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Māori Indigenous Health Institute (MIHI) research and publications

The Māori/Indigenous Health Institute (MIHI) undertakes and supports research that explores Maori health inequities and building excellence in research evidence that contributes to Maori health advancement.

Medical education research

MIHI began formally contributing to the undergraduate medical curriculum at the University of Otago, Christchurch in 2002 and has undertaken research with a focus on the role of Medical Education in Maori health advancement.

The place of indigenous health within the medical curriculum

This research argues for the use of evaluation frameworks that are able to draw on the complex interactions between variables that influence the design, implementation and evaluation of indigenous health curricula.

The importance of an indigenous health framework as a core component of an indigenous health curriculum, which promotes transformative practice and community investment within a medical school and broader health environment is noted.

This research offers a counter narrative to those documented within the literature of negative health experiences by indigenous communities.

This research found that an indigenous health medical curriculum can be a vehicle to promote positive health experiences as indigenous community members are re-positioned as key health stakeholders and experts in indigenous health, as opposed to solely ‘recipients’ of health care.

Application of the Hui Process and Meihana Model to clinical practice

MIHI continues to evaluate the impact of the Hui Process and Meihana Model as Māori health models that are integrated into clinical practice.

This has involved both medical students and health professionals including the Hawkes Bay District Health Board and Plunket (Canterbury).

Educating for equity

This is a collaboration between the University of Otago and the University of Auckland, as well as medical schools from Australia and Canada.

The focus of this project is to identify how medical education can both advocate and be a tool for Maori health advancement by addressing health inequities.

Medical education research publications

Pitama, S., Huria, T. & Lacey, C. (2014) Improving Māori Health through Clinical Assessment: Waikare o te Waka o Meihana. Viewpoint Article. New Zealand Medical Journal. 2 May 2014

Huria, T., Cuddy, J., Pitama, S., (2014) Working with Racism – Indigenous Nurse’s experiences of working in the New Zealand Health System. Journal of Transcultural Nursing. March 4 doi: 10.177.1043659614523991

Huria, T., Lacey, C., Pitama, S.(2013) Friends with benefits: Should Indigenous medical educators involve the Indigenous community in Indigenous medical education?, LIME Good Practice Case Studies vol. 2. The University of Melbourne. ISBN 978 0 7340 4847 9

Pitama, S. Hauora Māori Day. (2013) LIME Good Practice Case Studies. The University of Melbourne. ISBN 987 0 7340 4748 9

Pitama S. "As natural as learning pathology": The design, implementation and impact of indigenous health curricula. [Unpublished doctoral thesis]. Christchurch: University of Otago; 2012.

Huria, T (2012) Hauora Māori – Introduction to Clinical Immersed Learning. LIME Good Practice Case Studies. The University of Melbourne. ISBN 987 0 7340 4748 9

Lacey, C., Huria, T., Beckert, L., Gillies, M. & Pitama, S. (2011) The Hui Process: a framework to enhance the Doctor – Patient relationship with Māori . Viewpoint Article. New Zealand Medical Journal.

Pitama, S., Huria, T., & Lacey, C. (2011). Measuring learning outcomes in Indigenous health: What is working? Proceedings of the Leaders in Indigenous Medical Education Conference: LIME Connection IV: Medical Education for Indigenous Health: Building the Evidence Base, (pp. 82). Retrieved from http://www.limenetwork.net.au/content/post-conference-report-2011.

Ewen, S.C, Pitama, S.G., Robertson, K. & Kamaka, M.L. (2011) Indigenous simulated patient programs. A three-nation comparison. Focus on Health Professional Education: A Multi-disciplinary Journal. Vol 13, No 1, July 2011.

Jones, R., Pitama, S. , Huria,T., Poole, P., McKimm, J., Pinnock, R., Reid, P. (2010) Medical Education to Improve Māori health. New Zealand Medical Journal, 123 (1316), pp 113-22.

Chronic kidney disease

MIHI’s interest in this area has developed out of a collaborative relationship with Associate Professor Suetonia Palmer, who is a recipient of the Rutherford Fellowship and a Nephrologist.

