Enhancing responsiveness to Maori in a publicly funded bariatric service in Aotearoa New Zealand

Background Health equity is a fundamental right afforded to all regardless of ethnicity. However, in New Zealand (NZ), health inequities are most compelling for Indigenous Maori who experience inadequate access to services, poorer quality of care and poor health outcomes as a result. Bariatric surgery is the most effective intervention for weight loss and remission of obesity-related disease where all other interventions have been exhausted. This Kaupapa Maori qualitative study presents Maori perspectives of bariatric surgery from the largest public bariatric centre in NZ and offers solutions for enhancing bariatric service responsiveness to Maori. Methods This qualitative study was informed by Kaupapa Maori methodology and involved a general inductive thematic analysis of 31 semi-structured interviews with Maori patients who had bariatric surgery at Counties Manukau Health in South Auckland, NZ. Results Four key themes were identified following analysis: (i) Kaupapa Maori standards of health; (ii) bariatric mentors; (iii) bariatric psychologists; and (iv) community-integrated support. These themes offer four tangible solutions for optimizing bariatric pathways for Maori from the perspectives of Maori bariatric patients. Conclusion Kaupapa Maori, community-centred and greater non-surgeon aspects of bariatric supportive mechanisms comprise key areas of opportunity for public bariatric pathways in NZ. Surgical leadership is required to advance health equity and service responsiveness to Maori.