1.1
Shame: – shame has been major factor affecting people emotionally. Shame is when person s uncomfortable or embarrassed and has a low self-esteem therefore it is one of the barrier of a Māori client in seeking any sort of medical health assistance. The client feels whakama if doctors examine the private body parts for clinical purposes.
Feeling misunderstood: – this happens when the client feels whakama to openly discuss their problem with doctor. Language can also be one of the factor that emphasis misunderstood of each individual and cultural difference plays a major part as well.
Withdrawal:- This factor leads to the clients feeling whakama when he or she keeps away from community. This act as barrier lack of communication and opening the meeting up and hesitate to seek help
Self-doubt:- the client starts to experience whakama about their capabilities and sometime drive themselves to depression, shy, lack of confidence and keep themselves closed and are often discouraged to seek or talk about any medical or health all assistance they may require.
1.2
One to one consultation with health worker: – one to one consultation with health worker is more beneficial then group consultation. It encourage the client to speak more often and better understanding and information is made between two people especially if the client and worker with same gender. This approach would be able to reduce whakama and able to address the concerns of the client appropriately.
Group consultation with health worker: – it leads to embarrassment and discourage to speak and discuss more. Clients often feel whakama when discussing or sharing experiences and opinions in a large group. It can be positive impact where the client that he/she isn’t only that feels in certain way
One to one consultation with a health worker of a different gender: – it can cause the person to feel whakama, isolated, disconnected and worried about what’s going on their mind communication will be poor.
Group consultation with health worker of a different gender: – on the other hand, it may contribute the factor of understanding each other and someone experiencing the same situation will be helpful for them to speak up. Clients feel whakama on discussing issues and topics that are sensitive or taboo of their culture.
1.3
Adverse socio-cultural factor one (1) :- lack of identity: Maori are seriously affected by lack of identity because of urbanization impacts whereby they lose their identity because of cultural and economic factors i.e. they don’t know where their Maori heritage originates from, lack of whanau connections, generational impacts, can’t afford to travel back to their land of origin. These issues have huge impacts on Maori health affects
Poor education: poor education for Maori impacted by colonization, lack of education system that are conductive for Maori i.e. kappa Maori education facilities, Maori kit e Maori education programs, stigmatization stemmed from colonization
Adverse socio-culture factor one (2):- early childhood development– this has a major influence on a child life as they one at the delegate part of life and for them being exposed to abuse negativity and neglecting changes their perception on the society and this encourage them to feel shamed and isolated.
Customary right: Maori have constant barriers and challenges in mainstream providers when they request to practice their customary rights, their providers when they request to practice their customary rights, their rights are devalued, undermined, denied because of societal perceptions..Colonization is a huge part of why our rights are denied the treaty document informs society of our rights to perform customary practices
Maori have a fear to ask question because of feeling of inferiority, environmental settings, inappropriate approaches, lack of confidence with services, language barriers, and gender issues.
Adverse socio-economic factor (1):- alienation may be harmful because it may feel people low understanding, lack of confidence and weak communication skills. Lack of knowledge may they feel withdrawal. Maori have difficulty with gaining employment due to lack of education, racism stigmatisation, colonization impacts. Maori are impacted by racism due to colonization and assimilation impacts, Maori rights are not recognized
Adverse socio-economic factor (2):-low income is a factor that affecting people to seek medical assistance paying for consultation and medicine might be too. Maori are not capable to pay for medication. Maori discriminated by society perceptions that they are mower class citizen therefore inequalities are significant within society i.e. medical needs are not quality for Maori therefore Maori option is not return to service and they suffer from medical difficulties with poor health outcome due to lack of quality care in hospital. Most employment opportunities are given to non Maori.
2.1
Negative outcome (1): – Isolation and feeling unsafe while in hospital setting cause client to feel whakama especially if the whanau of the client is not involved in the hauora of the client. Also, feeling of isolation can stem from not allowing whanau access and support to assist with breaking down barrier of fear. Furthermore, feeling unsafe could well mean that whanau struggle with unfamiliar surroundings and environment. Language is the barrier which posses a communication which increases the risk of misunderstanding

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Negative outcome (2):- Clinical GP setting can cause whakama when the client is unfamiliar with the clinical and medical terms and procedures used by the doctors or healthcare practitioners. Unfamiliar setting poses a risk for accessibility and therefore impacts the health and wellbeing of whanau. Engagement with whanau is very clinical and non-inviting. Moreover, lack of patient/doctor rapport due to consultation time constraints
Negative outcome (3); – gender difference is another negative outcome because female patient sometime can’t explain their personal problems to the male doctor.so female will ignore to see the male doctor next time. Whakama impacts on hauora can stem from Maori not being in an environmental which support the use their Maori traditional medicine. Maori feel there is stigma of mistake regarding their use of rongoa and therefore they feel whakama
Positive outcome (1); – code of rights

You should always be treated with respect
No one should categorize against you
You care and treatment let you live a dignified independent life
You are treated with care and receive the right service
You have the right to be listened to
Your condition should be fully explained to you
It is your decision whether to go ahead with treatments or not and you are able to change your mind at any time
In most situations you can have a support person of your choice with you if you wish
All these rights also apply when you are taking part in teaching or research
You have the right to make a grievance

Positive outcome (2); – he korowai orange: Maori health strategy sets the way for Maori health development in the health and disability division. The strategy provides a structure for the public sector to take duty for the part it plays in supporting the health status of whanau
The generally aim of the korowai orange is whanau ora Maori families supported to achieve their maximum health and comfort
Positive outcome (3);-
Manaakitanga (caring, nurturing): honoring others by practicing hospitality, respect and the sharing of income
Whanaungatanga (making connections)
Good rapport is established at the first meet. Relationship can be strengthen, if possible, as an ongoing process
Wairuatanga; (spiritual aspect) to acknowledge that each individual may have a unique sympathetic of their own spirituality
Refrences
http://www.health.govt.nz
http://www.countiesmanukau.health.nz
http://healthpoint.co.nz