Patients’ perceptions and experiences of healthcare when preparing for dialysis treatment of end-stage kidney disease

This project is led by Associate Professor Suetonia Palmer with Wendy Cuthill, Nick Cross, Suzanne Pitama, Jessica Cuddy and Alison Tong as co-investigators.

This project is exploring patients’ expectations, experiences and perspectives of healthcare services when preparing for dialysis treatment of end-stage kidney disease.

This project is funded through the Royal Society of New Zealand.

“Created Equal”: Investigating health system perspectives of disparities in Aotearoa.

Tania Huria (Senior Lecturer at MIHI) is leading this project that will contribute to her PhD thesis.

Professor Lutz Beckert, Associate Professors Suetonia Pamer and Suzanne Pitama are co-investigators and PhD supervisors for this research.

This research will investigate health system perspectives of disparities for Māori in Aotearoa, using chronic kidney disease as a case study.

Tania has a Health Research Council PhD Scholarship to undertake this research.

Heart Health: The Hauora Manawa community heart study

MIHI’s interest in this area has developed out of whanau history and Māori health inequities in this area.

This led to a collaborative relationship with the Christchurch Heart Institute, which led to Associate Professor Suzanne Pitama and Professor Vicky Cameron as co-investigators in this project.

More information about Heart Health: The Hauora Manawa community heart study

This is a prevalence study investigating cardiovascular disease in Māori and non-Māori in two randomly selected cohorts in Wairoa, Hawkes Bay (Māori cohort only) and Christchurch (Māori and non-Māori). Participants have been assessed at baseline, 2 years and 5 years. This research is currently completing the 5th year follow up analysis.

Heart Health: The Hauora Manawa community heart study publications

Whalley,GA., Pitama, S., Troughton, RW., Doughty. RN., Gamble, GC., Gillies,T., Wells,JE,, Faatoese,A., Huria, T., Richards, M., & Cameron, VA. (2015) Higher prevalence of left ventricular hypertrophy in two Māori cohorts: findings from the Hauora Manawa/Community Heart Study. Australian and New Zealand Journal of Public Health. Vol. 39 (1), 26-31. February 2015.

Stamp LK, Wells, JE, Pitama, S, Faatoese, A, Doughty, RN, Whalley, G, Richards, AM, Cameron, VA. (2013) Hyperuricaemia and gout in New Zealand rural and urban Māori and non-Māori communities. Internal Medicine Journal, 43(6), 678-684

Faatoese, A., Pitama, S., Wells J.E., Cameron, V.A. Understanding Cardiovascular Disparities Between Māori And Non-Māori In New Zealand: Is There A Way To Reduce These Disparities? Chapter in Health Disparities: Epidemiology, Racial/Ethnic and Socioeconomic Risk Factors and Strategies for Elimination, Nova Publishers, Hauppauge, New York, 2013

Faatoese, A., Pitama, S. , Gillies,T., Robertson,P., Huria, T., Tikao-Mason,K. , Doughty,R., Whalley,G. Richards, M. Troughton, R., Sheerin,I., Wells. J.E., & Cameron, V.A. (2011) A Community screening for cardiovascular risk factors and levels of treatment in a rural Māori cohort. Australia New Zealand Journal of Public Health.

VA Cameron, AF Faatoese, MW Gillies, PJ Robertson, TM Huria, RN Doughty, GA Whalley, AM Richards, RW Troughton, KN Tikao-Mason, JE Wells, IG Sheerin, SG Pitama. (2012) A cohort study comparing cardiovascular risk factors in rural Māori, urban Māori and non-Māori communities in New Zealand. BMJ Open 2012; 2:e000799.

