The responsiveness of surgical research to Māori in Aotearoa, New Zealand—a scoping review

Abstract

Background

Māori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Māori in surgery in NZ and evaluated the responsiveness of this evidence base to Māori using two Indigenous frameworks.

Methods

Utilising a Kaupapa Māori methodological stance, a scoping review of all studies related to Māori and surgical care in NZ (2000–2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MĀORI frameworks to assess responsiveness to Indigenous Māori.

Findings

A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Māori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N = 172/254) rated as low quality in accordance with the MĀORI framework. More than half of all studies (55%) did not report Māori leadership, governance, and co-authorship. Studies that utilised Kaupapa Māori research were more likely to be considered high-quality.

Interpretation

This study shows that the current surgical evidence base is not responsive to Māori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples.

Funding

This study was supported by a Health Research Council of New Zealand Health Delivery Research Activation Grant (21/860) and Māori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication.