Objective: This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was ‘What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?’ Methods: A systematic search using PRISMA protocols and reflexive typology organised around the categories of Māori, public healthcare and qualitative research identified 14 papers that covered all three categories. We undertook a qualitative metasynthesis on these papers using a critical community psychology approach. Results: Māori patients and whānau from the included papers mention both barriers and facilitators to health. We categorised barriers as organisational structures, staff interactions and practical considerations. Facilitators were categorised as the provision of whānau support in the form of practical assistance, emotional care and health system navigation. Conclusions: For many Māori, the existing public health system is experienced as hostile and alienating. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Implications for public health: Public health providers must find ways to ensure that Māori consistently experience positive, high‐quality healthcare interactions that support Māori ways of being.

The COVID-19 pandemic and associated response have brought food security into sharp focus for many New Zealanders. The requirement to “shelter in place” for eight weeks nationwide, with only “essential services” operating, affected all parts of the New Zealand food system. The nationwide full lockdown highlighted existing inequities and created new challenges to food access, availability, affordability, distribution, transportation, and waste management. While Aotearoa New Zealand is a food producer, there remains uncertainty surrounding the future of local food systems, particularly as the long-term effects of the pandemic emerge. In this article we draw on interviews with food rescue groups, urban farms, community organisations, supermarket management, and local and central government staff to highlight the diverse, rapid, community-based responses to the COVID-19 pandemic. Our findings reveal shifts at both the local scale, where existing relationships and short supply chains have been leveraged quickly, and national scale, where funding has been mobilised towards a different food strategy. We use these findings to re-imagine where and how responsibility might be taken up differently to enhance resilience and care in diverse food systems in New Zealand.

The dominant research approach to both food insecurity and charitable meal provision is nutritionistic, deficit-orientated and ignores wider socio-economic issues. This reinforces existing power dynamics and overlooks the agency of people living food-insecure lives. We critique this dominant approach and draw on the everyday experiences of families facing food insecurity to ground an alternative approach that emphasises food as a social determinant of health.

Neoliberal narratives dominate constructions of poverty. The dearth of alternative legitimizing narratives effectively silences the lived experiences of issues such as food insecurity. In conjunction with hegemonic silencing, feelings of shame and personal inadequacy further drive these experiences from public view. People living with poverty learn to hide their everyday realities from public scrutiny and engage in social practices in an effort to reduce experiences of stigma, oppression, and social rejection. As part of a larger study into food and poverty, this paper draws on interviews with five householders who source and provide food for their respective families. In doing so, it documents how lived experiences of food scarcity bring the often hidden aspects of marginalized lives into view. Householders utilize practices of passing and food rationing in order to navigate the shame and moral accusations associated with poverty.

In this paper, whanau Maori highlight how a Kaupapa Maori-centred intervention (the Harti Hauora Tamariki tool, hereafter Harti tool) has improved interactions with health services. The Harti tool is undergoing a randomised control trial (RCT) at Waikato Hospital in New Zealand. As part of the RCT, the authors engaged in a series of qualitative interviews with whanau members of tamariki Maori (children aged 0–5 years) admitted to Waikato Hospital’s paediatric ward. Whanau who met at least one criteria for New Zealand’s domains of deprivation were included. Using a Kaupapa Maori approach to the study, participants shared their views on barriers and facilitators to accessing health resources and primary care services. The interviews conducted highlight how the Harti tool, when administered in a culturally appropriate and respectful manner that prioritised relationship-building, enabled better connection to healthcare services. Prevalent in our analysis were connections to wider determinants of health and ways to reduce existing health inequities. To conclude the paper, how the Harti tool has enhanced feelings of being in control of health, with the potential to reduce the likelihood of a hospital readmission, is highlighted.

The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.