Mauri oho, mauri tu, mauri ora: Enhancing Maori health and wellbeing through a critical engagement with social marketing
This PhD research originally explored the efficacy of social marketing as potentially beneficial for Maori health providers involved with Maori health promotion activities. However, as I became conscientised to the potentially assimilist and neocolortial impacts .of functional management disciplines, such as social marketing I turned my attention as a Kaupapa Maori researcher to the task of critique and transformative social action. I also became acutely aware that the future of Maori health advancement lies in the flourishing of Te Ao Maori - a flourishing deemed necessary for the wellbeing of the people and the natural environment .in which Maori live is presented in this thesis. Te Ao Maori is therefore repositioned as a way in which to conceptualise Maori health and wellbeing, based upon holistic and cultural principles of living. Based on the transformative aspirations of critical theorists and emerging theories of kaupapa Maori, I incorporate the holistic constructs of Te Ao Maori while minimising the impact of the externally imposed mechanistic and functional metaphors dominating the contemporary formulation of human wellbeing. Using a localised participative methodology called Kaupapa Maori, I have worked collaboratively with four Maori groups and various kaiarahi hauora in Tauranga Moana to examine and articulate a series of collective responses to research issues. As a result of this research, my findings indicate that Maori continue to articulate a desire to live by principles and practices espoused through holistic models of Maori health and wellbeing, nestled into Te Ao Maori. That vision however is affected by continual structural change, limited resources, lack of access to skilled people, the imposition of contractual regulations within the health system, the erosion of Maori cultural systems and the ongoing commodification of Maori health and wellbeing in concert with the principles of market driven economies driving much human activity globally. The experience of Maori in Aotearoa New Zealand is the localised manifestation of the experiences of indigenous people across the globe. We share with them a position of resistance to the values of others and the affirmation of our own values. The potential of social marketing to contribute to enhancing Maori health and wellbeing was critiqued within these lived experiences, not those defined by social marketers themselves. In the control of uncritical social marketers, social marketing models are one of many conceptual frameworks that are being used to intensify economic rationality associated with the contemporary form of capitalism and the exacerbation of resource scarcity sanctioned by the existing health services system. Many of the co-participants in this research sought to provide health services and programmes that resembled and encouraged strong Maori cultural practices based upon tikanga Maori that emphasises a commitment to Whanau, Hapu and Iwi. However, the current health system does not help these goals to flourish. Instead, proponents of the system endorsed a regime of health services that operated within the specific constraints of contractual agreements - agreements which require responsibility for outcomes and accountability protocols that consume many resources better spent elsewhere. The opportunity then to engage in the enrichment of Maori health and wellbeing, through a holistic means was reported by participants in this research to be often undermined, minimised and sometimes made impossible. This research demonstrates that Maori efforts to enhance Maori health development are negatively impacted upon by an ongoing commercialisation and commodification of health services. Ongoing efforts _must be made to reinvigorate with and within Maori, an enduring commitment to a foundation of holistic health and wellbeing in the future, stemming from our own worldview - Te Ao Maori. The critical and Kaupapa Maori theories that inform this thesis have been used to bring into the open the contradictions and paradoxes Maori health providers in the Tauranga region are facing. The transformational aspirations of these theories would invite attention to be paid to values underpinning Maori communities and the ways in which they are useful to them. As reported upon in this research, those Maori health advocates adopting social marketing will find it difficult to achieve these aspirations. Instead, the assimilist modem colonising practices inherent in social marketing would tum Maori adopters into self colonisers.
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