Maori knowledge: a key ingredient in nutrition and physical exercise health promotion programmes for Maori.

• Author: Henwood, Wendy
• Position: Report

Abstract

Nutrition and physical exercise health promotion programmes have been around schools and communities for a long time, but only recently has culture been acknowledged as an important feature of health promotion approaches. This paper draws on the experience of Korikori a Iwi, a community development action research project that used Maori culture as a basis for encouraging good nutrition and regular physical exercise in five Maori communities. Although community action objectives are grounded in research-based knowledge, the strategies used to achieve these objectives are grounded in the community's knowledge base--in this case, that of te ao Maori (the Maori world). In addition to findings from across the project sites, the way in which one of the programme providers, Hauora Whanui, approached Korikori a Iwi will be used to demonstrate how culture laid the foundation for a health initiative that supported the building of Maori capacity within the community. Formative evaluation assistance during the developmental phase of the programme provided a way to improve the link between research and public health practice, and to explore the significance of tikanga Maori (Maori customs and traditions) and related strategies as a vehicle for change, increased capacity and community resource development. The knowledge source drawn upon in this process is often referred to as Te Puna Matauranga, which implies that an existing pool or spring of knowledge is available and available to be accessed.

INTRODUCTION

Five Maori health providers (1) in Te Taitokerau region (Northland, Aotearoa/New Zealand) implemented the Ministry of Health-funded Korikori a Iwi project. The project sites involved a mix of rural and small-town communities in the far north and the Whangarei area, which were led by a coordinator appointed in each of the communities.

The broad health policy goal for the project was to improve health and wellbeing through health promotion programmes that promote healthy lifestyles. At a local level the objective was to develop community physical exercise and nutrition initiatives based on an integrated and holistic kaupapa Maori framework with Maori in the participating communities.

CONTEXT

Much has been written about mainstream health promotion and its focus on improving population health, about the importance of community capacity building, and about the need to anchor community programmes in the local context (Hawe and Shiell 2000, Raphael 2000). Despite this thinking being familiar in the health arena for some time, there are only scant references to specific indigenous examples in current literature.

The recent Bangkok Charter for Health Promotion in a Globalized World (World Health Organisation 2005), an international forum that built on the Ottawa Charter (World Health Organization 1986), highlighted as one of the key issues to be addressed, at both local and global levels, the links between inequalities being faced by indigenous people and their health status.

Maori are poorly represented in positive health and wellbeing statistics (Ajwani et al. 2003, Durie 1994, Pomare et al. 1995). There are a number of Maori models being utilised as frameworks for public health and development in Aotearoa. Te Pae Mahutonga (Durie 1999) is one example currently finding favour with a range of programme providers. Based on the Southern Cross constellation, the navigational guide comprises two "pointers" regarded as necessary to undertake tasks and roles--Nga Manukura (effective leadership) and Te Mana Whakahaere (autonomy)--and four "central stars" depicting the cornerstones of wellbeing--Mauriora (access to te ao Maori), Waiora (environmental), Toiora (healthy lifestyles), and Te Oranga (participation at all levels).

Whether or not an identified model is used to guide community initiatives, common Maori themes apparent in health and wellbeing programmes are:

* whanaungatanga, including relationships, roles and responsibilities

* tino rangatiratanga, including the authority to determine and drive issues, priorities, and solutions, and the development of aspirations

* Maori knowledge and resources, including the validation of Maori processes and knowledge, setting appropriate measures of success, and an acknowledgement of diverse Maori perspectives and realities (Conway et al. 2000, Moewaka Barnes 2000).

In discussing aspects of validation, Park (1993, cited in Raphael 2000) suggests that living experiences, or "interactive knowledge", that reflect a group's world views, values and principles are important in an evidenced-based approach to health promotion. Raphael (2000) supports this notion when he says "recognise what is known, and how and why it is known", as do Joubert and Raeburn (1998) when they talk about health promotion as building on individual and whanau strengths, and positive experiences.

Such strategies are neither new nor unique for Maori, but they have been dormant and/or not credited with any value in many places. Physical activity was always an integral part of holistic wellness for Maori. Traditional games and activities required coordination, stamina and fitness. Not only were they ways of having fun; they were also important in preparation for warfare, hunting, gardening, skills and leadership development, strengthening tribal development, and...