Whāia te iti kahurangi: Seeking perinatal mental health equity. Māori offer solutions for the health system

Abstract

Objectives

In Aotearoa, New Zealand (NZ), Māori experience significant perinatal health inequities. Perinatal mental health and maternal suicide are critical equity issues for Aotearoa, NZ's health system and require a systems level response. Health equity is mandated in Aotearoa, NZ, through Te Tiriti o Waitangi, however, Māori continue to face inequitable access to services, resources, and best practice perinatal healthcare. Qualitative data can enhance our understanding of a health system's impact and performance. The purpose of this paper is to utilise qualitative data to identify how Aotearoa, NZ's health system is performing, from the perspectives of Māori mothers and birthing parents experiencing perinatal mental illness.

Design

This qualitative research is grounded in Kaupapa Māori Research methodology. Kaupapa Māori Research methodology is an Indigenous research methodology that privileges the voices of Māori in the design and implementation of research. Semi structured interviews were undertaken with twenty Māori mothers/birthing parents with experience of perinatal mental illness. All participants had accessed a community perinatal mental health service within the previous 12 months.

Results

Expert analysis from Māori mothers and birthing parents identified key recommendations relating to services, treatment, workforce, and communication and education. These recommendations were grouped into sub-themes encompassing options, access and barriers, and whānau. The recommendations encompassed participants’ perceptions of how the health system can enhance efficiency, improve health outcomes and achieve equity for Māori within the perinatal period.

Conclusion

To achieve Māori health equity in the perinatal period, systemic and structural transformation of the perinatal health system is required. The recommendations identified by Māori mothers and birthing parents in this study can be applied at clinical, service, and system levels to remove the structural barriers faced by Māori in the perinatal health system and be utilised in the development of an equitable, early intervention and prevention focused perinatal mental health system.