Based on the recommendations made by TRK, and research conducted here and overseas, the adaptation of generic programmes to be culturally responsive to Māori is required. Doing so prioritises cultural competence in the delivery and content of programmes for Māori tamariki, taiohi and whānau attending generic programmes, and is likely to enhance their efficacy for Māori.
Based on this previous section and on research, cultural responsiveness includes:
the need for a holistic approach such as Te Whare Tapa Wha
a focus on whānau ora
incorporating Māori processes and values such as powhiri and aroha into programme content
the use of a whānau liaison worker/ advocate/ therapist
a Māori facilitator
the programme being delivered in an environment that can help enhance identity and connections, such as marae or turangawaewae.
TRK (2009) have called for a major investment in the gathering and analysis of evidence from a Te Ao Māori context to sit as a part of the evidence base in Aotearoa New Zealand. Māori need to have opportunity to implement programmes based on indigenous knowledge and best practice that can then be evaluated from a Māori perspective.
As discussed by TRK on 9 June 2009, it is vitally important that Māori know what works for Māori tamariki, taiohi and whānau. In the development of Te Ao Māori programmes it is just as important to be able to identify the factors that contribute to successful outcomes so that they can be replicated. The implementation, development and evaluation of Te Ao Māori programmes need to be undertaken within Māori frameworks and values.
These aspirations have previously been acknowledged:
All the universal risk factors and those specific to conduct disorder are much higher in Māori. It is therefore both equitable and a sensible allocation of investment resources to allocate a higher percentage of resources to Māori. Programmes for Māori need to be acceptable to Māori, and wherever possible owned by Māori within a culturally safe and appropriate kaupapa. However, Māori equally need professional evidence based prevention and intervention as key aspects in programmes, though within a Māori kaupapa. (Werry, ed, 2005, cited in Elder, 2009)
TRK have advocated that indigenous knowledge and experiences be recognised as valid contributions to the analysis and critique of programmes for conduct problems. It would appear that while an evidence base is being built around Kaupapa Māori or Te Ao Māori programmes, the indigenous knowledge, understanding and history that exist around tikanga, whakawhanaungatanga, pūrākau, waiata, te reo etc. needs to be accepted as just as valid a contribution to deliver outcomes for Māori.
There are many other facets of indigenous knowledge relevant to programme implementation and outcomes. The processes of hui and consultation, for example, should be viewed as having mana within Māoridom and just as valid in assisting Māori achieve whānau ora. In other words, the cultural protocols that give mana to Māori identity cannot be separated from sub-components or principles underlying any conduct problem programme as a conduit of whānau ora.
Durie (1997) discusses the issues of Māori knowledge and scientific enquiry in the context of the resurgence of traditional healing:
…conventional explanations may not only be inadequate to explain traditional knowledge, they might impose inappropriate frameworks which are incapable of encompassing the holistic nature of the understanding…. Full understanding requires the capacity to learn from quite different systems of knowledge and to appreciate that each has its own validity of its own within its own cultural context. Science is one such system. Māori cultural knowledge is another…a challenge will be to accommodate more than one system of knowledge without necessarily attempting to validate one using the criteria of the other. (Durie, 1997:11)
Durie is essentially advocating for different knowledge bases having their own standing. In discussing Māori-centred research, Durie (2005a) supports the utilisation of both generic/ scientific and Māori methodologies, rather then discounting one methodology in favour of the other. He calls this interface research and suggests that we need to:
Harness the energy from two systems of understanding in order to create new knowledge that can be used to advance understanding in two worlds. (Durie, 2005b, p. 306)
In considering best practice around evidence-based research and indigenous knowledge, it is useful to consider both quantitative and qualitative information. Given the dearth of quantitative information about indigenous programmes, different types of information need to be acknowledged. For example, in looking at the issue of evidence-based purchasing of health promotion initiatives, Rada, Ratima and Howden-Chapman (1999) were required to develop a framework for prioritising 22 health promotion interventions. They used a broad range of evidence which included scientific research,organisational capacity, socio-cultural factors and local community-basedknowledge. They concluded that for:
…evidence-based medicine, evidence-based health promotionmust employ both quantitative and qualitative evidence, andthat the final judgement about purchasing of health promotioninitiatives is essentially subjective and political. (Rada et al. 2003)23
The use of qualitative information and what has been endorsed by Māori through the process of hui and consultation is a form of knowledge which has a cultural validity and mana (standing) in the community. For example, Puao-te-ata-tu recommended a number of actions that needed to occur in order for the then Department of Social Welfare to be more responsive to Māori. The document outlined specific actions towards the department becoming bicultural. This specific strategy has not been researched; however the recommendations were based on extensive consultation with Māori and, therefore, the strategy has a type of cultural validity for Māori. Since the 1980s, Māori health hui have repeatedly called for the inclusion of wairuatanga in health practices when working with Māori (Durie, 1998), with the result that health services now acknowledge this component of wellbeing. In devising Hua Oranga, an extensive consultation process was used, whereby the Whare Tapa Wha framework was endorsed (Kingi & Durie, 2000). The qualitative information (ie, hui, consultation and community endorsement) must be given weight in considering best practice and for an evidence base.