Reporting Māori Participation in Paramedic Education and the EMS Workforce in New Zealand


Emergency Medical Services
Indigenous people

How to Cite

Morrison TA, Tunnage B. Reporting Māori Participation in Paramedic Education and the EMS Workforce in New Zealand. Australasian Journal of Paramedicine [Internet]. 2014Aug.30 [cited 2021Oct.28];11(5). Available from:



Indigenous people have poorer health outcomes and are under-represented in the general healthcare workforce. This study aims to: i) quantify Māori participation in paramedic education and the Emergency Medical Service (EMS) workforce in New Zealand, ii) compare these with reported Māori participation rates across healthcare education and the general healthcare workforce, and iii) identify factors that may promote or inhibit Māori engagement in the sector.


Providers of tertiary paramedic education and EMS systems were surveyed and relevant literature was reviewed.


Māori averaged 7.5% of total enrolments in tertiary paramedic education over a 5 year period and, in 2013, represented 5% of the total EMS workforce.

The literature review included 14 publications. Māori participation across the general healthcare workforce is low. Factors promoting Māori tertiary enrolment include the desires to attain a career, enhance Māori health and have a steady income. Barriers inhibiting academic studies include inadequate support, low academic and socio-economic backgrounds and the absence of a culturally safe learning environment. Aspects promoting workforce engagement include clear career pathways, support for workforce development, having role-models, mentors and leaders in the profession, and working in a culturally supportive environment.


Māori are significantly under-represented in the EMS sector and further research is required to determine which factors promote and inhibit participation. Recruitment and retention processes should be reviewed by employers and educators and teaching strategies within paramedic programmes reconsidered. Initiatives aimed at engaging Māori in the health workforce should ensure they promote paramedicine as a potential career choice.


Anderson I, Crengle S, Kamaka ML, Tai-Ho C, Palafox N, Jackson-Pulver L. Indigenous Health 1: Indigenous health in Australia, New Zealand, and the Pacific. Lancet 2006;367:11.

Māori Population Estimates: At 30 June 1991-2013 [database on the Internet] 2013a. Available at:āori-population-estimates.aspx [Accessed 28 May 2014].

Ministry of Health. Māori health, 2013. Available at: [Accessed 26 July 2013].

Ministry of Health. Factors affecting Pacific peoples’ health. 2013. Available at: [Accessed 26 July 2013].

New Zealand Period Life Tables: 2010-12 [database on the Internet] 2013b. Available at: [Accessed 28 May 2014].

Ministry of Health. An Indication of New Zealanders’ Health 2007, Welllington, 2007.

Campeau A. Introduction to the “space-control theory of paramedic scene management”. Emerg Med J 2009;26(3):213–6.

Crampton P, Weaver N, Howard A. Holding a mirror to society? The sociodemographic characteristics of the University of Otago's health professional students. N Z Med J 2012;125(1361):12–28.

Garlick P, Brown G. Widening participation in medicine. Br Med J 2008;336:1111–3.

Harris R, Tobias M, Jeffreys M, Waldegrave K, Karlsen S, Nazroo J. Racism and health: The relationship between experience of racial discrimination and health in New Zealand. Soc Sci Med 2006;63:1428–41.

Divi C, Kross RG, Schmaultz SP, Loeb JM. Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health C 2007;90(2):60–7.

Horvat L, Horey D, Romios P, Kis-Rigo J, editors. Cultural competence education for health professionals: John Wiley & Sons, 2011.

Health Workforce Advisory Committee. Strategic Principles for Workforce Development in New Zealand. Wellington, 2005.

St John New Zealand. What we do. Available at: [Accessed 28 May 2014].

Ministry of Health. Ethnicity Data Protocols for the Health and Disability Sector. Wellington. 2004.

Auckland University of Technology. Do I need Ethics Approval? 2014. Available at: [Accessed 17 July 2014].

Pūtaiora Writing Group and Health Research Council of New Zealand. Te Ara Tika Guidelines for Māori research ethics: A framework for researchers and ethics committee members, 2010. Available at:

Perez D, Belton A. Demography of medical students at the University of Otago, 2004-2008: A changing spectrum? N Z Med J 2013;126(1371):63–70.

Nursing Council of New Zealand. The New Zealand Nursing Workforce. A profile of Nurse Practitioners, Registered Nurses and Enrolled Nurses 2011-2012.

O'Connor T. Boosting Maori and Pacific nursing numbers. Nurs N Z 2008;14(12):20–1.

Medical Council of New Zealand. The New Zealand Medical Workforce in 2012.

Wilson D, McKinney C, Rapata-Hanning M. Retention of Indigenous nursing students in New Zealand: A cross-sectional survey. Contemp Nurse 2011;38(1-2):59–75.

Baker M. Developing the Maori nursing and midwifery workforce. Nurs N Z 2009;15(2):28.

Manchester A. Advancing the Maori and Pacific workforce. ibid. 2012;18(3):29.

Curtis E, Reid P. Indigenous Health Workforce Development: challenges and successes of the Vision 20:20 programme. Aust N Z J Surg 2013;83(1-2):49–54.

Poole P, Moriarty H, Wearn A, Wilkinson T, Weller J. Medical student selection in New Zealand: looking to the future. N Z Med J 2009;122(1306):88–100.

Simon V. A snapshot of Mäori nurses' health and safety issues. Nurs N Z 2004;10(10):14–5.

Hansen C, Carryer J, Budge C. Public health nurses' views on their position within a changing health system. Nurs Prax N Z 2007;23(2):14–26.

Rini D. Reflexivity in practice: A cultural journey in nurturing the growth of Indigenous Maori registered nurses. Aust Nurs J 2013;13(7):42–3.

Wilson D, Baker M. Bridging Two Worlds: Māori Mental Health Nursing. Qual Health Res 2012;22(8):1073–82.