Understanding nurses’ perspectives on Māori health equity: a systematic scoping review

BACKGROUND: Nurses have professional, ethical and legal obligations to address health inequities for Māori. OBJECTIVE: To investigate and synthesise the literature available on nurses' views of health equity for Māori to inform future research, policy and practice. DESIGN: Informed by kaupapa Māori methodology, the systematic scoping review was conducted with the JBI approach and reported with the PRISMA Extension for Scoping Reviews (PRISMAScR). Database searches included the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, EMBASE, Psychinfo, Ovid MEDLINE and Google Scholar with 634 articles screeded. METHODS: Data were extracted and charted by author SH and reviewed by VE and EG. The JBI framework was used to guide data charting, followed by thematic analysis. RESULTS: Three key themes were identified in the literature. For Māori nurses, health equity for Māori was seen as an obligation; non-Māori nurses often viewed health equity for Māori as optional. Barriers to achieving health equity for Māori were identified by both Māori and non-Māori nurses. Three subthemes were identified for Māori nurses: te ao Māori and tikanga Māori, dual clinical-cultural role and lived experiences of racism. For non-Māori nurses, two subthemes were identified: non-Māori nurses demonstrating both an understanding and a lack of understanding of health equity. CONCLUSION: Due to culture, Māori nurses had a greater commitment to addressing health equity. Conversely, non-Māori nurses appear to show greater ambivalence over whether to address health inequities. This study was limited by a small sample of non-Māori participants in the literature. Future research could focus on barriers and enablers for non-Māori nurses' commitment to health equity, valuing Māori nurses' cultural contribution and monitoring, education and action of NCNZ, nursing education institutions and professional leadership in addressing health equity.