If we can just dream horizontal ellipsis Maori talk about healthcare for bipolar disorder in New Zealand: A qualitative study privileging Indigenous voices on organisational transformation for health equity

Objectives This paper identifies barriers to equity and proposes changes to improve the organisation of healthcare in New Zealand for Maori with bipolar disorder (BD) and their families. Design A qualitative Kaupapa Maori methodology was used. Twenty-four semi-structured interviews were completed with Maori with BD and members of their family. Structural and descriptive coding was used to organise and analyse the data, including an analytic frame that explored participants' critique of attributes of the organisation of healthcare and alignment with Maori health policy. Results Transformation to the organisation of healthcare is needed to achieve health equity. Executive management must lead changes to organisational culture, deliver an equity partnership model with Maori, embed cultural safety and redesign the organisation of healthcare to improve wellbeing. Healthcare incentive structures must diversify, develop and retain a culturally competent health workforce. Information management and technology systems must guide continued whole system improvements. Conclusion This paper provides recommendations that should be considered in planned reforms to the organisation of healthcare in New Zealand. The challenge remains whether resourcing for an equitable healthcare organisation will be implemented in partial fulfilment of promises of equity in policy.

Automated summary

This study uses a qualitative Kaupapa Maori methodology to identify barriers to equity in healthcare for Maori with bipolar disorder and their families in New Zealand. The study suggests that transformation of the healthcare organization is needed to achieve health equity, including changes in organizational culture, the implementation of an equity partnership model, and the development of a culturally competent health workforce.