Māori Health models of wellbeing

The foundations of health are physical, psychological, spiritual, environmental and, other subcategories such as sexual orientation, socio-economic status, expectations from others, family, occupation, culture, and language. There are major disparities in the standards of health between Māori and Pākehā. (Durie, 2003)

Hauora is the Māori philosophy of health and well-being unique to New Zealand. The Whare Tapa Wha and Meihana models of wellbeing represent aspects of Hauora as the four walls of a whare, where each wall represents different dimensions that are necessary for healthy well-being. (2009).

“There are six dimensions of well-being including Whānau which means the capacity to belong, to care and to share where individuals are part of wider social systems. (Durie, 2011). Whānau provides us with the strength to be who we are. This is through a link to ancestral teaching, handed down through whakapapa, which influences the present and the future. Whānau support includes providing a safe space for the client to encourage the notion of healthy well-being.

The second dimension is Tinana which is the capacity for physical growth and development. (Durie, 2011). Physical well-being includes looking into the medical history of whanau and whakapapa. Poor physical well-being may inhibit positive psychological well-being, such as low self-esteem and eating disorders. For Māori, physical well-being is one aspect of health and cannot be separated from the aspect of mind, spirit and family. “Our physical ‘being’ supports our essence and shelters us from the external environment.” (Pitama et al, 2007)

The third dimension is Hinengaro, which is defined as the capacity to communicate, think, and feel within a person’s psychological state. (Durie 2011). Whanau and Whakapapa may contribute to mental illness from illness that has been passed through genealogy. Hinengaro includes Thoughts, feelings and emotions, which are integral components of the body and soul as a guide to building a sense of identity.

The fourth dimension is Wairua which means, “The capacity for faith and wider communication, which encompasses levels of attachment and engagement with spiritual beliefs which are strengthened through karakia and whakawatea. (Pitama et al, 2007). Wairua is influenced by whanau and Whakapapa Mauri. Wairua can also be described as a spirit or soul of a person existing after the physical being is dead, joining another wairua to Te Po or Hawaiki

The fifth dimension is Taio which means, whether the physical environment is safe and all services offered to Maori are appropriate, ensuring physical accessibility and the safety of the services. (Pitama et al, 2007). Some Organisational facilities are not appropriate due to distance from the car, or public transport. Some facilities are not whanau friendly, such as small interview rooms which do not promote the inclusion of whanau. There is a lack of advertisements for available services, such as posters and signage that are directed toward Māori. Within an organisation, there may be a visible lack of Māori staff who may not support the client and whanau in engaging with the service, as well as Māori friendly policies and fair recruitment and interview processes. The physical environment at home may not be appropriate, such as a damp home, or doesn’t have enough rooms for everyone in the household, making the environment busy and cluttered.

The sixth dimension is Iwi Katoa, which means to understand how much influence societal expectations have on the client and whanaus well-being. (Pitman et al, 2007). Iwi Katoa also identifies the need to manage national policies and prevailing societal attitudes and how these impact Māori clients and whanau which may contribute to Māori feeling unhinged.

Glossary

Ranga wairua: Inspiration, ideas and humour left as an inspiration to their people

Wairua Poke: Hauora

Karakia: prayer

Hauora Wairau: spiritual health

Hono-i-Wairua, Te: Gathering place of the Spirits

Powhiri: to welcome and invite

Pakeha: New Zealander of European descent

Mokopuna: Descendant, grandchild

Tamariki: to be a young, youthful, child

Tangi: to cry mourn

Tino rangatiratanga: Status of nationhood

Whakapapa: genealogy, ancestors

Whanau: Family

Whatmatua: fatherly

Whakawatea: to clear, free up. Cleanse or purify spiritually.

Mauri: life principle, the vitality of an identity

Te Po: the world of departed spirits

Hawaiki: the ancestral Homeland

Bibliography

Duria, M. (2011) The Whare Tapa Wha. Retrieved from https//:www.hauora.co.nz/te-whare-tapa-wha

Pitama, S., Robertson, P., Cram, F., Gillies, M., Huria, T., Dallas-katoa, W. (2007). Meihana Model: A clinical Assessment Framework. New Zealand Journal of Psychology. 36 (3). P. 118–124.

Pitama, S., Huria, T., Lacey, C. (2014). Improving Maori health through clinical Assessment: Waikare o Te Waka o Meihana. Journal of the New Zealand Medical Association, 127 (1393) P. 107–113