Māori child health, Te Tiriti and culturally safe care — formative SAQs

SAQ 1 (10 marks)

A 4-week-old Māori pēpē attends clinic with māmā. Enrolment is incomplete, immunisations are due, māmā smokes, and the baby sometimes sleeps in the adult bed after night feeds. [9] [17]

1. Define cultural safety and contrast it with cultural competence theatre. (3) [1]
2. Outline the Hui Process steps you will use in this visit. (3) [2]
3. Give four concrete equity actions for enrolment, immunisation, smoke and safe sleep (including culturally designed options where relevant). (4) [7] [9] [11]

Model answer

Cultural safety is defined by whether the child and whānau experience care as safe. It examines power, racism and equity. Competence theatre is clinician-centred self-rating and custom checklists that can still stereotype and leave outcomes unequal. [1]

Hui Process: mihi (greet/engage) → whakawhānaungatanga (connection) → kaupapa (purpose/agenda of the visit) → poroaki (closing and next steps). [2]

Actions: actively complete primary-care enrolment; offer indicated immunisation same day if valid; counsel smoke-free home/car and smoking cessation supports; teach room-share with firm flat bare sleep surface and discuss wahakura/pēpi-pod style options where available while addressing bed-sharing hazards without shame. Name a follow-up owner. [7] [9] [11]

SAQ 2 (10 marks)

A 5-year-old Māori child has recurrent otitis media, a failed B4 School Check hearing screen with no completed audiology visit, and recent impetigo in a high acute rheumatic fever incidence region. [12] [15]

1. Explain why “DNA = non-compliant Māori family” is a failed formulation. (2) [11]
2. List the dual axes of a Meihana-style assessment for this child. (3) [3]
3. Write a closed-loop management plan covering ear/hearing and skin/ARF risk. (5) [12] [15]

Model answer

DNA is often a system quality signal (hours, transport, trust, prior racism, appointment design), not an ethnic personality trait. Equity aims at equal outcomes, not equal intention. [11]

Meihana-style dual axes: standard clinical assessment (ears, hearing, skin, growth, development, red flags) plus Māori beliefs, values, experiences, supports and barriers that shape the problem and the plan. [3]

Plan: treat current ear and skin disease; rebook audiology/ENT with barrier removal (transport, timing, proactive recall); safety-net hearing and speech; in high-ARF settings use local skin/sore-throat pathways and educate on fever/joint symptoms; document ethnicity accurately; share plan with whānau using teach-back; name owner and timeframe for each step. [12] [15]