/ All District Health Boards
RONGOA MAORI – TRADITIONAL MAORI HEALING SERVICE
STATUS:Non Mandatory
Review History / Date
Published on NSFL / July 2002
Amendmentschanged to non-mandatory status by agreement with DHB GMs Planning and Funding. / July 2012

Note: Contact the Service Specification Programme Manager, Ministry of Health, to discuss the process and guidance available in developing new or updating and revising existing service specifications.

Nationwide Service Framework Library:

Rongoa Maori - Traditional Maori Healing Service

MAOR0107

1Definition

Rongoa Maori - traditional Maori healing offers a holistic healing service based on cultural sensitivity and spiritual healing. In practising Rongoa the patient’s total wellbeing is paramount; the client is partaking of a traditional service which is culturally safe and sensitive to Maori needs and aspirations.

The Rongoa Maori - traditional Maori healing service provides a service delivery that is equitable, accessible, efficient, effective and safe for Maori.

2Scope of Services to be Provided

2.1Client Group

The service will be available to all eligible persons resident in (enter region).

2.2Service Components Required

Service Component / Description
Provision of Rongoa Maori - traditional Maori healing / Diagnosis based on Maori values, beliefs, faith, rituals and science; classification of illness in cultural terms (using a Maori framework). Prescribing of Rongoa rakau and providing advice on use and storage of Rongoa rakau to clients. Spiritual healing. Cultural and mental healing. Provision of traditional healing practices for clients by providing spiritual, cultural, mental healing for patients and/or whanau. Assessment of the health and health needs of individuals and whanau. This includes but is not confined to: face-to-face responses to queries about health needs and advice on appropriate healing practices provision of information on traditional Maori healing issues and advice on appropriate healing practices provision of information on traditional Maori healing issues and other services which could compliment this information assessment of the needs of community through regular consultation with individuals and the wider whanau/community with the consent of individual and/or whanau, referral on to other professional service providers inclusive of both western trained/ recognised practitioners and other Maori practitioners from a range of healing practices liaison with other providers (where authorised to do so) on behalf of individuals and whanau including provision of treatment and information when requested by GPs support for individuals and whanau who may be having difficulty accessing the care they need and/or complying with treatment regimes assessment of seriousness of emergencies and provision of any initial care required until emergency services arrive and referral on to other services as required.
Kai-Awhina duties - kaumatua / Support during consultation and counselling. Support to healer and whanau. Kai Awhina to provide supportive counselling and consultation; support for physical comfort of patients; provide support to healer and the whanau. Whanaungatanga.
Kaimahi - Collection, and storage of Rongoa rakau / Collection, and storage of Rongoa rakau. Collection and cultivation of appropriate Rongoa rakau (while complying with any regulatory provisions or statutory obligations). Processing and production of Rongoa rakau using traditional means. The storage and labelling of Rongoa rakau using the clinic’s coding system (provided there is a written copy of the coding system available for perusal by persons authorised by the healer) - note “use by” date in quality specifications.
Healer or kaimahi supervised by healer / Monitoring of utilisation and effectiveness of Rongoa rakau in treating the health problem. Recording of the prescription in the patient record.
Kaiwhakahaere - Health education / Provide sessions on lifestyle risk factors and chronic diseases to prevent the development of disease, recurrences and deterioration in disease state. Compliance with national guidelines and incorporation of Maori health gain priority areas. Integration, where possible, with other relevant health promotion services.

2.3Provision and Level of Service

Most services will be provided from (enter clinic addresses) which will be available during business and after hours on an as needs basis. Services may be provided in other environments nominated by the client, and in private homes where appropriate.

2.4Key Linkages

The service is required to demonstrate good linkages and working relationships with:

  • general practitioners and their staff (particularly where a client is registered with a local GP or undergoing treatment by a GP)
  • other local health care providers
  • local providers of social and community services
  • Maori health providers.

These linkages would allow for healers and their colleagues to treat each other with respect, courtesy, fairness and good faith.

Healers will promote co-operation with colleagues, western practitioners as well as other Maori health professionals to develop clear and accessible communication links that would support the treatment choices of patients. Patients would also be required to register with a preferred GP who they would possibly visit to seek complementary treatment, and who the Healer would send and receive information from with regard to the treatment of a patient. This information sharing would be with the consent of the patient.

Healers will adhere to professional rather than commercial standards in making known the availability of their service.

You will have written protocols and systems in place to facilitate these linkages.

3Quality Requirements

In addition to the general quality requirements, the following quality requirements apply to this service:

  • Clinics must adopt local tikanga practices and protocols.
  • Healers must be affiliated to the National Body of Maori Traditional Healers (Nga Ringa Whakahaere o te Iwi Maori).
  • The service must comply with the Ministry of Health Standards for Traditional Maori Healing, June 1999.
  • Clinics will develop and implement a Quality Plan which incorporates:
  • code of ethics
  • rights and responsibilities of clients
  • standards of practice
  • hygiene standards
  • information system management and maintenance
  • policy for client complaints
  • policy for collection and storage of Rongoa rakau (including “use by” date for all Rongoa rakau)
  • only glass for dispensing and storage of Rongoa rakau.

