Puanga–Matariki Insights Series Concludes with Whānau Voice Report on Stroke and Gout
Kua mutu te Raupapa Rangahau o Puanga me Matariki, kua tāia te Pūrongo Reo Whānau mō te Mate Ikura Roro me te Mate Porohau
Kua mahi tahi te Poari Hauora o Āti Awa Toa ki a Stroke Aotearoa me Mateponapona Aotearoa kia mārama ake ki te pānga o te mate ikura roro me te mate porohau ki ngā whānau, ki ngā momo ratonga, tautoko hoki hei āwhina i a rātau. Nō muri mai i te rangahau tuihono e 6 wiki te roa i te tīmatanga o te tau, i kohikohi mātau i ngā wheako a ngā whānau Māori i te Te Whanga-nui-a-Tara (Pōneke/Porirua/Kapiti/Te Awakairangi).
Nā ngā mahi nei kua tāia tētahi pūrongo ko WHĀNAU VOICE: Whānau Māori experiences of stroke and gout across the Wellington rohe1. Ka whakaterehia tēnei pūrongo i te rā nei, koia ko te pūrongo tuatoru i te Raupapa Rangahau a te Poari Hauora o Āti Awa Toa o Puanga me Matariki mō 2026. Ka titiro te pūrongo nei ki ngā wheako a ngā whānau e ora ana me te mate ikura roro, te mate porohau puta noa i Te Whanga-nui-a-Tara, ka tohu hoki i ngā huarahi hei whakapaipai i ngā mahi aukati, maimoa, ngā hua mauroa, me te aro ki ngā ōritengakore e rongo ana a Ngāi Māori.
Hei tā te Manahautū o te Poari Hauora o Āti Awa Toa, hei tā Hikitia Ropata “Kitea ana i tēnei kaupapa te kaha o te mahi rangapū ki waenga i te Poari Hauora o Āti Awa Toa, i a Stroke Aotearoa me Mateponapona Aotearoa, e mahi tahi ana ki te hāpai i te reo o te whānau. Ko te pūrongo whakamutunga tēnei i tā mātau Raupapa Rangahau o Puanga me Matariki, ka whakamahara i a tātau ko te whakarongo ki te whānau te hātepe tuatahi noa iho nei. Kei te whai haepapa mātau ināianei ki te whakarite ka tārai ngā reo nei i ngā mahi whakamāherehere, tuku pūtea hoki me ngā ratonga hei tautoko i ngā anamata waiora mā ngā whānau puta noa i te rohe.”
E kī ana te kaihautu o Stroke Aotearoa, ko Jo Lambert “Ko te mahinga tahi nei ki waenga i a Stroke Aotearoa, te Poari Hauora o Āti Awa Toa me Mateponapona Aotearoa kua whakamiramira i ngā āputa ā-pūnaha e whai pānga ana ki ngā hua hauora a ngā tāngata i muri i te mate ikura roro, i te mate porohau me ō rātau whānau anō hoki. Ka whakamiramira ngā kitenga nei i ngā wāhi ka taea e te pūnaha te whakapaipai āna mahi, me pēnei ka tika, heoi mā te mahi tahi ka taea te tautoko ngā huarahi me ngā hua whai oritetanga hei whakahaere i ēnei mate mau-roa.”
Hei tā te kaihautu o Mateponapona Aotearoa, hei tā Philip Kearney “Ka whakatauira mai tēnei i ngā mahi ka taea ki waenga i ngā iwi, ngā whakahaere hapori me ngā hoa rangapū hauora ina ka mahi i runga i te whakaaro kotahi ki te hāpai i te ōritetanga me te hauora whānau. Mā te āta mahi rangapū, mā te whakatairanga i ngā reo o ngā whānau, ka mārama ake tātau ki ngā taiapa kei mua i te tangata, ka taea te mahi tahi ki te tautoko i ngā hua hauora, waiora hoki mō ngā whakatipuranga e heke mai ana.”