Sheerin, I, Pitama, S, Wells, JE, Faatoese, A, Tikao-Mason, K, Robertson, P, Huria, T, Gillies, T, Doughty, R, Whalley, G, Troughton, R, Richards, M, Cameron, V. (2012) Loose tobacco, ethnicity, smoking choice and quitting - the Hauora Manawa Study. Letter to ANZJPH 2012;36:291-292

Pitama, S., Cameron, V., Huria, T., Tikao-Mason, K., Faatoese, A. & Whalley, G. (2011) Adjusting protocols in clinical research: finding the point of cultural/clinical fusion. Journal of Primary Health Care. Vol 3. No. 1. Pp 72-73

Pitama, S. ,Wells. J.E.,Faatoese, A., Tikao-Mason,K. , Robertson,P., Huria, T., Gillies,T., Doughty,R., Whalley,G. Troughton, R., Sheerin,I., Richards, M. & Cameron, V.A. (2011) A Kaupapa Māori approach to a community cohort study of heart disease in New Zealand. Australia New Zealand Journal of Public Health. Vol 35 No.3 Pp 229-255

VA Cameron, AF Faatoese, MW Gillies, PJ Robertson, TM Huria, RN Doughty, GA Whalley, AM Richards, RW Troughton, KN Tikao-Mason, IG Sheerin, EJ Wells, SG Pitama. How to successfully undertake genetics research in partnership with indigenous Māori Communities. Royal Australasian College of Physicians Congress, 22-25 May 2011, Darwin, Australia. Internal Medicine Journal 2011: 41 (Suppl 2): 4

A Faatoese, S Pitama, M Gillies, P Robertson, R Doughty, G Whalley, M Richards, R Troughton, E Wells, I Sheerin, VA Cameron. Comparison of rates of diagnosed and undiagnosed cardiovascular disease and its risk factors among Māori and non-Māori communities in New Zealand. ESC 2010, Stockholm, Sweden, 28 August - 1 September 2010 (moderated poster) Eur Heart J 31 (Suppl 1): page 747.

Pitama, S., Cameron,V., Huria, T., Gillies. T., Whalley,G., Doughty, R., Richards, M., Faatoese,A., Tikao-Mason, K., Robertson, P. (2010) Hauora Manawa/Heart Health: The community Heart Study. Māori Research Symposium Te Waipounamu: Proceedings Book. ISBN 978-0-473-16461-4 (40% contribution, PI of HRC funded research project by which this chapter was based, led intellectual framing and write up of article.)

A Faatoese, E Wells, S Pitama, M Gilles, R Doughty, R Troughton, M Richards, V Cameron. Screening for Cardiovascular Disease in Māori Communities: The Community Heart Study. In the Proceedings of the Cardiac Society of Australia and New Zealand (CSANZ) 57th Annual Scientific Meeting, 13-16 August 2009, Sydney, Australia (Poster)

Respiratory disease

Collaborations with peers in the Hauora IV publication as well as a long-standing relationship with Professor Lutz Beckert (respiratory physician, CDHB) have supported ongoing work in this area.

Respiratory disease publications

Landers, A, Wiseman, R, Pitama, S & Beckert, L. (2015) Patient perceptions of severe COPD and transitions towards death: a qualitative study identifying milestones and developing key opportunities. npj Primary Care Respiratory Medicine 25, 15043; doi:10.1038/npjpcrm.2015.43; published online 9 July 2015

Landers, A., Wiseman, R., Pitama, S. & Beckert, L. Perceptions of patients with very severe COPD towards end-of-life care. Respirology 2014 DOI 10.111/resp12263_5.

Crengle, S., Pink, R. & Pitama, S. (2007) Respiratory Disease in Robson, B. & Harris, R. (eds) Hauora: Māori Standards of Health IV. A study of the years 2000-2005. Wellington: Te Ropu Rangahau Hauora a Eru Pomare. ISBN 978-0-9583 608-1-4. pp 169 – 179

Mental health

Maori mental health is a priority area within Maori health. Associate Professor Suzanne Pitama and Dr Cameron Lacey have clinical backgrounds in this field, which supports a desire to contribute to this area of research.

Stress cardiomyopathy and earthquakes

Following the Canterbury earthquakes an increase in the number of people presenting to the emergency department with stress cardiomyopathy (takotsubo) was observed. This research in collaboration with colleagues from cardiology, genetics and psychological medicine aims to discover the origins of this intriguing condition.


