Doing to Whānau or Working With Whānau? Reorienting Well Child Tamariki Ora Services Through Mahi Ngātahi

Māori (Indigenous peoples of Aotearoa New Zealand) continue to experience inequitable health and social outcomes shaped by colonisation and ongoing racism. Well Child Tamariki Ora (WCTO) services provide universal nursing and parenting support for whānau (extended family group) with tamariki (children) under 5 years, however, service design and delivery are not consistently aligned with Māori worldviews and whānau realities, limiting uptake and ongoing engagement. This study used a Kaupapa Māori methodology with constructivist grounded theory methods to explore Māori whānau experiences of WCTO services. Data were generated through interviews and focus groups with 35 Māori participants and analysed using constant comparative methods, with additional theoretical sampling to refine emerging categories. Three theoretical categories were identified: moving from ‘doing to whānau’ to working with whānau; upholding whānau mana; and supporting whānau to access what they need. These findings informed the Mahi Ngātahi framework, which outlines culturally responsive processes for relationships, communication and service delivery aligned with whānau realities. The study demonstrates that when services fail to uphold whānau mana and reflect Māori worldviews, engagement is reduced. In contrast, whakawhanaungatanga (relationship building), manaakitanga (care and hospitality) and flexible, whānau-led approaches support meaningful engagement. Strengthening culturally responsive practice within WCTO services requires attention to policy, workforce development and accountability to ensure culturally safe care and improved outcomes for whānau Māori.