Patient records to be stored in secure and confidential manner with access according to the current Health Information Privacy Code as issued from time to time by the Privacy Commissioner. The recording of patient details including reason advice is being sought, judgements made and treatment offered must be included in the records. Patient records must also show those that do not want to register with a GP and have not registered with a GP as stated as a requirement in 2.4.

4Information Requirements

  • Quarterly reports.

4.1Performance Measures

  • All Rongoa rakau medicines held within “use by” date.
  • Number of patients registered with the clinic.
  • Number of patients diagnosed and treated for the following (number of visits):
  • huango - asthma
  • mate huka - diabetes
  • mate pukupuku - cancer
  • ka katia te ngaa - respiratory disease
  • he wera, haututanga, nga mate ririki - burns, bruises, minor accidents
  • other.
  • Number of patients referrals from and to local general practitioners.
  • Number of patients currently undergoing treatment.

4.1.1Additional Performance Measures

  • The one-off funding is to be used for (if applicable):
  • the setting up of the service, eg, administration, policies and procedures, resources and any other support services needed for this service
  • recruitment of additional worker(s) for this service
  • any equipment that may be required to support this service
  • a quality plan
  • strategic business plan
  • plan on how you will meet the Ministry of Health Standards for Traditional Maori Healing, June 1999.

In your quarterly report due <insert date> please include a detailed narrative on how the one-off funding was utilised and applied to this service. Also in this quarterly report, please submit your Quality Plan, Strategic Business Plan and your plan on how you will meet the Ministry of Health Standards for Traditional Maori Healing.

4.1.2Reporting Requirements

  • Monthly data reporting requirements:
  • Number of ongoing consultations held and reason.
  • Number of referrals to other health services by type (hospitals, medical practitioners, another healer, other).
  • Number of referrals from other health services by type (hospitals, medical practitioners, another healer, other).
  • Quarterly reporting requirements:
  • Provide a brief quarterly narrative report on your performance against the quality standards listed in the service specification and the Maori Standard Terms and Conditions.
  • Provide a brief quarterly narrative report on the service, including the following:
  • number of full time equivalent staff
  • highlights, issues or concerns and any trends within the quarter
  • list the type of programme/s and types of activities or specific health education programmes that focus on health and wellness undertaken
  • Provide the following quarterly financial reports:
  • Income and Expenditure Account (accrued)
  • Balance Sheet
  • Cashflow Statement (not accrued).

4.1.3Performance Measures

  • All service and financial reports will be submitted by the due date required.
  • All information/data requested in the reporting requirements of the service specification will be forwarded to the Monitoring Team - Ministry of Health, Dunedin Office.
  • If for any reason you are unable to meet the reporting timeframes, you are required to contact the Monitoring Team - Ministry of Health, Dunedin to request an extension.
  • Establishment and the maintenance of a client register (by age, sex, ethnicity and by service type, etc)

*Ethnicity is recorded as perceived by the family/whanau. People may therefore perceive themselves as belonging to more than one ethnic group. Ethnicity is to be reported according to the following priority system: if perceived ethnicity includes:

  • Maori, report as Maori
  • Pacific, report as Pacific
  • otherwise, report as Other

4.2Outputs

  • Annual target: at least 650 individual client names are entered into the register and categorised by: point of entry into service.
  • Age, gender and ethnicity.*
  • Date of first consultation.
  • On-going Client Register recording the following:

Number of new clients per quarter by age, ethnicity, gender

Number of clients exiting the service per quarter

Total number of clients by age, ethnicity, gender

5Quality Requirements

Standard / Criteria / Standard / Criteria
Maori health gain areas: Maori health child health mental health asthma diabetes dental injury prevention tobacco control alcohol and drug sexual health. / Maori health gain is: integrated into health education strategies integrated into individual consultations specific programmes of health promotion are planned staff education is focused to address these. / Information / Information is provided in a clear and understandable manner conveying: hours of service availability contact telephone numbers staff names emergency contacts.
Participation / Purchasing agreements allow for Iwi and other Maori group to be engaged in the planning, implementation, maintenance and evaluation of services. / Consultation / Effectiveness and acceptability are gauged through six-monthly hui and public meetings.
Cultural safety / Cultural values and beliefs are recognised and integrated into all aspects of the service. Tikanga me ono Te Reo are recognised and integrated into service provision. With Iwi develop a vision for health and a model for service delivery. / Feedback / Is sought from individuals and whanau re service provision health gain. Iwi monitoring is undertaken.
Client register / Client register is maintained / Register is accurate and reasonably detailed as above at 4.2.

6.Financial and Services Reporting

Service Reports

The provider will report on service delivery and programme development progress using the performance indicators specified in the Schedules.

Service reports for each quarter / Report due by
1st quarter ended 30 September (insert year) / 20 October (insert year)
2nd quarter ended 31 December / 20 January
3rd quarter ended 31 March / 20 April
4th quarter ended 30 June / 20 July

Financial Reports

The provider will supply the following financial reports to the Ministry of Health.

