Māori Health

He tapu te whare tangata

Exploration of the cervical screening clinical pathway following offer of HPV self-test

Ministry of Health and Health Research Council of New Zealand project grants to the Centre for Women's Health Research, University of Victoria, Wellington, 2017-2020

Even though cervical cancer is preventable, our current screening programme is failing Māori women. There are unacceptable disparities experienced by Māori women, from access to screening to mortality. Māori women are twice as likely to die from cervical cancer than non- Māori women. 

Our project - He Tapu Te Whare Tangata - aims to increase cervical screening coverage through HPV self-testing, delivered through community-based health practices.  We will use technology that screens women for infection with the types of Human Papilloma Virus (HPV) that cause cervical cancer. The project is Māori led and Māori centred. It will improve the detection of pre-cancerous lesions in Māori women and aims ultimately to reduce the unnecessary inequity in mortality from a preventable cancer that disproportionately affects Māori women. If successful, it will inform the National Screening Unit policy on the rollout of HPV screening.

Publications

Adcock, A., Cram, F., Lawton, B., Geller, S., Hibma, M., Sykes, P., MacDonald, E. J., Dallas‐Katoa, W., Rendell, B., Cornell, T., Mataki, T., Rangiwhetu, T., Gifkins, N. and Hart, S. (2019). Acceptability of self‐taken vaginal HPV sample for cervical screening among an under‐screened Indigenous population. Aust N Z J Obstet Gynaecol, 59, 301–307. doi:10.1111/ajo.12933

Adcock, A., Stevenson, K., Cram, F., MacDonald, E.J., Gellar, S., Hermens, J. & Lawton, B. (2021). He Tapu Te Whare Tangata (sacred house of humanity): Under- screened Māori women talk about HPV self-testing cervical screening clinical pathways. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.13873.

Lawton, B., Heffernan, M., Wurtak, G., Steben, M., Lhaki, P., Cram, F., Blas, M., Hibma, M., Adcock, A., Stevenson, K., Whop, L., Brotherton, J. & Garland, S.M. (2020). IPVS Policy Statement addressing the burden of HPV disease for Indigenous peoples. Papillomavirus Research, 9, 100191.

MacDonald, E.J., Geller, S., Sibanda, N., Stevenson, K., Denmead, L., Adcock, A., Cram, F., Hibma, M., Sykes, P. & Lawton, B. (2021). Reaching under-screened/never-screened indigenous peoples with human papilloma virus self-testing: A community-based cluster randomised controlled trial. Aust NZ J Obstet Gynaecol. DOI: 10.1111/ajo.13285

Whānau Manaaki

Protecting maternal wellbeing - hapū ora

Funded by the Health Research Council of New Zealand, 2016-2020. This project is being led by Dr Beverley Lawton, alongside Dr Stacie Gellar, Dr Fiona Cram and Dr Liza Edmonds.

Whānau Manaaki is a Kaupapa Māori research programme that builds on our joint work and research findings to address Māori maternal-child health disparities. It puts the woman and her whānau at the centre and explores the health care delivery system and structural determinants of health (e.g. housing, racism, transport, income, education) that impact on the health and well being of Māori women and their babies. This will enable us to understand what needs ‘fixing’ to improve well-being for Māori whānau.

Publications

Adcock, A., Cram, F., Edmonds, L. & Lawton, B. (2023). Culturally safe neonatal care: Talking with health practitioners identified as champions by Indigenous families. Qualitative Health Research. DOI: 10.1177/10497323231164550

Adcock, A., Cram, F., Edmonds, L. & Lawton, B. (2022). He Tamariki Kokoti Tau: Whānau of preterm Māori infants (pēpi) reflect on their journeys from birth to first birthday. Journal of the Royal Society of New Zealand. 52 Issue sup1: He Āpiti Supplement: He Pito Mata – Awakening the Potential. Guest Editors: Sarah Moss, Sereana Naepi, Darren Powell and Wendy Larner.

Adcock, A., Cram, F., Edmonds, L. & Lawton, B. (2021). He Tamariki Kokoti Tau: Families of Indigenous infants talk about their experiences of preterm birth and neonatal intensive care. International Journal of Environmental Research and Public Health, 18, 9835. https://doi.org/10.3390/ijerph18189835.

Adcock, A., Storey, F., Lawton, B., Bennett, M., Lambert, C., Edmonds, L., Stevenson, K., Geller, S. & Cram, F. (2019). He Korowai Manaaki: mapping assets to inform a strength-based, Indigenous-led wrap-around maternity pathway. Australian Journal of Primary Care -  https://doi.org/10.1071/PY19029. Published online: 21 October 2019.

Edmonds, L.K., Sibanda, N., Geller, S., Cram, F., Robson, B., Filoche, S., Storey, F., Gibson-Helm, M. & Lawton, B. (2021). He Tamariki Kokoti Tau: Tackling preterm incidence and outcomes of preterm births by ethnicity in Aotearoa New Zealand 2010-2014. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.13855.

Lawton, B., Storey, F., Sibanda, N., Bennett, M., Lambert, C., Geller, S., Edmonds, L., & Cram, F. (2021). He Korowai Manaaki (Pregnancy Wraparound Care): Protocol for a cluster randomized clinical trial. JMIR Research Protocol, 10(1):e18154 doi: 10.2196/18154 PMID: 33512321

History

A history of Māori health inequities funded by the Ministry of Health, as background to WAI2775, the Kaupapa Hauora claims before the Waitangi Tribunal.

E Hine

A Kaupapa Māori (by, with & for Māori) longitudinal qualitative study with young Māori mothers. E Hine papers are listed in the publications page.

ShiftingMaoriHealthNeeds.pdf

Medical workforce

2010 examination of Māori population trends and the impact these are likely to have on Māori demands for health services over the next 10-20 years, looking specifically at the demands on the Māori medical workforce.

1.Access_ResearchReport.pdf

This report provides an integration of the findings from three literature reviews and key informant interviews about improving Māori access to health care.

2.Access_KeyInformants.pdf

Key Informants

Forty-seven key informants working in cancer, CVD, diabetes, Māori health, funding and planning, Ministry of Health, and health research speak about improving Māori access to health care.

3.Access_CancerLit.pdf

Cancer

Review of 2007-2013 literature on how to successfully intervene to make cancer health care services more accessible for Māori.

4.Access_DiabetesLit.pdf

Diabetes

Review of 2007-2013 literature on how to successfully intervene to make diabetes health care services more accessible for Māori through a focus on interventions that have worked for Māori and other Indigenous and ethnic minority peoples.

5.Access_CVDLit.pdf

Cardiovascular

Review of 2007-2013 literature on how to successfully intervene to make cardiovascular health care services more accessible for Māori through a focus on interventions that have worked for Māori and other Indigenous and ethnic minority peoples. 

future-directions-maori-dental-workforce.pdf

Dental Therapy

2010 analysis of the needs of the Māori dental therapist workforce over the next eight years.