Lacey C, Mulder R, Bridgman P, Kimber B, Zarifeh J, Kennedy M, Cameron V. Broken heart syndrome — is it a psychosomatic disorder? J Psychosom Res. 2014;77:158-160

Epilepsy and depression

This work arouse out of Dr Cameron Lacey’s former position and ongoing collaboration with University of Melbourne. It aims to discover risk factors for psychiatric comorbidity in patients with epilepsy.


Lacey CJ, Salzberg MR, D'Souza WJ. Risk factors for depression in community-treated epilepsy systematic review. Epilepsy & behavior in press

Lacey CJ, Salzberg MR, D'Souza WJ. Serotonin transporter genexenvironment and risk of depression in community-treated epilepsy. Epilepsy & behavior 2014;39C:33-37

Lacey CJ, Salzberg MR, D'Souza WJ (2014): Risk factors for psychological distress in community-treated epilepsy. Epilepsy & Behavior. 35:1-5.

Broad mental health kaupapa

Work alongside the National Addiction Centre at the University of Otago, Christchurch, student supervision and having a focus on clinical application of Hauora Maori models to psychological practice have driven broad mental health research interests within MIHI.


Porter, P. Mulder, R. Lacey, C. DSM-5 and the elimination of the major depression bereavement exclusion. Australian and New Zealand Journal of Psychiatry 47 (4), 391-393 (Invited Editorial)

Lacey, C. Differences in patients’ perceptions of Schizophrenia between Maori and New Zealand Europeans Aust N Z J Psychiatry, first published on January 5, 2012 doi:10.1177/0004867411432077

Newton-Howes G, Lacey CJ, Banks D. Community treatment orders: The experiences of non-Maori and Maori within mainstream and maori mental health services. Social psychiatry and psychiatric epidemiology. 2014;49:267-273

Jordan J, Carter JD, McIntosh VW, Fernando K, Frampton C, Porter RJ, Mulder RT, Lacey C, Joyce PR. Metacognitive therapy versus cognitive behavioural therapy for depression: a randomized pilot study Aust N Z J Psychiatry, first published on May 8, 2014 doi:10.1177/0004867414533015

Philip J. Schluter, Janet K Spittlehouse, Vicky A Cameron, Stephen Chambers, Richard Gearry, Hamish A Jamieson, Martin Kennedy, Cameron J Lacey, David R Murdoch, John Pearson, Richard Porter, Mark Richards, Paula M L Skidmore, Richard Troughton, Esther Vierck, Peter R Joyce. Canterbury Health, Ageing and Life Course (CHALICE) study: rationale, design and methodology. NZMJ 31 May 2013, Vol 126 No 1375; ISSN 1175 8716

Haitana, T., Pitama, S. & Rucklidge, J. (2010) Cultural biases in the Peabody Picture Vocabulary Test (III): Testing Tamariki in a New Zealand Sample. New Zealand Journal of Psychology. Vol 39 No 1 Pp 24-35

Cave, T., Robertson, P., Pitama, S. & Huriwai, T. (2008) He Tete Kura: Māori addiction treatment 1980 -2008. Matua Raki. Otautahi, Christchurch, New Zealand. ISBN: 978-0-473-13542-3

Pitama SG, Robertson PJ, Cram F, & Gillies M. (2007) Meihana Model: Clinical Assessment Framework. New Zealand Journal Of Psychology, 36 (3), Pp 119-126.

Robertson PJ, Haitana T, PJ, Pitama S & Huriwai TT. (2006) A Review of the Workforce Development Literature for Māori in the Alcohol and Other Drug Field in Aotearoa/New Zealand. Drug and Alcohol Review, Pp 25: 1-7.

Robertson PJ, Pitama S, Ahuriri-Driscoll A, Haitana, T, Larsen JJ & Utaii S. (2005) Developing Services in Te Rohe o Ngai Tahu for Māori with Gambling Related Problems. New Zealand Journal of Psychology,34 (1): Pp 28-36.

Schroder, R., Sellman, D. Bagshaw,S., Pitama, S., Frampton, C., Deering, D. & Todd, F. (2004) Factors Affecting Youth Retention in Alcohol and other Drug Treatment: A Review of the Literature. New Zealand Treatment Research Monograph. Alcohol, Drugs and Addiction.

