Māori-Led Internship Programme Aims to Reshape Heart Health Workforce in New Zealand

Cardiovascular disease remains the leading cause of death in Aotearoa New Zealand, and the burden it places on Māori communities is starkly disproportionate. Māori, the Indigenous People of New Zealand, experience significantly higher rates of cardiovascular disease and mortality than the wider population, and researchers trace these disparities back to structural determinants shaped by colonisation and systemic racism rather than to individual lifestyle choices alone. Against this backdrop, a team of Māori and allied researchers has now published a detailed account of an ambitious attempt to attack the problem at its roots: not through another clinical trial or public awareness campaign, but by deliberately growing a health workforce that is Indigenous led, culturally grounded, and structurally positioned to change how heart health research and care are delivered. The programme, called Kura Raumati, is described in a new research article in BMC Health Services Research, led by Erina Korohina, Whetu Marama Manihera, and Anna Rolleston of the Manawaora Integrated Health & Research Centre in Tauranga, together with Anuj Bhargava of the University of Auckland.

Kura Raumati, whose name evokes a summer house of learning, is a Māori-designed internship programme created to strengthen Māori participation and leadership in heart health research and practice. It is hosted by a Māori-led community research centre, a placement that matters analytically as well as symbolically. Rather than recruiting Indigenous students into institutions and asking them to adapt, the programme brings the institutional experience into a Māori-controlled environment and wraps the professional development in cultural scaffolding. The design rests on kaupapa Māori theory, a framework grounded in Māori knowledge, skills, and values, and it explicitly prioritises tino rangatiratanga, or self-determination, alongside relational learning and collective wellbeing. In practical terms, this means the programme is not simply a paid internship with a cultural add-on; the cultural foundation is the operating system on which every other component runs.

The architecture of the programme has three interlocking components. The first is a culturally grounded residential learning workshop, an immersive educational gathering in the tradition of wānanga, where students, mentors, and elders come together on a marae, the traditional Māori meeting complex. These gatherings open with karakia, prayer or incantation that sets intentions and provides spiritual support, and they are structured around tikanga, the cultural protocols and appropriate ways of behaving that govern how people meet, speak, and share knowledge. The second component consists of paid research placements in both university and community settings, giving students genuine research experience on projects addressing cardiovascular health equity rather than peripheral or token tasks. The third is intensive mentorship, delivered through relationships that draw on the tuakana–teina model, a reciprocal dynamic of support and learning in which each person may act as elder or younger sibling depending on context, so that knowledge flows in multiple directions rather than only downward from senior academics.

Across two cohorts, 21 Māori students moved through the programme, engaging in a diverse range of research projects all oriented toward cardiovascular health equity. The paid nature of the placements is a deliberate design choice with equity implications: unpaid internships systematically filter out students who cannot afford to work without income, a filter that falls disproportionately on Indigenous and low-income students. By paying participants, Kura Raumati removes one of the structural barriers that has historically kept Māori students out of research career pipelines. The programme’s designers describe three intertwined goals: fostering cultural identity, building research capability, and supporting ongoing engagement in health-related careers. Each goal addresses a documented failure point in conventional workforce pipelines, where Indigenous students frequently report feeling isolated, culturally unsafe, or pressured to leave their identity at the door of academic and clinical institutions.

The theoretical foundations of the programme deserve close attention because they represent a methodological argument as much as an educational one. Kaupapa Māori theory insists that Māori knowledge, or mātauranga Māori, which encompasses spiritual, environmental, and genealogical knowledge systems, is a legitimate and rigorous epistemological base for research, not a cultural garnish to be sprinkled onto otherwise conventional methods. Within the programme, values such as whanaungatanga, the kinship-based sense of connection and collective responsibility, and manaakitanga, the practice of hospitality, care, and generosity, are treated as pedagogical mechanisms. The concept of ako frames learning as reciprocal between teacher and student, while utu, or reciprocity, and the protective wrap of the korowai, the cloak, describe the relational obligations that bind the learning community together. These are not decorative Māori terms appended to a Western curriculum; the authors position them as the actual causal machinery through which the programme is expected to produce a stronger, more resilient workforce.

