Māori women have organised to improve their health status and, as part of that, have challenged understandings of what health means. Māori health activism has been shaped by a concern that colonisation, population loss and a resulting cultural breakdown has undermined health. Building communities and extending the protective effect of strong whānau bonds has been an important outcome of initiatives such as kōhanga reo (preschool language ‘nests’).
Development of Māori-centred models of health began in the 1970s, as part of the challenge from Māori to mainstream health providers. These models included emotional, physical, whānau and spiritual wellbeing. Alongside that theoretical framework, Māori set up their own health providers.
The Maori Women’s Welfare League, Tipu Ora and kōhanga reo were all set up to improve the wellbeing of Māori communities and Māori women.
Standard measures of health actually measure illness and death. The Maori Women’s Welfare League’s 1984 Rapuora report measured wellbeing, including physical health, peace of mind, family, lifestyle and paid work. Using this measure, a comprehensive profile of Māori women in good health was developed.
Maori Women’s Welfare League
The Maori Women’s Welfare League was set up in 1951. Health was a major concern of the league. In the 1950s and 1960s members worked with public health nurses and Māori mothers, assisted with immunisation, and discussed family planning, obesity and tuberculosis. In the 1970s the league included domestic violence as a health issue; in the 1980s it set up the Healthy Lifestyles programme and released a report, Rapuora: health and Maori women. In 1993 the league, with the National Maori Congress and the New Zealand Maori Council, set up Te Waka Hauora, a national Māori health authority. At a regional level the league also became involved in the provision of health and wellbeing services to families in the 1990s and 2000s.
The first kōhanga reo was set up in 1982 and others swiftly followed; a decade later there were 630 kōhanga. The aim was survival of the Māori language (and, along with that, Māori culture). The method used – care for and teaching of pre-school children, usually by women – strengthened whānau and hapū relationships, sometimes helping build communities in urban centres. Strong whānau bonds are well-understood as a protective element in maintaining physical and emotional health.
Concerned at worsening Māori health, Tipu Ora, a health organisation, was set up in 1989 by the Te Arawa-based Women’s Health League. It has been strongly family-focused, working with new mothers and teenage parents, and setting up midwifery services.
Activism in the 1970s and 1980s
During the 1970s and 1980s there was an expansion of Māori women organising around health issues. They identified a number of problems, including monocultural training of health-care workers, a lack of consultation and engagement with Māori communities, and an unwillingness to share resources. Many health projects were started by women.
Māori health providers and government
Knowing that delivery of health services was often ineffective, Māori began setting up their own health-provider organisations. Many of these new organisations took on government contracts.
Government attention to Māori health issues grew in the 1990s, and included active development of Māori health providers. In 2000 a directorate of Māori health was set up within the Ministry of Health, and by 2004 Māori health teams began work on mental health, disabilities, cervical screening and public health.