Sudden death rates for babies in Northland have halved but Maori infants still make up more than 90 per cent of overall deaths.
Statistics in a new report by the Child and Youth Mortality Review Committee (CMRYC) found from 2002-2015 Maori babies in Northland were slightly over six times more likely to die from SUDI than non-Maori, with 52 of the 57 babies (91.2 per cent) who died over those 13 years of Maori descent.
However Northland District Health Board (NDHB) statistics show the average number of SUDI deaths had halved with an average of six to 10 SUDI deaths per year five years ago compared with an average of two to four SUDI deaths per year now.
Jeanette Wedding, NDHB general manager of Child, Youth, Maternal, Public and Oral Health Services, credited the decline to a combination of interventions including the safe sleep spaces like wahakura - woven flax sleeping baskets to allow mothers to safely co-sleep with their baby developed by the Nukutere Weavers' Collective in Gisborne in 2006.
Maori-focused initiatives delivered by the DHB included wananga facilitated by Maori midwives and Whakawhetu which involved more than 45 marae since 2013; and hapu wananga (kaupapa Maori antenatal education) facilitated by Ngati Hine Health Services Trust.
"There is a significant inequity for Maori whanau experiencing SUDI. NDHB's efforts are intentional toward ensuring all community engagement and awareness-raising about SUDI is culturally relevant for Maori whanau and builds on existing strengths, knowledge and networks within Maori communities."
Lisa McNab, Northland regional adviser for Whakawhetu - a kaupapa Maori programme dedicated to reducing SUDI for Maori; and member of CYMRC for Northland District Health Board (NDHB), said there needed to be more investment in Maori health.
"I acknowledge the decrease in statistics and the work the DHB is doing. However the rates are showing inequity between Maori and non Maori.
"There needs to be a big and long-term investment not just for SUDI but health overall."
Ms McNab said wahakura were an example of a Maori initiative which had worked.
Ms Wedding said since the pilot of a SUDI prevention programme in 2013 NDHB had bought more than 500 wahakura waikawa and 1000 Pepi-Pods for distribution to whanau with babies with identified SUDI risk factors.
Ms Wedding said NDHB also had baseline funding for 180 safe sleep spaces per year and was waiting on details of Ministry of Health funding which could increase the number of safe sleep spaces provided.
Safe sleep spaces were important as the CYMRC report said studies showed that babies of a mother who smoked during pregnancy and bed-shared were at a 32 times greater risk of SUDI than those who neither had a mother who smoked nor bed-shared.
This was because babies of mothers who smoke during pregnancy also have low birth weight, are premature and suffer conditions such as asthma.
The report also found inadequate housing, poor financial resources, a lack of transport and difficulty accessing support from health providers made it difficult for families to engage, or stay engaged, with healthcare and support services.
Ms McNab said she had mixed emotions looking at the statistics in the report.
"It angers first, and then it's sadness, and then it's anger again.
"Then the whanau are questioned, not the system, when the lens is put on the wrong place, not what is causing this. When you read in the report that one of those houses was cold so they slept with baby - anybody would do that," she said.
Ms Wedding said families accessing NDHB maternal and child healthcare services also had social workers who could facilitate access to social services that can assist with accommodation which may include referral to the Manawa Ora (Healthy Housing) programme.