Puanga–Matariki Insights Series Concludes with Whānau Voice Report on Stroke and Gout
Āti Awa Toa Hauora Partnership Board has partnered with Stroke Aotearoa and Arthritis NZ Mateponapona Aotearoa to better understand how stroke and gout affect whānau and what services and support would help. Following an online survey that ran for 6 weeks at the beginning of the year, we gathered experience from whanau Māori in the Wellington rohe (Pōneke/ Porirua/ Kāpiti/ Te Awakairangi).
This mahi has resulted in a report called WHĀNAU VOICE: Whānau Māori experiences of stroke and gout across the Wellington rohe. This report is being launched today and is the 3rd report in Āti Awa Toa Hauora Partnership Board’s Puanga-Matariki Insights Series 2026. The report examines the experiences of whānau living with stroke and gout throughout the Wellington region, identifying opportunities to improve prevention, treatment and long-term outcomes while addressing persistent inequities experienced by Māori.
Āti Awa Toa Hauora Partnership Board Manahautū, Hikitia Ropata says “This kaupapa demonstrates the strength of partnership between Āti Awa Toa Hauora Partnership Board, Stroke Aotearoa and Arthritis NZ Mateponapona, working together to elevate whānau voice. As the final report in our Puanga–Matariki Insights Series, it reminds us that listening to whānau is only the first step. Our responsibility now is to ensure those voices shape planning, investment and the services that support healthier futures for whānau across our rohe.”
Stroke Aotearoa CE/kaihautu Jo Lambert says “This collaboration between Stroke Aotearoa, Āti Awa Toa Hauora Partnership Board and Arthritis New Zealand has shone a spotlight on systemic gaps which impact health outcomes for people managing their life after stroke and / or with arthritis, as well as their whānau. These insights highlight where the system could and should be doing better, and by working collectively our organisations can support equitable pathways and outcomes for the management of these long-term conditions.”
Arthritis NZ Mateponapona Aotearoa CE/kaihautu Philip Kearney says “This kaupapa demonstrates what is possible between iwi, community organisations and health partners when we come together with a shared commitment to equity and whānau wellbeing. Through authentic partnership and by elevating the voices of whānau, we can better understand the barriers people face and work collectively to support health and wellbeing outcomes for future generations.”
Te Māra o Hine-Raraunga
Purpose
Te Māra o Hine‑Raraunga (the report) was commissioned in partnership between Āti Awa Toa Iwi Māori Partnership Board and Manatū Hauora to identify culturally appropriate whānau voice data storage and protection solutions that also enable appropriate sharing and utilisation of whānau voice data. This work recognises that for whānau voice to be used effectively to set local and regional health priorities for Māori, trusted processes that uphold the mana of those voices are required.
The report provides:
- an assessment of the limitations in current approaches to whānau voice collection, storage and protection
- a proposed framework (Te Māra o Hine‑Raraunga) describing the key components of a strong whānau voice system
- a staged pathway for how IMPBs can move toward a sovereign, fit-for-purpose system.
Key challenges to the current approach
Current systems are not fit-for-purpose
Whānau voice includes narrative, lived experience and whakapapa-linked kōrero, but is typically collected and stored using tools designed for administrative or transactional data. This creates a fundamental mismatch between the nature of the information and the systems used to manage it, meaning it is not handled in ways that reflect its significance or sensitivity.
Whānau voice data approaches are fragmented and poorly governed
Data is often held across multiple locations, formats and tools, with inconsistent approaches to who can access the data, how it can be used, and what protections apply. Good governance therefore is not embedded in system design.
Data sovereignty cannot be enacted in the current system
The reliance on international corporate platforms means whānau voice data may remain subject to external control and legal jurisdiction. The report suggests that this infrastructure is incompatible with the principles of Māori data sovereignty and does not support rangatiratanga.
Trust in how whānau voice is managed is not assured
Where storage, governance and use are unclear, confidence in the system can be undermined. The report stresses that trust is a necessary precondition to the collection and use of whānau voice. Without confidence in how their kōrero will be handled, whānau may be less likely to share it.
