June 22, 2020

Contributing to a robust Pasifika healthcare system

Every person across Aotearoa should have the freedom to access culturally appropriate healthcare, without distinction of economic or social factors. 

Despite successive governments developing explicit policy commitments to improve the health of all New Zealanders, Pasifika communities continue to face an inequitable burden of preventable chronic diseases including diabetes, obesity and high blood pressure. These factors lead to Pasifika people living on average seven years less than that of non-Māori and non-Pasifika.

The current healthcare systems in place to support Pasifika communities operates in a way which sets/pits organisations against one another, for funding and resources. This leads to limited sharing of information and data, duplication of services, inconsistent messaging to Pasifika communities, and organisations operating in isolation with an ‘inward-facing’ perspective.

Since 2019, Healthy Families Waitākere has been working to disrupt this system, developing high trust relationships throughout the network of Pasifika organisations and collectives in West Auckland, with the intention to influence and support organisations to collaborate and build links across the system. The efforts have been focused in particular on relationships between Pasifika community and community organisations, alongside Pasifika representatives in governing system organisations, including local and national government, DHBs, funders, tertiary institutes and NGOs. Healthy Families Waitākere Systems Innovator, Fole (Daleki) Finau, explains.

“The approach reflects and responds to an existing dominant focus on information and data gathering, which has created significant research fatigue in the Pasifika community and has not resulted in enough action or accountability in governing systems to enhance Pasifika wellbeing. Healthy Families Waitākere is working to shift the balance towards reciprocal support, aligning with the ‘give and take’ reciprocity value within Pasifika culture.”

Healthy Families Waitākere is uniquely positioned to act as a conduit between the community and Pasifika organisations, operating as a neutral party to amplify community voice and build a strong Pasifika network across West Auckland. The approach is already demonstrating value, with Healthy Families Waitākere team member Fole (Daleki) Finau selected for board positions on the West Auckland Pasifika Forum and the Pacific Island Food and Nutrition Action Group, alongside a partnership agreement with The Fono, New Zealand’s largest Pasifika NGO health and wellbeing services provider.

The development of cross-organisational information sharing has already lead to tangible outcomes for Pasifika, including the phasing out of sugary drinks in Pasifika churches and community groups across West Auckland. Through the Fono’s DHB funded Enua Ola programme, a water-only pledge has been translated into eight Pasifika languages and signed by over 20 churches and community groups. The pledge was developed alongside the Enua Ola leaders, ensuring a culturally centred format and language. The pledges have proven so popular, several organisations from other regions across the motu have reached out to Healthy Families Waitākere to learn how this was accomplished.

Healthy Families Waitākere has also prompted other collaborations which have produced specific positive practice and policy changes, such as the Tula’i Pasifika Youth Leadership Programme, which operates in West Auckland secondary schools. Healthy Families Waitākere brought together several organisations to collaborate and deliver modules in areas such as nutrition, sexuality and suicide, where previously there had not been an appetite for such inclusions.

This role of serving both governing and community organisations to better map and connect the Pasifika wellbeing system supports “both ends” to operate collaboratively towards enhanced Pasifika wellness outcomes.

Given the challenges many Pasifika communities experiences, it is unsurprising health is often not the first priority. Health services need to identify and acknowledge Pasifika specific challenges, facilitate pathways to improve access to health and social services, including housing, education and employment support, so it is seamless for communities who need it most. Furthermore, Governing systems need to sanction cross-sector sharing of data, information and resources to promote collaboration and achieve collective impact.

The term “Pasifika” is used to refer to those who originate from the Pacific Islands or identify with the Pacific Islands in terms of ancestry or heritage. This means they derive from a diverse range of cultural and language backgrounds, identifying with one or more of the Pacific groups, including Samoa, Tonga, the Cook Islands, Fiji, Niue, Tokelau, or Tuvalu. There are of course many inter- and intra-ethic variations between people of these groups, and while some identify common values and beliefs across these groups, not all people accept the label “Pasifika”. It would be incorrect to view Pasifika as a single ethnicity and an awareness of the diversity amongst Pasifika groups and individuals can help prevent stereotyping.