Browsing by Author "Koia, Monica Ngaire"

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    Enhancing Māori mental health workforce : "Te Rau Puawai o te kawakawa o te ora" : a 152.800 thesis presented in partial fulfilment of the requirements for the degree of Master of Management at Massey University, Manawatu, New Zealand
    (Massey University, 2010) Koia, Monica Ngaire; Koia, Monica Ngaire
    At the Hui Whakaoranga (Maori Health Planning workshop) in 1984, and again during the health reforms in 1990, the shortage of qualified Maori employed within the Maori mental health workforce was highlighted. Since this time, the importance of accelerating the professionalism of the Maori mental health workforce has continued to become a focus for Maori health. To support this movement, Te Rau Puawai was established in 1999. Its aim was to recruit, retain and increase completion rates of Maori students, studying towards a health related qualification at Massey University. The greater vision was to support the Maori mental health arena, by contributing qualified Maori to work within the sector. Using a qualitative approach grounded in a kaupapa Maori (Maori topic) framework, this research examined the Te Rau Puawai programme, identifying key characteristics of the core business, and its effectiveness, in an attempt to understand how Te Rau Puawai impacted upon the Maori mental health workforce. The thesis explores the manner in which Te Rau Puawai mentors and supports students to successfully complete qualifications. Further, it attempts to understand the unique and particular nature of Maori health students, as they work towards degrees in this field. This study examines in detail the components of the programme that positively impact on the students, creating an environment of excellence. The programme is also assessed against its initial purpose to determine its success. In addition, the governance, management and implementation structures of Te Rau Puawai are revealed, showing a mixed method approach, involving Western approaches, but firmly based in tikanga Maori (Maori customs and traditions). The findings uncovered within this research study, are used to produce a framework (Te Rau Puawai o te kawakawa o te ora) that summarises the key findings. In essence, this framework is a best practice model for mentoring Maori students studying towards health related degrees. While the success of the programme is an important factor, the paramount goal is the health and well-being of all Maori people.
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    He pito ora : exploring the role of Māori cancer navigators : a thesis presented in partial fulfilment of the requirements of the degree of Doctor of Philosophy in Public Health (Māori Health)
    (Massey University, 2019) Koia, Monica Ngaire
    In Aotearoa, New Zealand, cancer is now the leading cause of death. The cancer burden is disproportionately high for Māori, the indigenous people, compared with non-Māori across all stages of the cancer continuum. Additionally, Māori experience access barriers to timely and quality cancer care. Māori cancer navigator positions were created to assist patients in negotiating the complex cancer system. To date, no research has examined the Māori cancer navigator’s contribution to cancer service provision, including the ways in which they undertake their key role of providing supportive care to patients with cancer. The overall aim of this study was to examine the implementation of Māori cancer navigator/coordinator roles, and their contribution to and impact on the experience of Māori health consumers, patients, and whānau during their cancer care journey. The objectives of the study were to: 1) describe the ways in which Māori cancer navigator positions have been developed across the cancer continuum; 2) examine the contextual factors impacting on Māori cancer navigator roles; and 3) identify key success factors relating to the ways in which Māori cancer navigator positions make a difference to the patient/whānau cancer experience. The study is underpinned by kaupapa Māori methodology. Participants were recruited from Māori health consumers, patients, whānau, Māori cancer navigators, and clinical and non-clinical health professionals involved in cancer care. Data was collected via semi-structured interviews, observation and hui (n=24), and an online survey (n=52). The data were analysed using thematic, whakapapa and experiential analysis and the emergent themes applied to a continuity of care framework. The major themes/principles identified from this work were: whanaungatanga, which relates to trust and multiple relationships; whakamōhio, which encompasses communication and the sharing of information and; manaakitanga, where consistency in care and system influences are the key factors. These principles were developed into a model He Pito Ora for this thesis. Māori cancer navigator/coordinator positions help facilitate patient/whānau continuity of care. Greater integration of Māori cancer navigators/coordinators within cancer services will help address fragmentation in care and improve communication between health professionals and with patients and whānau. These are key areas which can improve the quality of care and potentially make a difference to patient/whānau cancer outcomes.