E nga mana, e nga reo, e nga waka, i roto te motu o Aotearoa, tena koutou. Tena koutou hoki i o tatou tini aitua kua ngaro ki te ao wairua, haere atu ra koutou, haere. Ratou nga konohi ngaro kia ratou, tatou nga kanohi kitea, tena koutou, tena koutou, tena tatou katoa.

Greetings also to those who have passed onto the spirit world, farewell to you all. Greetings to us all. They the dead have passed on, we the living, remain.

Introduction

The New Zealand Guidelines Group (NZGG) acknowledges the importance of the Treaty of Waitangi to New Zealand. The Treaty establishes a unique and special relationship between iwi, Māori and the Crown. The NZGG considers the Treaty principles of partnership, participation and protection as central to improving Māori health. Therefore, the NZGG will operate in a manner that is consistent with these principles with the overall aim of improving Māori health and reducing disparities in health status between Māori and non-Māori.

The NZGG acknowledges that Māori Health is a specifically identified health gain priority area in New Zealand. This purpose of this document is to:

• outline Māori involvement in guidelines activity to date 
• document the NZGG's Māori health policy 
• specify how the NZGG intends to implement this policy by proactively involving Māori and explicitly considering Māori health improvement in its activities.

Previous and current Māori involvement in NZGG’s work

The NZGG has explicitly involved Māori health professionals and consumers in its governance. The following are previous and current Māori members:

• Professor Colin Mantell
• Owen Lloyd 
• Wendy Walker
• Sharon Lambert
• Dr. Dwayne Crombie (current)
• Janet Maloney-Moni
• Dr. Jim Vause (current)

A number of Māori health professionals and consumers have been involved in the development of evidence-based guidance; for example: NZGG often has sub-groups in place to deal specifically with issues specifically relevant to Māori. Most of its guidelines have specific chapters addressing issues for Māori. For example:

• the Management of Type 2 Diabetes guideline contains a chapter on Māori perspectives 
• the Assessment and Management of People at Risk of Suicide guideline has a chapter addressing assessment and crisis management with Māori
• when NZGG developed the Assessment Processes for Older People guideline, a summary developed and printed in Māori and was reviewed by Wi Keelan from the Ministry of Health
• the Care of Women with Breech Presentation or Previous Caesarean Birth guideline has a chapter on Māori Perspectives 
• the Management of Burns and Scalds in Primary Care guideline has a specific chapter on burn injuries in Māori.

NZGG policy on Māori health 

In order to help achieve improvements in Māori health and reduce Māori/non-Māori health disparities, the NZGG will continue to involve Māori proactively in its activities and consider explicitly the health needs of Māori in its work.

Implementation of this policy

NZGG’s commitment to improving Māori health outcomes means we work as an organisation to identify and address Māori health issues relevant to each piece of guidance.

NZGG works to ensure that Māori participation is a key part of the guidance development process. It is important to differentiate between involving Māori in the process (the aim of which is to encourage participation and partnership) and specifically considering Māori health issues pertinent to that guidance. While Māori participation in guidance development aims to ensure the consideration of Māori health issues by the guidance team, this is no guarantee of such an output; the entrenched barriers Māori may encounter when involved in the health care system (in this case guidance development) need to be addressed. NZGG attempts to challenge such barriers by specifically identifying points in the guidance development process where Māori health must be considered and addressed. In addition, it is expected that Māori health is considered at all points in the guidance in a less explicit manner.

NZGG specifically gives effect to its policy by:

1. having at least two Māori directors on its Board to ensure Māori input into its governance (Dr Jim Vause is the first Māori Chair)
2. ensuring that guidance advisory/development teams and implementation advisory groups sponsored directly by NZGG include Māori representation
3. ensuring that the process of developing guidance is inclusive, through ensuring that:
   • it is collaborative and incorporates a broad range of perspectives 
   • guidance development teams have time to listen to each other and form a view on the evidence together, before the guidance is circulated externally
   • all members of guidance development teams feel safe to present their points of view and have these perspectives heard, acknowledged and valued
   • there is transparency about the focus of the evidence and range of methodologies when searching for and appraising evidence
   • there is a focus on research questions and methodologies that are relevant to consumers
   • evidence of a qualitative nature should be woven into scientific evidence.
4. promoting a policy of inclusion of Māori participants on all evidence-based guidance teams that are not directly sponsored by the NZGG
5. having a methodological approach to the consideration of implementation strategies for Māori health and disability professionals and consumers
6. maintaining and developing links with Māori health care professional organisations, such as Te Ora, Nga Ngaru Hauora O Aotearoa, Māori health care and disability support providers and Māori consumer groups to help promote the principles of evidence-based practice with these groups
7. having a methodological approach to the consideration of evidence about the effectiveness of health and disability practice for Māori where such evidence exists
8. ensuring that there are Māori participants in all guidance training activities
   9. working with Māori organisations such as Te Ora to improve the inclusion of Māori values in the development and implementation of best-practice guidance
9. promoting evidence-based practice throughout the health care sector so that Māori, who suffer a disproportionate burden of disease, are able to benefit from the most effective diagnosis and management
10. disseminating information about effective practice widely to Māori health and disability professionals and consumers to improve overall knowledge of what practice is effective

The Advisory Board maintains a plan to ensure that the New Zealand Guidelines Group remains responsive to the needs of Māori in its operations.