Kōrero Mai: A Kaupapa Māori study exploring the experiences of whānau Māori caring for tamariki with atopic dermatitis

Abstract

Racism and colonisation have caused the systemic exclusion of Indigenous Māori populations in Aotearoa (New Zealand) and the perpetuation of health inequities. Atopic dermatitis, a chronic skin condition, is one such example where Māori tamariki (children) are disproportionately affected. International research highlights the challenges of caring for children with atopic dermatitis; however, there has been no such research in Aotearoa. This small qualitative study, using Kaupapa Māori (Indigenous Māori) methodology, aimed to explore the experiences of Māori parents caring for their tamariki with atopic dermatitis. Cultural engagement was paramount to the research using kaupapa kōrero (cultural narrative) through kanohi-ki-te-kanohi (face-to-face) interviews to explore the lived experiences of six whānau Māori (Māori families). Data were analysed thematically using a kaupapa Māori lens with five overarching themes: 1) the constant hard work of maintaining good skin health for tamariki; 2) the embarrassment is punishing for whānau; 3) courage is required to maintain vigilance; 4) constantly seeking solutions; and 5) whānau/people-focused solutions. Kōrero (conversations) illustrated that whānau Māori experience systemic racism across health, education, and social systems; implicit bias; and differential treatment within health services that impact caring for their tamariki. These findings reiterate the failure of mainstream primary healthcare institutions to enact Te Tiriti o Waitangi obligations and ensure health equity for whānau Māori. To survive and thrive within their contexts, Māori whānau drew on mātauranga Māori (Māori knowledge systems) in their everyday practices. Therefore, strategies to support whānau to reclaim and maintain Indigenous practices, alongside the responsibility of healthcare providers to improve health outcomes, are imperative to achieve health equity for Māori.