Responsiveness to Māori in dysphagia research: beyond ‘kai’ (nutrition), ‘inu’ (hydration), and ‘te reo’ (Māori translation)

Abstract

Dysphagia services are embedded in a colonial health system that was not designed for Māori (Indigenous peoples of Aotearoa New Zealand). Despite the obligations of Te Tiriti o Waitangi and the United Nations Declaration on the Rights of Indigenous Peoples, dysphagia research that benefits Māori remains to be established. A paradigm shift in the dysphagia literature warrants critical analysis and reflection on different ways of knowing, doing, and thinking. In Aotearoa New Zealand, the effects of colonization, racism, systems, and power dynamics on Māori with swallowing problems should be further examined. Relationships must be meaningful between dysphagia research teams and Māori (patients, whānau (family), hapū (sub-tribe), iwi (tribe), communities, health professionals, researchers) and support Māori leadership. Future dysphagia research should encompass Te Tiriti obligations, Māori rights to health, cultural safety, and Māori ethical considerations, such as Māori data sovereignty. This paper considers how an equity-based approach in dysphagia research can better support Māori with swallowing problems and their whānau, and achieve equitable outcomes.