This page outlines some different Māori models of health and models of practice.
Te Whare Tapa Whā – Mason Durie
The four cornerstones (or sides) of Māori health in the Te Whare Tapa Whā model of health are:
- Taha tinana (physical health – capacity for physical growth and development)
- Taha wairua (spiritual health – the capacity for faith and wider communication)
- Taha whānau (family health – the capacity to belong, to care and to share)
- Taha hinengaro (mental health – the capacity to communicate, to think and to feel mind and body are inseparable)
Image credit: Ministry of Health, NZ
The cornerstones interlock and together provide stability. Each is essential for maintaining health and wellbeing. Damage to any of these may result in an individual or collective becoming ‘unbalanced’ and unwell. Read more about the Te Whare Tapa Whā model of health.
Meihana model – Pitama, Robertson, Cram, Gillies, Huria and Dallas-Katoa
Image credit: University of Otago, NZ
This builds on the Te Whare Tapa Whā model, adding two extra elements, to form a mental health practice model for working with Māori.
The additional elements are:
- Taiao (physical environment, eg, warmth of housing, access to services)
- Iwi Katoa (societal context, eg, societal values, laws and beliefs about appropriate behaviour).
Pitama and colleagues describe it as “a framework that facilitates fusion of clinical and cultural competencies to better serve Māori within mental health service delivery. It has six dimensions that interconnect to form a multidimensional assessment tool”. It is intended to be used from the start of the first contact with a client and their whānau and builds a comprehensive picture of whānau circumstances and how the client’s presenting issues fit within the picture.
A full description of the model, its development and how it is designed to be used can be found here.
Te Wheke – Rose Pere
In this model of Māori health, the dimensions are based on Te Wheke, the octopus and the 8 tentacles that collectively contribute to waiora or total wellbeing:
-
Te whānau – the family
- Waiora – total wellbeing for the individual and family
- Wairuatanga – spirituality
- Hinengaro – the mind
- Taha tinana – physical wellbeing
- Whanaungatanga – extended family
- Mauri – life force in people and objects
- Mana ake – unique identity of individuals and family
- Hā a koro ma, a kui ma - breath of life from forbearers
- Whatumanawa – the open and healthy expression of emotion.
Read more about the Te Wheke model.
Te Pae Māhutonga – Mason Durie
Te Pae Māhutonga (Southern Cross star constellation) brings together elements of modern health promotion.
Image credit: Ministry of Health, NZ
The four central stars represent:
- Mauriora – cultural identity
- Waiora – physical environment
- Toiora - healthy lifestyles
- Te Oranga – participation in society
The two pointers represent Ngā Manukura (community leadership) and Te Mana Whakahaere (autonomy). Read more about the Te Pae Māhutonga model.
Learn more
Māori models of health Ministry of Health, NZ
Te Wheke Ministry of Health, NZ
Lecture on Meihana method for better understanding Māori patients’ health needs Ministry of Health, NZ
Piripi T, Body V. Tihei-wa mauri ora NZ J Couns. 2010;30(1):34-46.
Durie M. Te Pae Māhutonga – a model for Māori health promotion Health Promotion Forum of New Zealand Newsletter 49
References
Māori models of health Ministry of Health, NZ, 2017
Pitama S, Robertson P, Cram F. et al. Meihana model – a clinical assessment framework NZ J Psycol. 2007;36(3):118-125.
Piripi T, Body V. Tihei-wa mauri ora NZ J Couns. 2010;30(1):34-46.
Tihei-wa Mauri Ora
Three models of practice were described by Te Rau Matatini in Indigenous Insight, Inspiring Innovation - Kaupapa Māori Models of Practice Series 1. The aim was to enhance knowledge of Māori models of practice and demonstrate the strengths of Māori in Aotearoa.
1. Te Ahikaa – Elaine Ngamu
A practice model for working with methamphetamine ‘P’ users in a residential setting. The model has four aspects: raising awareness; learning and support, whānau involvement and intervention, and new possibilities.
It is based on the principles/values of:
- Whanaungatanga – make connections, engage with and get support from others
- Manaakitanga – make sure the children and taken care of and help whanau to health
- Mōhiotanga – know what you are dealing with and know when to do what
- Kaha – doing whatever it takes.
2. Tihei-wa Mauri Ora! – Teina Piripi and Vivienne Body
Informed by the writings of Rev. Māori Marsden, the “kaupapa of this framework is in the ‘knowing’ that the Māori worldview holds the knowledge for Māori to make sense of their own existence and life to begin their own healing journey”. Tihei-wa Mauri Ora is a narrative suicide risk assessment tool originally developed for at-risk teenagers.
Image credit: https://tihei-wamauriora.mystrikingly.com/
It is based on the Māori worldview of creation which has 5 realms as follows:
- Te Kore Kore – The vast mass of potential being, imbued with divine essences (conception)
- To Pō Realms – Darkness and night stages of growth and development (the child grows within the mother’s womb)
- Ki Te Whai-Ao – The realm of coming into being, critical changes and transition, glimmer of light (mother goes into labour in process of birthing)
- Ki Te-Ao Marama - The realm of light and being, this world, mortality (child is born into the realm of light)
- Tihe-wa Mauri Ora – The breath of life.
These stages of being represent any aspects of our lives that can be represented metaphorically with Māori cultural understandings of growth, development, life and being. For example, how we feel, our relationships and our health and wellbeing. By understanding the concepts and the stories behind them people can apply them to what is happening in their own lives.
It is based on the principles of:
- Whāia Te Oranga – willingness to grow/change, wellbeing
- Mātauranga Māori – provides meaning and understanding, purpose
- Kia Ū Ki Te Rongomau – healing and wellbeing.
There are no specific guidelines for its application, but further information is available.
3. Te Pito Whānau Healing Model – Kim Whaanga-Kipa and Manny Kipa
“Te Pito - As an analogy, Te Pito (umbilical cord) is the lifeline that connects us to our past and future. Te Pito provides sustenance and has the ability to protect whakapapa. It has the ability to cleanse the impurities when contaminated. However, when abused it too can become the vehicle to alter whakapapa. This is likened to the healing journey of whānau who have been impacted due to historical grief and trauma which can lead to addictions, violence and suicide. Healing needs a process of understanding what transformation means, not only to the individual, but also to the collective or whanau” (p. 17).
The kaupapa of Te Pito is about a healing model for whānau led by whānau with experience of addictions, mental health and violence. It acknowledges the process that happens when a person is transforming and learning to move from being an individual to being part of a collective. This process was seen to be missing from other practice models. Based on whakaaro Māori (Māori thinking) it is a healing model for those in addiction recovery. It acknowledges that ‘getting straight’ is one thing but there is a need to learn to live and restore relationships. It was developed to meet the ongoing need for support following treatment.
The model focuses on 5 states of being where whānau determine where they are at, at any given moment or in any given state:
- Kahupō, being a state of spiritual blindness or oppression
- Whakaoho, being the awakening, realising that change needs to occur
- Whakawātea, being about dispelling the illusion, creating a safe place to be, creating opportunity to talk together and finding support
- Te Pūtake, being a state of readiness to change
- Tū Wawata, being a state that focuses on future planning and aspirations.
The principles it is based on are:
- Whanaungatanga - restoring relationships, weaving people together
- Manaakitanga - nurture and support people to ‘be’ and ‘become’.
