Health inequities exist in Aotearoa New Zealand and one example is the higher rate of, and mortality from, cervical cancer experienced by Māori compared to non-Māori (1). The impact of colonisation created biased systems, and these continue to perpetuate inequity and health disparities (1,2). Equity is defined by WHO as "the absence of unfair, avoidable or remediable differences among groups of people... Health equity is achieved when everyone can attain their full potential for health and wellbeing.” (3). It has been proven that changing the system is one component of achieving health equity (1-3). The current cervical screening program fails Māori, along with other minority ethnicities, with low screening rates attributed to the high rates of cervical cancer and mortality (4). HPV testing is a better screening tool to prevent cervical cancer and HPV self-testing has been shown to be an acceptable screening tool for under-screened or never screened Māori women (5). Let’s test for HPV (and prevent Cervical Cancer) was a pilot HPV cervical screening study which aimed to evaluate the practicalities and process of implementing HPV testing with the option of a self-test. The study involved 3309 people across three regions in Aotearoa NZ. Let’s test for HPV study was a collaborative project with representation of Māori, Pacific, general practices and community groups. We wished to assess how this inclusivity, and co-design aspect, improved the equity of the study design. In order to assess the equity, one validated tool He Pikinga Waiora Implementation Framework was applied and findings regarding the study design and equity opportunity are discussed here (6).
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