Three position statements currently guide the strategic decision-making of the Board with regard to good sexual and reproductive health services for Māori. The position statements are informed by Mātauranga Māori and current Māori research.

Māori and comprehensive sexuality education

School-based comprehensive sexuality education that is informed by Mātauranga Māori understandings of sexual and reproductive health is an important vehicle for achieving Māori individual and collective health and wellbeing. Mātauranga Māori-based sexuality education should be a core component of the curriculum for all rangatahi attending Māori and English-medium schools. Taught well, Mātauranga Māori-based sexuality education supports rangatahi and whānau to participate in te ao Māori, build individual and collective capacity, strengthen cultural and intellectual resources, and expand the Māori estate for the future. However, success across these domains requires schools to work in partnership with local Māori experts to develop and deliver age-appropriate Mātauranga Māori-based sexuality education that meets rangatahi and whānau expectations. English-medium schools with large Māori student populations and all kohanga reo, kura kaupapa Māori and wharekura should be well resourced and supported to develop and deliver sexuality education programmes that draw upon traditional and contemporary Māori knowledges, including Mātauranga-a-iwi where appropriate. Unfortunately, many English-medium schools use a ‘one-size-fits-all’ approach to sexuality education, adding the occasional ‘out-of-context’ whakatauki or Māori term to what is essentially a programme for Pākehā students. Such programmes problematise rangatahi and whānau perspectives of sexuality, sexual experience, gender and sexual identity, pregnancy, contraception and sexually transmitted infections. Evidence-informed sexuality education programmes that are informed by Mātauranga Māori resonate for Māori and are a critical component of broader Māori community development, health and wellbeing.

MĀORI AND SEXUALLY TRANSMITTED INFECTIONS (STIs)

Early STI testing, treatment and prevention is central to achieving good Māori health and wellbeing, now and in the future. Undiagnosed and untreated STIs can cause serious health problems for rangatahi, young parents, and newborn babies. STIs also present a serious risk to the whakapapa of whānau, hapū and the prosperity of future generations: infertility is not commensurate with healthy, self-determined Māori futures. Most rangatahi attending school report they use condoms consistently but little is known about those reporting intermittent condom use. Further, little is known about barriers to good sexual and reproductive health for rangatahi attending Alternative Education Centres and rangatahi who are out of education, employment and training. Differential access to employment, education and housing are key factors driving health disparities experienced by Māori in the area of sexual health and this is especially true for rangatahi. STI-related stigma and discrimination AND the low health literacy of sexual health organisations and health professionals delivering sexual and reproductive health services are likely barriers to testing, treatment and prevention services, including testing for HIV. Māori of all ages, but in particular rangatahi out of education, employment and training urgently require free and accessible culturally appropriate, decolonised and evidence-informed STI information, testing, treatment and prevention services.

MĀORI AND ABORTION

Annually, Māori women comprise one quarter of the total number of women in Aotearoa New Zealand having an abortion. Roughly one quarter of all pregnancies in Aotearoa New Zealand end in abortion, and 1 in 4 women has an abortion in her lifetime. Pūrakau suggest fertility control, including abortion, was a feature of pre-colonial whānau, hapū and iwi groups –  particularly in times of warfare, raupatu and displacement from tribal territories. However, little research has been conducted on this matter, including research with Māori women and whānau regarding their specific worldviews and requirements associated with early access to medical and surgical abortion. Abortion is regulated by a number of laws, one of which is the Crimes Act 1961 which is ill-suited to determine what is a matter of health, not a criminal activity. The barriers to early access to abortion services for some populations, including some Māori communities, is of concern. So too is the failure of recent abortion service guidelines to prioritise the development of free, accessible Mātauranga Māori-informed, decolonised abortion services and information that meets the needs of Māori women of all ages, and their whānau. Research by Māori that explores traditional and contemporary Māori concepts and understandings relating to abortion is urgently needed to inform timely access to abortion information, guidelines, and services.

DEVELOPMENT OF THE POSITION STATEMENTS

As a kaupapa Māori sexual and reproductive health promotion organisation, we developed statements in order to facilitate rangatiratanga for whānau and Māori communities. The statements are evidence-based and informed by Mātauranga Māori. Our Board uses the statements to guide their strategic decision-making. The statements also provide the Māori communities with the rationale for our approach to sexual and reproductive health.

In May 2013, the Health Services Research Centre, Victoria University, were contracted to research and write reviews of relevant literature about sexuality education, sexually transmitted infections, and abortion published between 2000 and 2013. The reviews were updated by Te Whāriki Takapou in 2015 and three statements were produced. A fourth position statement on contraception is planned.

HOW TO USE THESE POSITION STATEMENTS

We encourage anyone involved in sexual and reproductive health services with Māori to consider the position statements in relation to what, why, and by whom those services are developed and delivered. Evidence-informed discussion and decision-making is required to reorientate sexual and reproductive health policy and existing services. We value your input. Please add your comments below or email tewhariki@tewhariki.org.nz.