Early childhood caries (ECC): A Waikato-Tainui Kaupapa Maaori approach to reducing chronic illness dental decay amongst tamariki and mokopuna “He awa o Mokopuna oranga niho”

Abstract

Early childhood caries (ECC) are a significant health concern for Indigenous Maaori children in Aotearoa New Zealand. In an effort to address the significant impact of ECC on the health of Indigenous children, the Health Research Council (HRC) funded a randomised control trial (RCT) “Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention”. The study reported here, was a unique oral health collaborative Indigenous study in Australia, Canada, and Aotearoa New Zealand. A qualitative study was carried out to explore the experiences of waahine Maaori (Maaori women) of a randomised control trial to improve the oral health of their peepi (baby, babies). In addition, this study sought to understand the knowledge of, attitude toward, and practice of waahine Maaori for the oral health for their peepi (baby, babies); and to see if waahine Maaori were able to express their experiences and understandings within kawa/tikanga Maaori. The Kaupapa Maaori Research (KMR) philosophical framework utilised kaanohi-ki-te-kaanohi (face to face) interviews, puuraakau (stories, narratives) and adapted Motivational Interviewing (MI) to engage with waahine Maaori and whaanau (family, extended family) participants. The Te Niho Taniwha (TNT) iwi (tribe) Kaupapa Maaori model was developed as part of Kaupapa Waikato-Tainui to bring together a theoretical framework for the Waikato-Tainui iwi. The results reveal three key themes: Taonga Tuku Iho (gifts, knowledge, beliefs, values, and practices), Oranga Kai (Eating well) and Tamariki/Mokopuna ora (Health service access). Through the methodology, waahine Maaori shared experiences about ways to improve the oral health of their tamariki/peepi/mokopuna (children/baby, babies/grandchildren). Tuupuna (grandparents, ancestors), maatua (parents, fathers) and whaanau were seen to have an influential role in the outcomes of tamariki/peepi/mokopuna. The recommendations provided are focussed on achieving improved outcomes for Indigenous children and address practice, policy, and research. By adopting whaanau ora (maximising health and wellbeing for families) approaches to address ECC amongst Indigenous Maaori, particularly tamariki/peepi/mokopuna to achieve Mokopuna ora (health and wellbeing for future generation).