Maaori Midwifery

HEATHER MURIWAI 

Clinical Lead Advisor – Maaori Midwifery

He pou koorero

(statement of intention)

Ko te tumanako a tenei poaari he whakarato i teetahi o ngaa taupori Maaori nui, taupori Maaori matatini, puta noa i te motu. Ko te whakakikokiko i te mana-taurite hauora Maaori teetahi o aa maatou tino whaainga. Ko too maatou hiahia ko te whakamana, ko te whakatinana hoki i te wairua me ngaa maataapono o Te Tiriti o Waitangi hei tuuaapapa i taa maatou e whai nei, me te whakapono nui -maa te aata whakapakari i te ara whakawaiora Maaori e taea ai te whakatutuki i te mana taurite hauora moo te katoa As a district health board, we serve one of the largest and most diverse Maaori populations in the country. Achieving Maaori health equity is a key priority for us. Our commitment to this is driven by our desire to acknowledge and respect the Treaty of Waitangi and our belief that if we are serious about achieving health equity for our total population, we must first strengthen our commitment and drive to accelerate Maaori health gain in our community.

(COUNTIES MANUKAU HEALTH 2020/21 ANNUAL PLAN)

It was with this intention as a focus that the position of clinical lead advisor, Maaori midwifery was created within the Maaori Health team. The position is a key senior midwifery leadership position, and Heather Muriwai (Tangahoe) was appointed to the role in July 2019.

The lead clinical advisor, Maaori midwifery supports CM Health’s transition to a fully integrated whole-of-system approach that will ensure it becomes a leader in providing services to Maaori and whaanau.

Recruiting and retaining a Maaori midwifery workforce and achieving health equity are overarching goals for the health board. They will be achieved by: • engaging with mana whenua and Maaori communities to establish strategic priorities for Maaori maternity and midwifery, and services for mama, peepi and tamariki

• building and maintaining strong external working relationships with non-governmental organisations, primary health organisations and tertiary education providers • maintaining a strong focus on quality improvement that enables innovation and challenges practice • optimising research opportunities with tertiary education partners to enable a research culture • leading and engaging the sector on Maaori health and workforce issues at a national, regional and organisational level • providing expert clinical advice.

In the past year, we have worked towards achieving these overarching goals in Women’s Health by providing a strategic, operational and quality lens focusing on health equity and cultural safety across:

• Recruitment and retention – there are currently 38 Maaori midwives (both core and lead maternity carer) working across the Counties Manukau region. A Maaori Midwifery Forum has been set up, enabling these midwives to meet quarterly for whakawhanaungatanga and professional development. We have also actively recruited Maaori

midwives as part of a national midwifery recruitment drive (see poster on right).

• As of February 2021, there will be 90 Maaori midwifery students across the 4-year undergraduate

Bachelor of Midwifery programme at AUT. These students are supported by the Pu Ora Matatini programme – a collaboration between AUT, CM

Health and the Tindall Foundation, which provides pastoral support for the tauira.

• Education – the clinical lead advisor, Maaori midwifery provides education across Women’s Health focusing on health equity and cultural safety in relation to our

Treaty of Waitangi obligations. • Contraception – we are working to improve access to contraception (in particular long-acting reversible contraception) for waahine Maaori using a clinically and culturally safe process.

• Sudden unexpected death in infancy (SUDI) prevention – we have instigated a SUDI Maaori caucus to specifically address the disproportionate number of

Maaori SUDI cases.

• Child protection services and hospital-based Oranga

Tamariki involvement – we seek to ensure that the views and solutions for child protection have had culturally safe lens applied, both at a regional and national level.

Maaori Midwifery Research Symposium

One of the highlights of the past 12 months has been the Maaori Midwifery Research Symposium, which was held on 28 July 2020: see images overleaf.

At the symposium, Te Rau Ora, Ngaa Maia Maaori Midwives Aotearoa and CM Health presented a comprehensive proposal to the Ministry of Health and Health Workforce New Zealand to establish a National Maaori Maternal and Child Health Workforce Strategy. The strategy would ameliorate the Maaori health and workforce differences by expanding the Maaori maternal health care continuum.

Te Rau Ora developed the evidence through four pieces of work.

• Rapua te aronga-a-hine – a review of the literature about the Maaori midwifery workforce in

Aotearoa. There is a wealth of Maaori research that substantiates the need for change to achieve Poster targeting Maaori midwives, which appeared in national midwifery publications as part of a midwifery recruitment drive

equitable health and wellbeing for Maaori. • Kimihia te aronga-a-hine – information was collected using a survey from the workforce tasked with caring for mama, peepi, tamariki and whanau.

• Whaia te aronga-a-hine a nga kaiwhakawhanau

Maaori – a qualitative focus group looked at Maaori midwifery workforce needs in Aotearoa, as described by Maaori midwives. • Whaia te aronga-a-hine nga mama – a kaupapa

Maaori analysis was carried out of Maaori mama’s shared experience of the maternity care workforce.

The symposium was also a platform for other learned waahine to present their valuable and informative hauora Maaori research.

• Hinewirangi Kohu-Morgan presented her work on spiritual health, which she defined as the capacity and ability to seek, experience, and express meaning and purpose in our lives from a te ao Maaori world view.

• Dr Naomi Simmond presented Ukaipo Mana Waahine, using the whakapapa and story of her tupuna Mahinaa-rangi while hapu.

Following the symposium, Te Rau Ora (with its partners) was offered the opportunity to develop an evidence base from which to inform workforce priorities, with a particular focus on Maaori women, babies, children and whaanau.

Midwifery Research Symposium

The provision of equitable and both clinically and culturally safe care for whaanau across Women’s Health will continue to be a focus. This sometimes necessitates that we challenge long held view points and models of existing care. The wellbeing of our Maama and peepi demands that we do this. This will then ensure that we are fulfilling our commitment to acknowledge and respect Te Tiriti O Waitangi to therefore accelerate Maaori health gains in our community.

Participants at the Maaori Midwifery Research Symposium 2020

Flyer for the Maaori Midwifery Research Symposium