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BN501 Session 11 : Hauora Maori. Session Outcomes. At the end of this session students will be able to: Explain the relationship between health, culture, the Treaty of Waitangi, nursing and New Zealanders Explain how cultural safety relates to the Treaty of Waitangi and nursing practice
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BN501 Session 11: Hauora Maori
Session Outcomes At the end of this session students will be able to: • Explain the relationship between health, culture, the Treaty of Waitangi, nursing and New Zealanders • Explain how cultural safety relates to the Treaty of Waitangi and nursing practice • Demonstrate an understanding of the concept of Hauora Maori and Pacific models of health • Discuss the Treaty of Waitangi as it relates to health and culture for migrant and refugee health
How does our history relate to nursing in New Zealand? If you would understand anything, observe its beginning and its development. Aristotle
How does the Treaty of Waitangi relate to professional nursing in New Zealand?
NCNZ Competency Registered Nurse Scope of Practice Domain One: Professional Responsibility 1.2Demonstrates the ability to apply the principles of the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice. (NCNZ, 2006) What does this mean for your nursing practice?
The Treaty Principles • Partnership • Participation • Protection (Royal Commission on Social Policy, 1988) • To nursing practice • ALL New Zealanders
Cultural Safety “The concept of cultural safety incorporates a broad definition that expresses the diversity that exists within cultural groups. It includes* cultural groups that are as diverse as social, religious and gender groups, and is in addition to ethnicity. “ (NCNZ, 2005, pp. 1-2)
Unsafe cultural practice is “ any action which diminishes, demeans or disempowers the cultural identityand wellbeing of an individual” (Nursing Council of New Zealand , 2011 , p. 7).
Kawa Whakaruruhau • Cultural safety within the Maori context • Inherent component of Maori health and nursing • Achievement of positive health outcomes. (NCNZ, 2005)
Tikanga Maori “One way to improve the health status of Maori is through a culturally aware workforce, Cultural safety is about respecting difference and this us where this concept and honouring the Treaty of Waitangi merge for nurses working in a healthcare facility in New Zealand.” (Hally, 2009, p. 95.)
What is Pasifika? Pasifika refers to the diverse ethnic groups in New Zealand that trace their origins to indigenous peoples of the island nations of the Pacific
Pacifika health • Pasifika health models • Fonua: a Pasifika model • Applying ‘Fonua’ to health promotion
NZ Statistics 2006 • The largest Pacific peoples ethnic group was Samoan. • There were 131,103 people of Samoan ethnicity, an increase of 14 percent (16,083 people) since the 2001 Census. • Nearly one in two people of Pacific ethnicity were of Samoan ethnicity.
The next largest groups of Pacific peoples ethnicity were: • Cook Islands Maori (58,011). • Tongan (50,478). • Niuean (22,476). • Fijian (9,864). • Tokelauan (6,822). • Tuvaluan (2,625).
Why Pasifika Models? • Diverse cultures means diverse tools in order to be effective; one tool for all is a recipe for disaster • Pacific peoples see the world through their own eyes and experience • To provide tools that are culturally appropriate and effective for Pacific peoples in order to improve and maintain their material and spiritual health and wellbeing • Pacific peoples have special relationship with NZ Govt. • Cultural democratic rights – UN 1948 • Indigenous knowledge enriches our basket of knowledge
Dimensions of Fonua • Sino –Physical • ‘Atamai – Mental and intellectual • Laumalie – Spiritual • Kainga – Community • ‘Atakai – Environment (both built and natural • environment) • These five dimensions are inter-connected. All must be cared for in a balanced approach
Purposes of Fonua • The ultimate purpose of this relationship and exchange between the environment and humanity is to maintain harmony in life in sustainable ways - melino (peace, harmony), or health and wellbeing
Levels of Fonua • Five levels identified • Taautaha - Individual • Kainga - Family • Kolo - Village • Fonua - nation • Mamani – global society
Phases of Fonua • As a process at the societal level, there are four phases in fonua. These phases can also be regarded as tools or strategies for community development and health promotion. • Kumi Fonua – exploratory stage – search and navigate new, physical or cultural contexts • Langa Fonua – formative stage - build and construct the community/society • Tauhi Fonua – maintain and sustain the community • Tufunga Fonua – reform and re-construct society
Applying Fonua Model • Identify and scope health issue or need • Identify parties concerned and parties affected • All parties consult • Identify causal/contributing factors • Identify affected dimensions and levels • Identify and apply related values • Generate solutions • Plan and implement • Review, close or plan again
Resources Durie,M.H. (1989). The Treaty of Waitangi and health care. NZ Med J, 102, 283-285. Indigenous Media Network Ltd. (2006, May 9). Hauora for the Mind and Body [Image]. Rangikainga, 7. Retrieved from http://www.tangatawhenua.com/rangikainga/issue7.htm Maori Health Directorate. (n.d.) Our history and current position. Retrieved August 4, 2009 from http://www.maorihealth.govt.nz/moh.nsf/pagesma/325?Open Ministry of Health. (2001). Refugee Health Care – A handbook for health professionals. Retrieved from http://www.moh.govt.nz/moh.nsf/49ba80c00757b8804c256673001d47d0/d85ce7cd090faaa4cc256b050007d7cb?OpenDocument Nursing Council of New Zealand. (2005). Guidelines for cultural safety, the Treaty of Waitangi and Maori health in nursing education and practice. Wellington: Author. Nursing Council of New Zealand. (2006). Competence assessment form for the registered nurse scope of practice. Wellington: Author. Royal Commission on Social Policy. (1988). The April report vol ii future directions / Royal commission on social policy. Wellington: Author. Taufe‘ulungaki, ‘A (2004) Fonua: Reclaiming Pacificcommunities in Aotearoa. Keynote address, Lotu Moui Symposium, Counties Manukau DHB, December 1, 2004 Tu’itahi, S. (2007) Fonua, A Pacific model, Hauora newsletter,April 2007 edition, Health Promotion Forum www.hauora.co.nz (Health Promotion Forum website) Tu’itahi, S. (2005) Langa Fonua: How a Tongan Kainga strived for social and economic success in Aotearoa, Unpublished MPP thesis, Massey University Tu‘itahi Sione (2009). A collaboration between Pasifika@Massey, the Health Promotion Forum of New Zealand, and the Hawkes Bay Pacific Health Service