"Mā te rongo, ka mōhio; mā te mōhio, ka mārama; mā te mārama, ka mātau; mā te mātau, ka ora."
Through listening, comes knowledge; through knowledge, comes understanding; through understanding, comes wisdom; through wisdom, comes wellbeing.
Generally speaking, tikanga are Māori customary behaviours or practices. The concept is derived from the Māori word ‘tika’ which means ‘right’ or ‘correct’. To act in accordance with tikanga is to behave in a way that is culturally safe or appropriate for Māori people.
The basic principles underpinning these tikanga best practice guidelines are familiar throughout Māori culture. However, different iwi (tribes), hapū (sub-tribes) and marae (Māori community meeting places) may have their own variations.
The tikanga best practice guidelines have been adapted from various sources and Māori knowledge to further support Pinnacle MHN general practices in their endeavours to improve Māori health outcomes.
Founded on Māori concepts, views of health, tikanga (Māori values/practices) and Te Tiriti o Waitangi, this resource aims to contribute to providing services and understanding that is responsive to Māori rights/rites, needs and interests.
The most effective way to engage and understand your tūroro Māori (Māori patients) is through whakawhanaungatanga (engagement/relationship building process). Establishing authentic and meaningful relationships with tūroro through whakawhanaungatanga, is a common expectation, as it is a typical first step in Māori culture. This process, infused with manaakitanga (hospitality, kindness, care), helps tūroro feel safe and respected, fostering trust between patients and their healthcare providers. Furthermore, the use of te reo Māori (the Māori language) is encouraged and the correct pronunciation of patients’ names is crucial for demonstrating manaakitanga and respect, thereby strengthening whakawhanaungatanga with tūroro Māori.
For many Māori, karakia (blessings, incantations, or prayers) are essential in protecting and maintaining their spiritual, mental, emotional, and physical health, particularly in a healthcare setting. In Te Ao Māori (the Māori world), wairuatanga (spirituality) plays a critical role in wellbeing, and many tikanga processes are deeply connected to the nurture and protection of wairua. Understanding this connection helps healthcare providers to provide a holistic form of care that builds on trust.
Family and extended family is of fundamental importance to Māori. Whānau support can be crucial to tūroro wellbeing. The concept of family extends beyond the nuclear or biological family concept.
Taonga (valuables/whakapapa heirlooms) have importance to Māori extending beyond sentiment to spiritual value. A taonga worn on the body has protective significance. Any requirement to touch taonga is discussed first with the tūroro and whānau. Respect for taonga should be adhered to.
Tapu and noa are key concepts that underpin many Māori health practices. Tapu (sacred) things are kept separate from things that are noa (not restricted). In many cases, these align with good health and safety procedures that should be practiced by staff.
When health care information is communicated in a way perceived by Māori as sensitive to their cultural beliefs and values, there is a better likelihood of understanding, treatment adherence and improved outcomes.
This is a guide to best practice, however the advice is not mandatory for every situation.
Most people prefer not to act in ways that are offensive to others, especially when dealing with people in close vicinity. These best practice guidelines have been compiled in an effort to increase awareness of Māori culture within primary care, and to avoid confusion or uncomfortable moments when health professionals may be unsure of what to do.
While focused on Māori in the primary health care setting, the guidelines can be adapted and applied to both secondary health services and/or other ethnicities as they include best practice standards of care suitable for various situations, circumstances, and health environments.
Ultimately, these guidelines are a call to action: to move beyond discomfort, embrace cultural humility, and actively cultivate a healthcare environment where every interaction is an opportunity to build trust, affirm people’s cultural identity, and contribute to a healthcare system where all people feel truly safe and valued.
Mauri ora.
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