An integrative literature review has highlighted the need for system-level transformation to embed cultural safety and equity across surgical pathways. The review included 11 peer-reviewed studies published since 2017 (six from New Zealand and five from Australia). Inequities were noted in prehabilitation, primary care access, and referral processes. Guiding principles for culturally centered models included grounding initiatives in Māori worldviews, institutional commitment, barrier reduction, cultural training, whānau engagement, and Indigenous-led hospital design to achieve equitable Māori surgical outcomes.