The programme’s designers anticipate that Kura Raumati will strengthen relationships between Māori students, their communities, and academic institutions, a triad that is often strained in conventional research training. When research is conducted on Indigenous communities rather than with them, communities understandably become wary, and students who come from those communities can find themselves caught between worlds. By hosting the programme inside a Māori-led community research centre and routing placements through both universities and community settings, the model builds what might be called relational infrastructure: networks of trust and obligation that persist beyond any single internship cycle. The whānau, or extended family and community, is treated as part of the learning environment rather than as a background variable, reflecting the Māori understanding that individual achievement is embedded in collective wellbeing. Sub-tribal and tribal structures, the hapū and iwi, provide the wider kinship context within which students’ professional identities can develop without rupture.

From a health services research perspective, the significance of the programme lies in its theory of change for addressing cardiovascular inequities. The dominant clinical model treats disparities as problems to be solved within consultations, through cultural competency training or targeted outreach. Kura Raumati operates upstream, on the composition and orientation of the workforce itself. The underlying logic is that a workforce in which Māori knowledge, values, and community relationships are embedded across care systems will produce services that are more responsive to Māori communities, and that this responsiveness is a structural property of the system rather than a matter of individual clinician goodwill. This aligns with the broader concept of cultural safety, which shifts the burden of change from the patient to the institution and requires services to examine their own power structures. The programme is explicitly framed as a contribution to a sustainable, equity-focused health workforce, with future evaluation planned to assess its impact on workforce preparedness, cultural safety, and Indigenous leadership in heart health research.

It is worth noting what the published paper does and does not claim. The article reports on the theoretical foundations, design, and implementation of the programme across two cohorts; it is a design and implementation paper, not an outcome evaluation. The authors are careful to state that formal evaluation of outcomes is planned for future phases, and the manuscript itself notes that it reports aggregated administrative data from routine programme operations rather than research data collected from individuals, which is why formal ethics approval was not required under New Zealand Health and Disability Ethics Committee guidance. This restraint is methodologically honest and also strategically important: premature claims of workforce impact are a known weakness in the health workforce literature, where programmes are often celebrated at launch and never rigorously assessed. By publishing the design in detail now and committing to evaluation later, the team is creating a documented, citable model that others can replicate, adapt, and test.

The transferability of the model is one of its most consequential features. The authors argue that Kura Raumati offers insights for health systems seeking to integrate Indigenous knowledge into workforce and service development, and the core design principles travel well beyond Aotearoa New Zealand. Indigenous communities in Australia, Canada, the United States, and elsewhere face parallel patterns of cardiovascular and chronic disease inequity rooted in colonisation, and parallel shortages of Indigenous health professionals and researchers. The specific cultural protocols of Kura Raumati are Māori and cannot be lifted wholesale, but the structural logic, Indigenous leadership of the programme, payment of participants, immersion in Indigenous pedagogy, reciprocal mentorship, and hosting within community-controlled institutions, constitutes a replicable template. The programme was co-funded by the Pūtahi Manawa Centre of Research Excellence and the Heart Foundation of New Zealand, a funding partnership that itself models the collaboration between research infrastructure and community-oriented health organisations that the programme seeks to cultivate.

The closing sentiment of the paper is captured in a whakataukī, a proverb, quoted by the authors: Poipoia te kākano, kia puawai, nurture the seed and it will bloom. It is a fitting summary of the programme’s wager. Conventional workforce policy tends to measure inputs and outputs, numbers enrolled, numbers graduated, numbers employed. Kura Raumati instead invests in the conditions of growth: identity, relationship, reciprocity, and self-determination, trusting that capable, culturally grounded professionals will follow. Whether that wager pays off at scale will depend on the evaluations now planned for future phases, and on whether funders and institutions are willing to support Indigenous-led models long enough for their distinctive mechanisms to mature. What the published design already demonstrates is that a health workforce pipeline can be built from the ground up on Indigenous terms, inside Indigenous institutions, and that doing so is not a concession to culture but a serious, theoretically grounded strategy for tackling one of New Zealand’s most persistent health inequities.

Subject of Research: An Indigenous-led internship model for strengthening the Māori cardiovascular health workforce in New Zealand

Article Title: Designing an indigenous-led internship model to strengthen the Māori health workforce: the Kura Raumati programme in Aotearoa New Zealand

Article References: Korohina, E., Manihera, W. M., Bhargava, A., & Rolleston, A. (2026). Designing an indigenous-led internship model to strengthen the Māori health workforce: the Kura Raumati programme in Aotearoa New Zealand. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15778-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15778-3

Keywords: Māori health, Indigenous workforce, cardiovascular disease, health equity, kaupapa Māori, cultural safety, internship programme, health services research, New Zealand, workforce development, decolonising research, heart health