Providing health services to indigenous peoples

A combination of conventional services and indigenous programmes is needed Although indigenous health is influenced by many factors outside the formal health sector, access to quality health services is none the less an important determinant of good health.1 In New Zealand, efforts to improve Maori health have resulted in substantial shifts across the entire health sector. The primary driver for reorienting health services is linked to health gains and a reduction in disparities between Maori and non-Maori. However, the position of Maori as indigenous people adds another dimension, reflected in section 8 of the New Zealand Public Health and Disability Act (2000), requiring health services to recognise the principles of the Treaty of Waitangi, an 1840 agreement that saw sovereignty exchanged for Crown protection. Because of the treaty, Maori occupy a position that is not afforded other non-indigenous ethnic minority groups, even where comparable standards of health exist. Of the several approaches to improving health services for indigenous health two broad directions can be identified: increasing the responsiveness of conventional services and establishing dedicated indigenous programmes. Both approaches are endorsed in legislation and government health policy. The …