Persistent inequities in health experiences and outcomes are observed for Māori compared to non-Māori in Aotearoa New Zealand. We conceptualised factors associated with Māori consumer experiences of health programs and services and characterise how the recommendations arising from qualitative research inform strategies to address inequities. In this systematic review, electronic literature searching was conducted in February 2018. Qualitative studies reporting Māori consumer experiences of health services and programs in Aotearoa New Zealand were eligible. Māori consumer experiences of health services were mapped to the WHO Commission of Social Determinants of Health (CSDH) conceptual framework on health inequities as related to: (i) the socioeconomic and political context; (ii) socioeconomic positioning; or (iii) intermediary factors that increase exposure to health-compromising conditions. Recommendations to improve consumer experiences were mapped to the CSDH framework for tackling social determinants of health inequities as policy directions on: (i) unequal consequences of illness (individual interaction); (ii) risks of exposure to health-damaging factors (community); (iii) exposures to health-damaging factors (public policies); and (iv) mitigating effects of socioeconomic and political stratification (environment). Fifty-four studies were included. Māori consumer experiences mapped to social determinants of health inequities were most frequently related to direct interactions with health services and programs, particularly patient-clinician interactions (communication, relationships) and cultural competencies of clinicians and the system. Key recommendations by researchers mapped to potential strategies to address inequity were identified at all levels of the political, social and health system from individual interactions, community change, and broader public and system-level strategies. Recommendations were predominantly focused on actions to reduce risks of exposure to health-damaging factors including health literacy interventions, increased resources in cultural competencies and Māori capacity in health service development and workforce. Māori consumer experiences of health services and programs are an important informer of variables that impact health inequity. Strategies to tackle health inequities informed by Māori consumer experiences can be drawn from existing empirical research. Future qualitative exploration of how socioeconomic, political and public policies influence Māori consumer experiences of health services and programs could inform a broader range of structural policies to address health inequities.

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定性研究中报告的毛利消费者对卫生系统和计划的体验：荟萃综合的系统评价

在新西兰，毛利人与非毛利人相比，在健康经历和结果方面持续存在不平等。我们概念化了与毛利消费者的健康计划和服务体验相关的因素，并描述了定性研究产生的建议如何为解决不平等问题的策略提供信息。在本次系统评价中，于 2018 年 2 月进行了电子文献检索。报告新西兰毛利消费者对健康服务和项目的体验的定性研究符合条件。毛利消费者的卫生服务体验被纳入世界卫生组织健康问题社会决定因素委员会 (CSDH) 关于健康不平等的概念框架，涉及以下方面：(i) 社会经济和政治背景；(ii) 社会经济定位；(iii) 增加暴露于危害健康状况的中间因素。改善消费者体验的建议已纳入 CSDH 框架，以解决健康不平等的社会决定因素，作为以下政策方向：(i) 疾病的不平等后果（个人互动）；(ii) 接触有害健康因素的风险（社区）；(iii) 接触有害健康的因素（公共政策）；(iv) 减轻社会经济和政治分层（环境）的影响。纳入了 54 项研究。与健康不平等的社会决定因素相对应的毛利消费者体验最常与与卫生服务和计划的直接互动有关，特别是患者与临床医生的互动（沟通、关系）以及临床医生和系统的文化能力。研究人员根据个人互动、社区变革以及更广泛的公共和系统层面的战略，在政治、社会和卫生系统的各个层面确定了解决不平等问题的潜在策略的关键建议。建议主要集中于减少接触有害健康因素的风险的行动，包括健康素养干预措施、增加文化能力资源以及毛利人在卫生服务发展和劳动力方面的能力。毛利消费者对医疗服务和计划的体验是影响健康不平等的变量的重要信息来源。可以从现有的实证研究中得出根据毛利人消费者体验解决健康不平等问题的策略。未来对社会经济、政治和公共政策如何影响毛利消费者的医疗服务和计划体验的定性探索可以为更广泛的结构性政策提供信息，以解决健康不平等问题。