He mana tō te mātauranga - knowledge is power: a qualitative study of sexual and reproductive healthcare experiences of wāhine Māori.
Harris C, Bidwell S, et al. • Journal of primary health care • 2025
Wāhine Māori want to be told more about their health and options when encountering healthcare providers regarding sexual and reproductive health, as being informed is empowering while feeling uninformed results in a breakdown in trust in the healthcare system and inability to exercise mana motuhake (autonomy).
Key Findings
Results
An overarching theme of 'He mana tō te mātauranga' (knowledge is power) emerged from wāhine Māori's experiences of sexual and reproductive healthcare.
Twelve wāhine Māori were interviewed in this Kaupapa Māori qualitative study.
Thematic analysis was performed on transcribed and coded interviews.
The overarching theme encompassed four subthemes related to information, consent, communication, and knowledge dissemination.
The wāhine valued being well-informed about their health and options, however their experiences of receiving information varied.
Results
Being informed about contraceptive options was identified as empowering for wāhine Māori.
This emerged as one of four subthemes from the thematic analysis.
Participants expressed that receiving clear information about contraceptive choices positively impacted their sense of agency.
The theme reflects the broader finding that health literacy directly impacts health outcomes.
Results
Informed consent was identified as important to wāhine Māori in their sexual and reproductive healthcare interactions.
Informed consent emerged as a distinct subtheme in the analysis.
This finding suggests that consent processes during SRH encounters were a notable concern for participants.
The importance of informed consent connects to participants' ability to exercise mana motuhake (autonomy).
Results
High-stress situations in healthcare were associated with a need for better communication from healthcare providers.
Better communication during high-stress situations was identified as a distinct subtheme.
This suggests that existing communication practices were perceived as insufficient during particularly stressful SRH encounters.
Healthcare providers play a critical role in enhancing patients' health literacy by providing clear, accessible information and guidance.
Results
Wāhine Māori identified a need for improved dissemination of sexual and reproductive health knowledge.
Improved dissemination of SRH knowledge was identified as the fourth subtheme.
Feeling uninformed was described as resulting in 'a breakdown in trust in the healthcare system.'
Facilitating improved dissemination of knowledge about SRH may help improve SRH outcomes for Māori by supporting health literacy.
Indigenous peoples including Māori have poorer SRH outcomes than non-Indigenous peoples, providing context for this finding.
Discussion
Feeling uninformed undermined wāhine Māori's trust in the healthcare system and their ability to exercise autonomy.
The study found that lack of information resulted in 'a breakdown in trust in the healthcare system and inability to exercise mana motuhake (autonomy)'.
This finding contrasts with the empowerment experienced when participants were well-informed.
The authors suggest that supporting health literacy so 'Māori can make informed decisions about their health' may improve SRH outcomes.
What This Means
This research explored the sexual and reproductive health (SRH) experiences of Māori women (wāhine Māori) in New Zealand, specifically focusing on how they receive information from healthcare providers. Using a Kaupapa Māori (Māori-led) research approach, researchers interviewed twelve wāhine Māori and analyzed their experiences. The central finding was captured in a Māori proverb: 'He mana tō te mātauranga' — knowledge is power. When women felt well-informed about their health options, including contraception, they felt empowered and able to make their own decisions. However, their experiences of actually receiving this information from healthcare providers were inconsistent and often fell short of what they wanted.
The study found that when wāhine Māori felt uninformed during healthcare encounters — including during stressful situations — it eroded their trust in the healthcare system and limited their ability to exercise autonomy over their own health. Informed consent was also highlighted as a key concern. These findings matter because Māori already experience worse sexual and reproductive health outcomes than non-Māori New Zealanders, and gaps in communication between healthcare providers and patients may be contributing to this disparity.
This research suggests that healthcare providers could make a meaningful difference by improving how they share sexual and reproductive health information with Māori women — particularly during high-stress situations like procedures or difficult diagnoses. Better communication practices that prioritize clear, accessible information could help build trust, improve health literacy, and ultimately support wāhine Māori to make informed decisions about their own health.
Harris C, Bidwell S, Hudson B, Patu M, McKerchar C, Al-Busaidi I. (2025). He mana tō te mātauranga - knowledge is power: a qualitative study of sexual and reproductive healthcare experiences of wāhine Māori.. Journal of primary health care. https://doi.org/10.1071/HC24103