Barriers and facilitators for Maori in accessing hospital services in Aotearoa New Zealand

AIM: This paper reports the findings of a literature review to answer the research question, "What are the barriers and facilitators of access to hospital services for Maori?" METHOD: MEDLINE (Ovid) and PsycINFO were searched using keywords to identify relevant literature published between 2000 and 2020. The data analysis was informed by a Kaupapa Maori positioning and the CONSIDER statement on reporting of health research involving Indigenous peoples. RESULTS: Twenty-three papers met the inclusion criteria. We identified five themes that captured the barriers for Maori accessing hospital services (practical barriers, poor communication, hostile healthcare environment, primary care barriers and racism) and five facilitatory themes were identified (practical facilitators, whakawhanaungatanga, whanau, manaakitanga and cultural safety). CONCLUSION: This article confirms existing knowledge about practical barriers and facilitators to healthcare access for Maori and contributes to an emerging body of evidence about the impact of racism and culturally unsafe services in preventing Maori from accessing healthcare services. The facilitators identified provide a potential roadmap for the redesign of services so they are accessible and effective for Maori. Improving services in this way would support district health boards, the Ministry of Health and professional organisations to comply with their commitments to providing culturally safe services and health professionals.