Robertson P, Pitama S, Ahuriri-Driscoll A, Larsen J, Utaii S & Haitana T. A framework for the development of gambling services for Māori in te rohe o Ngai Tahu. Christchurch: He Oranga Pounamu, 2003. (ISBN 09582458 3 5)

Pitama, S (1997) “The effects of traditional and non-traditional adoption practices on Māori mental health” In Adoption and Healing: Proceedings of the International Conference on Adoption and Healing.” New Zealand Adoption Education and Healing Trust. Wellington

Broader Maori Health Kaupapa

MIHI staff have also contributed to a wide range of kaupapa with a focus on Maori health advancement alongside sustained and new research collaborations, these are reflected in ongoing publications.


Pitama, S. Lacey, C. & Huria, T. (2015) Sudden unexpected death in infancy (SUDI) in New Zealand: discussion over the last 5 years and where to from here? New Zealand Medical Journal. Vol 128 (1413) pp 9-11.

Pitama S, Cave T, Huria, T, Lacey C, Cuddy J & Frizelle F. (2012) Exploring Māori perspectives on colorectal cancer and screening. New Zealand Medical Journal. 8 June 2012. Vol 125. No 1356.

Pitama S, Ahuriri-Driscoll A, Huria T, Lacey C, Robertson P.(2011) The Value of Te Reo in Primary health Care. Journal of Primary Health Care. 3 (2) pp 123-127

Pitama, S., Huria, T., Beckert, L., Lacey, C. (2011) Assessing the Assessment: cultural competence and understandings of pain. New Zealand Medical Journal. Vol 124. No. 1328. pp 10-12

Cunningham, E., Cameron, VA, Evans, J., Irvine, V., Pitama, S. & Robertson, P. (2007) The development of guidelines for handling samples and specimens collected for research involving Māori . New Zealand Medical Journal. Vol 120 No 1264

Completed Master’s thesis: Melbourne, M. (2003) Testing Rongoa for Antimicrobial Activity. Unpublished Master’s thesis, School of Biological Sciences, University of Waikato, Hamilton, N.Z

Kirk, R., Barnett, P., Clayden, C., Cumming, J., Heckert, K., Penrose, A., Pitama, S., Richards, D., and Siataga, P. (2002) Evalutation of the Pegasus Health Global budget Contract. New Zealand Health Technology Assessment (NZHTA) ISBN 1-877235-40-7

Cram, F. & Pitama, S. (1998) “Ko toku whanau, ko toku mana” in Adair, V & Dixon, R (eds). The Family in Aotearoa New Zealand. Longman pp 130-157

Community service

MIHI has a strong emphasis on social accountability related to Māori health advancement.

More information about MIHI's community service

MIHI demonstrates maintains strong relationships with local Kura Kaupapa schools as well as running several free cardiovascular clinics at major events.

MIHI encourages all of its kaimahi to support community activities through membership with the Māori Womens Welfare League and professional bodies such at Te Ora (Māori Doctors Association.)


Reirti-Crofts, A., Wallace, S., Wallace, M., Clarke, S., Greer, B., Dick, M., Henry, V., Clarke, A., Pitama, S. & Huria, T. (2013). Te Mana o Te Whanau: Quality Indicators for Improving Health Care for Maori. Monograph. Maori Women’s Welfare League.

Pitama, S, Robertson, P., Gillies, M., Baxter, J., Ahuriri-Driscoll, A., Haitana, T., Wells, E., Toop, L., Gower, S., Richards, D., Richardson, A., (2003) Focussing on Ngai Tahu 2025: the Ngati Wheke Pilot. Commissioned report for Ngai Tahu Development Corporation.

Cram, F., Henare, M., Hunt, T., Mauger, J., Pahiri, D., Pitama, S. & Tuuta, C. (2002) Māori and Science Three Case Histories. Monograph. International Research Institute for Māori and Indigenous Education. University of Auckland

Pitama, S (1997) “The effects of traditional and non-traditional adoption practices on Māori mental health” In Adoption and Healing: Proceedings of the International Conference on Adoption and Healing.” New Zealand Adoption Education and Healing Trust. Wellington