and political context of Aotearoa New Zealand. Qualitative research methods were applied and were guided by kaupapa Māori principles. Semi-structured one-on-one interviews were conducted with nine Māori experts from a range of iwi and hapū across Aotearoa New Zealand (five experts working in human health, one in animal health and three in environmental health). All interviews were transcribed verbatim, and inductive thematic analysis was used to analyse the data. Four themes were identified that capture One Health considerations for AMR from the perspective of Māori experts: 1) ‘The importance of AMR education for Māori’, 2) ‘The connection of mātauranga Māori and AMR’, 3) ‘Colonisation and the negative impacts on hauora Māori’, and 4) ‘Collaboration across spheres of health as a priority for Māori’.
Overall, the findings illustrate how culturally appropriate education about AMR is important for Māori as part of achieving health equity. In addition, the findings support the recommendation that clinical education can help non-Māori health practitioners develop the skills needed to be more culturally safe. This kind of skill-building is needed to enable better health outcomes for Māori, including reducing the impact of AMR for Māori. Applying a Whānau Ora approach to AMR was identified as a pertinent way to minimise the impact of AMR in Aotearoa New Zealand. Based on these findings, greater recognition of a One Health approach to AMR grounded in Te Ao Māori should be a priority for government agencies and health organisations in Aotearoa New Zealand.