Opinion: Time for a new way to save our Māori & Pasifika pēpi

 Cultural competence is defined as the ability of practitioners, providers and organisations to effectively deliver health care and services that meet the social and cultural needs of patients.

by Professor Tipene-Leach

We’ve spent billions of dollars fighting Covid-19, but unless we find a way to seriously address income disparity in New Zealand, then we are clearly saying that it’s okay to have 30 mostly brown babies from overcrowded homes die in their sleep each year.

The recent numbers are stark. Sixty-four infant deaths died between November 2018 and June 2020 with some indication of a recent increase in numbers, particularly among Māori infants.

Right now Māori infants are 8.5 times more likely to die of SUDI (sudden unexpected death in infancy) than non-Māori, non-Pacific infants.

The recently reviewed Ministry of Health SUDI (Sudden Unexpected Death in Infancy) figures, requested under OIA and reported by Radio New Zealand, confirm that families who lost infants through SUDI were usually living with financial insecurity, while the ethnicity of the infants was predominately Māori (65.6 per cent), and Pasifika (20.3 per cent).

The review paints a grim picture as it shows that the steady decrease in SUDI deaths noted in the early to mid-2010s is over. And although it is not new, bed sharing (common in crowded homes) and smoking in pregnancy (common in deprived communities) is still problematic.

What is new however, is clear evidence of exhausted parents with unwell babies who had recently sought medical attention.

The parents, the review said, are not ignorant of SUDI risk – they heard and have understood the safe sleep messages.

The problem was that on that particular night, exhausted with a sick kid on their hands, they decided to take the baby to bed where the tragedy struck.

The causes of SUDI are complex and are inextricably linked with poverty, poor health, and some unfortunate choices.

But what about Ministry of Health bungling? The Whakawhetū SUDI Prevention Programme was closed down in 2016 and the new Hāpai Te Hauora National SUDI Prevention Programme didn’t get off the ground until early 2018.

Hāpai Te Hauora had to ‘start from the beginning’ with half the resources of the old programme and only 10 per cent of the total budget allocated to SUDI.

The rest went to the DHBs to pay for distribution of safe sleep devices – Pēpi-Pods and wahakura.

It is fair to say that the Ministry programme has not delivered the outcomes that everybody had hoped it would and a common catchphrase is of programme failure.

Perhaps we are ‘just catching up’ after the Ministry’s late start? Or this might be ‘all we get for the 8500 safe sleep devices’ distributed annually.

And we certainly need to take ‘smoking in pregnancy’ more seriously! But now is the time to try something completely different.

The smaller picture says that we need to reclaim the antenatal space for Māori programming like Hapū Wānanga and our ‘weaving for pregnant Mums’ centre, Te Whare Pora.


We know that educational programmes like this work, and we need to roll out more of them across the country. We also need to improve our stop smoking in pregnancy programmes – we are not good enough at this.

But the big picture says that we need to deploy some serious money into protecting our infants.

When on earth will we spend real money protecting brown babies. The Government had a busy first term with ‘political issues’ to deal with.

Now is the time for boldness. We need a new approach; we are all tired of the same old news.

Dr David Tipene-Leach is Māori and Indigenous Research Professor at the Te Aho a Māui (EIT) in Hawke’s Bay. He is the inventor of the wahakura, the woven flax bassinet for babies, and is an advisor to the National SUDI Prevention Programme. From Pōrangahau and of Ngāti Kere and Ngāti Manuhiri descent, David has spent his working life promoting Māori health.