There is no structured pathway toward tino rangatiratanga
Finally, the report emphasises that there is no clear pathway toward a data system that is fundamentally built on Māori data sovereignty principles. As a result, improvements tend to be incremental and ad hoc and do not address the underlying misalignment between existing systems and Māori data governance aspirations.
What the report proposes
The report proposes a sovereignty-first approach to whānau voice data. In practice, this means moving toward systems that are hosted in Aotearoa (as opposed to international corporate systems) and governed in ways that uphold Māori authority and tikanga.
To achieve this, the report introduces Te Māra o Hine-Raraunga; a framework that uses the analogy of a garden to position how data can be collected, stored and used in tikanga-aligned ways. The framework describes five connected components of a successful whānau voice data system:
Foundations
Secure and locally held infrastructure.
Collection
Ensuring the right information is gathered in the right way.
Protection
Safeguarding tapu information.
Use
Turning data into insight and benefit for whānau.
Governance
Tikanga-led oversight and decision-making.
Staged Pathway
The framework also sets out a four-stage pathway for improving whānau voice systems. This staged pathway acknowledges that the ideal state (Stage 4) will take time and investment to reach, but that any change or action made towards the earlier stages will still support a more secure and rangatiratanga-focused whānau voice collection system.
It is also important to note that each stage is not about establishing distinct and new systems and approaches. Rather, the stages represent a progression along the same core dimensions: how whānau voice is collected, stored, protected and used, with each stage improving how these elements are applied.
At their core the stages are:
Stage 1: data is handled consistently and safely.
Stage 2: data is captured in a way that makes it easily usable.
Stage 3: data is handled differently depending on what it is (governance).
Stage 4: the system is defined by a Māori worldview and owned by Māori.
Stage 1| Foundation | Whakarite i te oneone – Preparing the whenua
Stage 1 is about getting to a point where all whānau voice is handled in a consistent, safe way, with basic rules in place for consent, access and use.
It is about moving from the current approach where each IMPB, and potentially each kaimahi, has their own approach to documenting, storing, and labelling data. In stage 1, data is kept in one place, with clear information about what whānau agreed it could be used for, who can access it, and how it can be protected and used.
Stage 2 | Capability Building | Whakatō – Selecting the kakano
At Stage 2, the system moves from simply storing whānau voice to capturing it in a structured way that makes it easier to bring together and identify patterns.
The core shift is that kōrero is no longer just recorded, but organised at the point of entry so it can be used without needing revision or re‑analysis at a later time. At this stage, analysis is built into the way the data is captured.
Stage 3 | Advancing Autonomy | Poipoia te kākano – Nurturing the tupu
This stage is about making sure different types of insights are handled differently, based on clear rules set by the organisation.
The core improvement is from just creating easily usable data to ensuring there are deliberate and unique rules and governance that are tailored to the data that is being collected. Good governance will ensure access, sharing and use of the data is in line with whānau desires and consistent across various whānau voice collection methods.
Stage 4 | Tino Rangatiratanga | Pūawaitia – Sharing the hua
This stage focuses on achieving full sovereignty, where the system is fully designed and shaped by Māori, and reflects tikanga in how whānau voice is collected, protected and used.
In Phase 4, the system itself is designed, structured and owned in line with Māori authority, so that not only the rules, but the underlying logic and use of data reflect tikanga. This represents a shift from controlling a system to defining and owning the system itself.
Final thoughts
The report recognises that most IMPBs currently rely on international corporate systems (such as Microsoft) and that a change to a more sovereign system will need to happen over time. The intention is to provide IMPBS with a road map on how IMPBs can strengthen the approach to their whānau voice collection via specific elements one step at a time.
To support any action arising from this report, IMPBs may also need to first undertake a current state scan – reviewing and understanding their current system and approaches in place for collecting, storing, analysing, protecting, and using whānau voice data. Through improving the understanding of current practices, IMPBs will be better able to identify where exactly changes can be made towards the first Stage of the pathway, beginning the journey to strengthening whānau voice protection.
Or you can read the report online below:
A Summary: Te Oranga o ngā Māmā me ngā Pēpi i tō tātou rohe 2018–2026
Frequently Asked Questions: Te Oranga o ngā Māmā me ngā Pēpi i tō tātou rohe 2018–2026
This is a local monitoring report researched and drafted by the Āti Awa Toa Hauora
Partnership Board that looks at how well the health and wider system is supporting
Māori māmā and pēpi in our rohe – from pregnancy through early life. It combines
whānau voice with health, housing and social data to provide a fuller picture of both
lived experience and system performance.
The report covers 2018 to 2026, bringing together long-term trends with the most
recent available data to show both progress and persistent inequities.
The report draws on a mix of local and national data sources, including:
- Health data (maternity care, immunisation, hospitalisations)
- Housing and social data (deprivation, living conditions)
- National datasets such as Census and Integrated Data Infrastructure (IDI)
- Local service and provider insights
Whānau voice was gathered through wānanga and engagement with māmā and
whānau (2024–2025).
These insights are treated as equally important as quantitative data and are woven
together to shape the report’s findings.
The period from pregnancy through the first two years of life is critical for life-course
health and wellbeing outcomes. The physical and mental health of the māmā and
her broader environment affects the health of the developing baby. It is also in this
period that most brain development occurs, laying the foundations for life.
Māori māmā and pēpi continue to experience inequitable outcomes across multiple
areas – including poorer access to health care, quality housing, and early support.
The report shows these outcomes are driven by system barriers, including:
- Late or difficult access to services
- Cost and affordability
- Transport challenges
- Poor or insecure housingFragmented or hard-to-navigate systems
The report highlights the real-life experience of many whānau trying to access care;
needing to overcome multiple barriers just to get basic support.
Yes. Some improvements are being seen, such as rising immunisation rates.
However, inequities remain significant.
- Investment in kaupapa Māori, whānau-centred models of care
- Earlier and more proactive engagement with māmā
- Improved access to maternity and primary care
- More coordinated, joined-up services
Services that are: kaupapa Māori – whānau-centred – accessible and trusted
consistently show better engagement and improved outcomes.
Health sector leaders, government agencies, and commissioning bodies all have a
role in improving access, investing in effective models, and addressing wider system
barriers.
The findings will inform ongoing monitoring, advice to decision-makers, and future
investment and planning to improve outcomes for Māori māmā and pēpi.
Purpose
This report provides a summary of the oranga of Māori māmā and pēpi across our Āti Awa Toa Iwi Māori Partnership Board rohe, combining whānau voice with health, housing, and social sector data to assess how well the system is working and where change is needed. It is a monitoring dashboard within a kaupapa Māori framework and is designed to support ongoing system learning and transformation.
How the report was developed
The report draws on multiple sources of evidence across the period 2018–2026,
including:
- Wānanga and engagement with māmā and whānau (2024–2025)
- Health sector data (e.g. maternity care, immunisation, hospitalisations)
- Housing and social data, including deprivation and living conditions
- Local and national datasets (e.g. Ministry of Health, IDI, Census)
Collectively, these sources provide a fuller picture of both lived experience and system performance.
First two years of life
The period from pregnancy through the first two years of life is critical for long-term health and wellbeing. Getting this stage right improves lifelong outcomes; getting it wrong significantly increases the likelihood of poorer health, development and wellbeing over time.
Accessing Early Support
For too many Māori māmā and pēpi, accessing early support is still an obstacle course. Barriers such as cost, transport, housing conditions and fragmented services mean whānau are often unable to access care early, consistently or in ways that work for them.
Findings
Late or no access to maternity care: In 2023, 12.9% of Māori māmā were not enrolled with a Lead Maternity Carer at any stage during pregnancy.
Missed access to specialist care: In 2024, Māori women missed 28.9% of first specialist maternity appointments, compared with 3.5% for non-Māori non-Pacific women.
