Organisational policy to support oral health equity in Aotearoa New Zealand
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University of Otago, Wellington, New Zealand
Te Ao Mārama Aotearoa Māori Dental Association, Ngāpuhi, New Zealand
Ngāti Toa, New Zealand
Wellington and Chair Māori Oral Health Providers Quality Improvement Group, University of Otago, New Zealand
Māori Oral Health National Coordination Service, New Zealand
Te Ao Mārama Aotearoa Māori Dental Association, New Zealand
Te Aitanga-a-Māhaki, Ngāti Maniapoto, New Zealand
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1719
Background and Objective: Severe, unacceptable and avoidable oral health inequities persist for MāORI in Aotearoa New Zealand (NZ). Recognising and addressing equity should be core priorities of professional organisations, which in NZ, includes recognising Te Tiriti o Waitangi (Te Tiriti), the foundational treaty between Māori and the Crown that ensures health equity for Māori. We aimed to understand oral health organisations' knowledge of, and commitment to, Te Tiriti and equity, and shift taken-for-granted practices, policies and systems generating and perpetuating inequities. Methods: The spokespersons of nine organisations-professional networks, associations or organisations that support oral health professionals in fulfilling their role--were interviewed. Questions were sent in advance allowing participants to consider their responses, gather relevant documentation and obtain members' viewpoints. A Te Tiriti-based framework guided analysis. Each organisation was provided with strengths-based feedback on activities they were doing well and opportunities for improvement. Results: Participant organisations represented a range of oral health professions, with members being either predominantly public-sector or predominantly private-sector. Knowledge and commitment to Te Tiriti and equity varied, but was greater among public-focused organisations. One organisation had a Tiriti responsiveness plan, otherwise there were few Māori health or equity plans, policies or position statements, or equity tools, used to guide and monitor activities. While some had Māori in leadership roles, there was little purposive co-governance and few activities supporting normalisation of Māori worldviews. All participants commented that the interview process was insightful and committed to future action. Conclusions: Differences between public and private-facing organisations likely reflects equity being an expectation of public-facing work, and access to relevant training. Organisations that had Te Tiriti or equity policies or roles had progressed, demonstrating that purposeful policy enables action to promote health equity at group and individual levels. These findings have implications for all nations with indigenous populations.