"They think they know me without listening": Restoring relational care and authority in Māori health encounters
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Updated: Apr 17, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Tania Kahika-Foote1, Angelique Reweti1, Mary Breheny2
1School of Health Sciences, Massey University, Private Bag 11 222, Palmerston North, Aotearoa, 4442, New Zealand.
Abstract:
Despite universal healthcare provision, Māori-the Indigenous peoples of Aotearoa New Zealand-continue to experience persistent inequities across all major health indicators. While these disparities are well documented, fewer studies centre Māori voices in describing how inequity is lived and felt within everyday healthcare encounters. This study draws on stories from Māori contributors (n = 114) shared through Wāhi Kōrero, a national online story-sharing platform from 11 April to 31 August 2024. Participants responded to the prompt "I felt too whakamā to go to the doctor," reflecting on experiences of accessing and engaging with healthcare services. A reflexive thematic analysis was undertaken through an Indigenous Māori analytical lens, guided by tikanga, whakawhanaungatanga, and manaakitanga. Three interrelated themes were identified: (1) Whakawhanaungatanga as care-being known, heard, and believed; (2) Enacting tino rangatiratanga and mana motuhake in everyday care-asserting autonomy and authority in healthcare decisions; and (3) Recognising the true costs of care through manaakitanga-acknowledging that financial, cultural, and spiritual burdens extend beyond monetary expense to include the erosion of dignity and trust. Across these themes, stories demonstrate how colonial hierarchies are reproduced through routine everyday clinical interactions, while also illuminating Māori resilience, agency, and leadership in navigating care. We argue that restoring equitable healthcare requires systems that honour tino rangatiratanga (Treaty-affirmed Māori authority) and enable mana motuhake (Māori autonomy in practice). Embedding Māori governance, knowledge, and values across all levels of healthcare has the potential to transform care from a site of exclusion into one of relational restoration, reciprocity, and respect.
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