Improving the health status of Māori and reducing health care inequity is a key priority for the Canterbury Community Pharmacy Group. Appropriate responses to the needs and
diversity of Māori within the Canterbury Health System and specifically, through interactions with Pharmacy will contribute to progression of equitable health outcomes for Māori in Canterbury.
These messages are for all Pharmacy staff to reflect on how they interact with Māori and hopefully gives some insights to how you can better engage with your local Māori population.
We cannot treat every patient/customer the same, this is Equality. Equality is ‘sameness’, while equity is an ethical construct that recognises that different groups may require different approaches and resources to achieve the same outcomes. Māori and The Crown signed Te Tiriti and therefore as a health system, we are obliged to prioritise Māori health outcomes.
These Matauranga Māori ideas and stories aim to help Canterbury Pharmacists (and Pharmacy staff) to provide culturally responsive health and disability services to Māori. The
report is underpinned by Māori values, protocols, concepts, views of health and Te Tiriti o Waitangi.
Learning Māori Health Frameworks lead to increased understanding
Māori views on health are framed by an holistic approach that encompasses four key elements - wairua (spiritual), hinengaro (psychological) tinana (physical) and whānau (extended family – beyond immediate relations and could include neighbours etc.). Karakia (blessing or prayer) has an essential part in protecting and maintaining these four key elements of health care.
The key to being culturally sensitive and not patronising is by using skills to consider each individual background within a patient interaction. For example, using active listening and showing empathy should be enough. The most important thing to remember is, don’t be afraid to ask if you don’t know.
Whānau is of fundamental importance to Māori
The concept of whānau extends beyond the biological family. Whānau support can be crucial to the patient’s well-being and recovery. Always ask if there is someone they would like to join for a conversation about that patients medicines, then acknowledge and involve this person.
When handing out a prescription, I always ask, “Are you the healer in your whānau?” or “Who’s the healer in your whānau? Are they with you today?” It may be that the healer is in
fact a family friend or an aunty or an uncle, this is perfectly normal and it is important to recognise this and include the healer in the consultation.
Even a simple question like “Who else can I tell about your medicines, have you got a significant other?” New Zealand tends to have a very individualistic way of doing things, this is true for most Western societies. When engaging with Māori, it is important to try not put this ‘Western’ individualistic lens on things. (This is also true for other ‘Eastern’ ethnic populations such as African, Indian and Asian – all of these cultures also embrace the whānau-centric, community as the healers, mantra).
This is about taking the time to get to know the patient or customer with each interaction. Creating an authentic relationship with the person in front of you. E.g. DO NOT choose the cheapest product straight away, slow down and perform WWHAM then explain all options and give the patient / customer the choice. This process is called whakawhānaungatanga.
One fundamental element of whakawhānaungatanga is pronunciation. Being able to pronounce somebodies name correctly, may be the single most important thing you can do to improve that patients health outcome.
“If the Pharmacy doesn’t have time to learn how to pronounce his name, then why should
he take their medicine?”
We cannot assume that going over the side effects the first time, has sunk in so it’s important to question how the medicine is going with each interaction, and questioning about side effects again. This also shows the patient you have genuine interest in their health which leads to the patient improving their self-care.
Most kaumātua report that seeing Māori signage in the pharmacy as welcoming to them. Even Māori who are not fluent in te reo still feel that their Pharmacy is at least
considering a Māori perspective and makes them feel like they belong there (in the Pharmacy) and aren’t out of place. One kaumātua stated that signs in te reo, promote both sides of learning – the Pharmacy staff and also the patient.
Read the full report here.