Inequities continue into early childhood: As at February 2026, Māori tamariki had the highest rate of not being fully immunised at 24 months, at 8.8%.
Higher rates of preventable harm: In 2024, tamariki Māori were 1.3 times more likely to experience an avoidable hospitalisation event than non-Māori non-Pacific children.
Housing and deprivation are affecting health: Poor and insecure housing conditions are strongly linked to higher rates of illness and hospitalisation for tamariki.
What this tells us
These outcomes reflect structural barriers within the system – including access, affordability, service design and wider social conditions.
What is working well
The report highlights that where services are:
– kaupapa Māori
– whānau-centred
– accessible and trusted
then whānau engage earlier and outcomes improve. Local models show the effectiveness of integrated, relationship-based support.
What needs to change
– Earlier engagement with māmā, particularly young māmā and those in high
deprivation areas
– Improved access to maternity and primary care
– More coordinated support across health, housing and social systems
– Investment in holistic, kaupapa Māori models that whānau use and trust.
Change the system
The evidence from 2018–2026 shows that these inequities are persistent and systemic. If we want better outcomes, we need to fix the barriers within the system – not expect whānau to successfully navigate around them.
Ati Awa Toa Annual Report 2025
This year, we tell our story through the two periods that guide our mahi: our Maramataka, from Matariki 2024 to Matariki 2025, and the financial year, from 1 July 2024 to 30 June 2025.
Whānau Voice Insights Report 2025
This report affirms that whānau voice is not only critical to understanding the challenges of the health system, but also offers the pathways to solutions.
Whaitua Geo-Mapping Tool: https://reports.hqsc.govt.nz/
Whānau Voice Report: https://atiawatoaimpb.nz
For more information contact Christine Ammunson 0274457333 or christine.ammunson@roheora.nz
Community Health Plan
- Our Community Health Plan sets out our initial priorities and work programme to achieve our mission – an oranga ecosystem for our mokopuna to thrive.
- It draws on the stories of our people, their health experiences and their aspirations for oranga – good health in all its dimensions.
- As mana whenua we support the wellbeing of Māori and of all whānau who reside in our rohe.
- We bring local solutions, relationships and experience and look forward to working in partnership with health and other decision-makers to make this plan a reality.
- This plan is a living document – we will update it as we progress towards our long-term goals
Hikitia Ropata
Manahautū
Ripoata Taurua 2022 - 2024 - Ati Awa Toa Partnership Board Biennial Report
This Biennial Report covers Atiawa Toa Hauora lwi-Mãori Partnership Board’s (AATHB) journey from establishment in 2022 through to June 2024 – a period focused on laying strong foundations, building relationships, and navigating a health system that continues to shift and evolve. On behalf of our poari, we mihi to our iwi boards and leaders for their unwavering support, guidance and endorsement of our mahi.
Key findings from engagement with Te Ohu Reo Manawataki o Ngāti Toa Rangatira
ĀATHPB held a hui with Te Ohu Reo Manawataki o Ngāti Toa Rangatira, in December 2024. This was an opportunity for ĀATHPB to wānanga with reo and tikanga experts about the intricates of waiata, reo-ā-tinana, haka, poi, wairuatanga both marae-based and competition-based and how this influences the oranga of Ngāti Toa iwi and hapori. The kōrero kanohi ki te kanohi from within our communities is helping to enrich our understanding of why many health inequities persist as well as pointing to what can be done – their insights into the things that would make a difference.
Ātiawa Toa Health Profile – Volume 1
The kōrero kanohi ki te kanohi from within our communities is helping to enrich our understanding of why many health inequities persist as well as pointing to what can be done – their insights into the things that would make a difference. In doing so, we acknowledge the legacy of work associated with Māori-led health data reporting to date – from the seminal Hauora series to Tatau Kahukura and the 2015 District Health Board Māori Health Profiles, this report continues the commitment to excellence that Māori communities and whānau both need and deserve.