Financial reports for each quarter / Reports due by
1st quarter ended 30 September (insert year) / 20 October (insert year)
2nd quarter ended 31 December / 20 January
3rd quarter ended 31 March / 20 April
4th quarter ended 30 June / 20 July

Monthly payments will be suspended if reports are not received by the due date.

The reports are to consist of an Income and Expenditure Account (accrued), Balance Sheet and a Cashflow Statement (not accrued).

Draft end of year reports (Income and Expenditure Account and Balance Sheet) are to be supplied to the Ministry of Health within one month of the end of the financial year, ie, 31 July 2001. The provider will use its best endeavours to have audited end of year financial reports (Income and Expenditure Account and Balance Sheet) supplied to the Ministry of Health within three months of the end of the financial year, ie, 30 September 2001.

Appendix I:

Standards for Traditional Maori Healing

Standard of Practice for Tohunga Puna Ora

Tohunga Puna Ora will ensure that assessment is performed in a way that is relevant to the needs of the māuiui.

Tohunga Puna Ora will ensure that the diagnosis, assessment and treatment of māuiui is in accordance with tikanga Maori, is culturally safe and recognises the needs of māuiui.

Tohunga Puna Ora will co-operate with other Tohunga Puna Ora and health professionals, as appropriate to the wishes and needs of the māuiui.

Tohunga Puna Ora will ensure that (where appropriate) māuiui are referred to other appropriate services, particularly if they have any emergency and/or acute needs.

The participation of whanau in care is facilitated.

Māuiui will be given the information needs to give informed consent to ongoing care activities.

Māuiui Referrals

Services provided to māuiui should be within the scope of the Whare Oranga. Where the needs of the māuiui change or move outside the scope of the Whare Oranga services, appropriate arrangements should be made to refer, and / or seek support from other service providers.

When māuiui are referred to other service providers, the referral process must ensure that:

māuiui have informed choice

the service / s to which the māuiui is referred to appropriate to each māuiui

provision is made for the review of any referral should this be requested

provision is made for effective co-ordination of services where a māuiui or whanau required the services of a number of organisations

policies, procedures and resources are consistent with effective referral processes.

Māuiui Records

A record must be made for every mauiui that attends the Whare Oranga.

A record should be sufficiently detailed to enable:

identification of personal details (name, age, address, ethnicity and person to contact in an emergency)

identification of the reason for seeking care and the treatment objectives

identification of the māuiui history pertinent to the condition being treated, including relevant details of present and past medical history, family history and social considerations

details of treatment provided

the māuiui to receive effective continuing care

clear identification of ‘alert’ notation for conditions such as allergic responses, adverse drug reactions, and infection risks, properly displayed in the record.

effective communication between the healing whanau

the evaluation of māuiui care

allocation of diagnosis and procedure codes (as required by the Ministry of Health)

It is the responsibility of the Tohunga Puna Ora for the proper and timely completion of māuiui / Whare Oranga records. An entry should be made for each visit. Each entry should be dated and, if the Whare Oranga has more than one Tohunga Puna Ora, state the name of the tohunga Puna Ora. The māuiui name should be on each page of the record.

Each Whare Oranga must have a person responsible for servicing Whare Oranga records. This person should keep in mind the following needs:

providing education / training to Tohunga Puna Ora and Kai-awhina to assist in the appropriate completion of Whare Oranga records

regularly assessing the content of Whare Oranga records to ascertain that the recorded Whare Oranga information is sufficient for the purpose of providing and evaluating māuiui care.

retrieval of data as required by the Ministry of Health

Care must be taken to safeguard māuiui information against loss. Paper records should be stored safely and protected from any damage, including water and fire damage and theft. If the records are stored on computer, a backup disk should be made regularly and stored away from the Whare Oranga.

Care must also be taken so that unauthorised persons do not have access to, or use of, māuiui information.

If abbreviations, and symbols are used, and there is more than one Tohunga Puna Ora, there must be a list of acceptable abbreviations and symbols to be used the Whare Oranga records.

Māuiui Rights and Responsibilities

Māuiui Rights

Māuiui have the right to choose their Tohunga Puna Ora

Consultations are to be provided only on request.

Whare Oranga shall provide Māuini with access to independent advocacy services and will act on the issues which arise from the complaints and the advocacy process. These services are available to whanau as well as Mauiui.

Mauiui have the right to personal and informational privacy as stated in the Privacy Act 1993 and the Health Information Privacy Code 1994.

Mauiui have the right of access to support people independent of the Whare Oranga.

Mauiui have the right to have full understanding of the consultation and healing process.

Māuiui Responsibilities

Mauiui have the responsibility to respect the kaupapa of the Whare Oranga and Tohunga Puna Ora

Consultations may be requested but not demanded.

Protection of the Whare Oranga Whanau

The Whare Oranga shall define the roles and responsibilities of the members of its whanau.

Trainees and assistants should receive regular training and supervision. They should have defined training objectives. These should be summarised in a training record together with regular assessments of their progress.

The scope of practice of trainees and assistants should be clearly defined.

Liaison / Networking

Effective relationships are to be maintained:

between Whare Oranga

with national and other appropriate health agencies and organisations, including the Ministry of Health, Ministry of Health and the Maori Health Commission