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Māori are protected from communicable diseases across the life-course
The Komiti noted the importance of lifting immunisation rates for Māori, as well as concerns of the effectiveness of current planned interventions by Health New Zealand to deliver on immunisation targets. The Komiti have provided advice on further initiatives to help address this gap. The Komiti thinks evidence shows that Māori-led outreach programmes and tailored communications are critical levers to address low Māori immunisation rates. The 2020 Māori influenza vaccine programme and the 2021 Māori measles and influenza vaccine programme outperformed the general vaccination campaigns in both years.
Tamariki Māori immunisation rates remain lower than other groups at each milestone age and have continued to decrease over the last five years. The key trend is that Māori are shifting away from getting vaccinated at general practices, with an increase in pakeke receiving their vaccinations at pharmacies, and pēpi receiving their vaccinations in hospitals.
The Komiti would like Health New Zealand to focus on increasing the choice of providers and settings for immunising tamariki and their whānau, particularly the most vulnerable. They would also like to stress the importance of a level playing field for Māori health providers. The Komiti recommended that recently announced funding and training for Plunket nurses to be vaccinators should be extended to all Well Child Tamariki Ora nurses, many of whom work for Māori health providers.
Māmā and pēpi receive consistent, quality care during pregnancy and into the early years
The Komiti recognises that growing, supporting, and utilising the specialised skills of the Māori health workforce is critical to making a difference in this area. They want to highlight the evidence demonstrating the ongoing success of the Māori workforce development programmes. These focus on ensuring a pipeline for Māori into the health workforce from high school to employment.
There has been an increase in the proportion of midwives identifying as Māori in recent years. This reflects the success of Māori workforce programmes, such as Te Ara ō Hine – Tapu Ora. The Komiti supports the commitment to protect the $749 million hauora Māori appropriation, from which these programmes are funded. However, they note that some programmes are under review, therefore the Komiti will seek a briefing on any reviews of Māori health workforce programmes.
The Komiti supports the intention of the Kahu Taurima programme to deliver integrated, culturally tailored services for all māmā and pēpi across the early years, but there is more to do. As it stands, hapū māmā and their pēpi are less likely to be enrolled with maternity services, Well Child Tamariki Ora, and general practice. The Komiti notes their concerns that these rates have not changed much over time. The data also shows hapū māmā are accessing lead maternity carers later in their pregnancy journey (third trimester or postnatally).
The Komiti will also request further information from Health New Zealand about the progress of Kahu Taurima. They will be seeking to ensure that it remains focused on addressing the challenges highlighted in the monitoring report. As noted above, the Komiti want to ensure Māori health providers have the same opportunities to build services that meet the needs of māmā and pēpi.
Pakeke are accessing primary and community healthcare early, with positive outcomes and experiences relating to diabetes and cardiovascular disease
The Komiti can see that workforce pressures, resulting in long wait times and out-of-pocket costs for patients, are the main barriers to timely access to quality health care for Māori. These barriers are hampering efforts to reduce the significant inequities in diabetes and cardiovascular disease.
Pakeke Māori (aged 15 years and above) are less likely to be enrolled with a general practice than other adults and this has not changed much over time. Schemes that reduce the cost of accessing general practice are important for supporting Māori access to primary care. In 2024, 58% of pakeke Māori had low-cost access to a general practice, meaning discounted general practice visits through either a Community Service Card or a very low-cost access practice. Despite this, cost continues to be a barrier to accessing primary care for pakeke Māori. It was second only to wait times, which is indicative of the pressures on the primary care workforce.
The Komiti notes that Health New Zealand is developing a national diabetes action plan. They will request information from Health New Zealand on this plan and how it will address the needs of Māori. The Komiti also notes the increased use of telehealth as a method for addressing barriers to care, especially in rural areas. They will seek information from Health New Zealand to ensure that this method of service provision works for Māori. They will be looking to see iwi-Māori partnership board (IMPB) involvement in the design and monitoring of these services.
