Lecture 6 Health 112.pdf

Pacific Peoples Health Lecture 6 Associate Professor Damian Scarf  Lecture Outline Pacific Peoples NZ Health Survey Pacific Health Strategy Pacific Peoples Kiribati Tuvalu Tokelau Samoa Fiji Niue Tonga Cook...

Pacific Peoples Health Lecture 6 Associate Professor Damian Scarf  Lecture Outline Pacific Peoples NZ Health Survey Pacific Health Strategy Pacific Peoples Kiribati Tuvalu Tokelau Samoa Fiji Niue Tonga Cook Islands Pacific Peoples  Pacific Peoples Samoan Tongan Cook Islands Maori Niuean Fijian Tokelauan Tuvaluan i-Kiribati 0 50,000 100,000 150,000 200,000 Population in Aotearoa  Pacific Peoples 34,269 6,924 50,520 247,083 Pacific Peoples Only Pacific Peoples/European Pacific Peoples/Maori Pacific Peoples/Asian  NZ Health Survey The New Zealand Health Survey (NZHS) provides information about the health and wellbeing of New Zealanders. The NZHS became a continuous survey in 2011, enabling the publication of annual updates. Information collected through the New Zealand Health Survey supports the development of health services, policy and strategy. Survey data is collected continuously but findings are reported annually. The results provide data for people selected for the survey period from July to June each year. Over 13,000 adults and the parents or primary caregivers of over 4,000 children take part in the survey each year.  Health Access Unmet need for GP due to cost Confidence and Trust in GP 20% 84% 82% 15% 80% 78% 10% 76% 82% 81% 16% 15% 5% 74% 9% 10% 77% 72% 75% 0% 70% GP Good at Explaining Health Conditions GP Good at Involving Patient in Decision and Treatments Making Process 94% 92% 90% 92% 88% 94% 91% 90% 89% 91% 91% 86% 89% 90% 87% 88% 84% Māori Pacific Asian NZE/Other Māori Pacific Asian NZE/Other  Health Conditions Anxiety Disorder Depression 10% 10% 8% 8% 6% 6% 4% 4% 2% 2% 0% 0% Diabetes Chronic Pain 15% 25% 20% 10% 15% 10% 5% 5% 0% 0% 2015 2016 2017 2018 2019 2020 2021 2015 2016 2017 2018 2019 2020 2021 Dr. Api Talemaitoga  Pacific Health Strategy Lalanga Fou Lalaga Potu Fale Fono Vaka Moana Te Kupega Pacific Cultural Partnership & Performance & Capabiliy Values & Principles Governance Improvement Pacific Models of Health Fonofale Model (Samoan, Fuimaono K Pulotu-Endemann) Fonua Ola Model (Tongan, Sione Tu'itahi) Kakala Model (Tongan, Konai Helu-Thaman) Fa'afaletui Model (Samoan, Carmel Peteru & Kiwi Tamasese) Ta and Va (Tongan, 'Okusitino Mahina) Te Vaka Atafaga (Tokelauan, Kupa Kupa) Tivaevae Model (Cook Island, Teremoana Maua-Hodges) Prof. Siautu Alefaio-Tugia Fonofale Model of Health Samoan Model Fuimaono Karl Pulotu-Endemann Pacific Island AIDs Trust (1991) Fonofale Model of Health TIME EN T VI X RO E N T CULTURE N M CO EN T PHYSICAL MENTAL SPIRITUAL OTHER* FAMILY *Sexuality, Gender, Age, Socioeconomic Status  Te Vaka Atafaga Kupa Kupa Tokelau Model “He Toeaina ke nofo i te mulivaka”  Te Vaka Atafaga Puipuiga o Te tino o Te Tagata (Environment) Tapuakiga/Talitonuga (Spirituality/ Belief systems) Te tino o Te Tagata (Physical Body) Mafaufau (Mind) Kaiga/Pui-kaiga (Family) Fakalapotopotoga/Tautua (Social / Support systems)  Seitapu Framework Developed by Pava /MoH (1996) Te Rau Hinengaro The Negotiated Space  Seitapu Framework Consumer Cultural Theory Health Sector Clinical Theory Ethics Organization Tapu Competent Worker Language Families Cultural Practice Clinical Practice & Families  Families Working with the family of Pacific consumers is key to the successful recovery of Pacific consumers. 1. What is the consumer’s sense of cultural identity? Which family, village, and/or tribe do they belong to? Where were they born and/or raised? What languages do they speak? 2. What is the consumer’s status in their family and culture? E.g. How might their age and position affect their relationship with other members of their family or community? 3. How might the cultural status of the consumer affect the way you act? Who might you involve to acknowledge their cultural status? E.g. ministers of religion, family members. 4. On a continuum from ‘traditional cultural orientation’ to ‘adapted cultural orientation’ where would you locate the consumer’s cultural orientation? Does this match the cultural orientation of the family?  Language Language provides the medium for effective communication. Working with Pacific peoples requires access to workers with language competency. 1. What is the consumer’s first language and preferred language of communication? What is the consumer’s family’s first language? What is their preferred language of communication? Who could assist me in communicating better with the consumer in their preferred language? 2. What is my interpretation of Pacific body language? How does this differ from my own cultural interpretations of body language? What types of body languages might be difficult for me to interpret and so require assistance? 3. What is the appropriate Pacific greeting or terms of respect for this consumer and their family? What is their preferred language for communication? What cultural situations are more likely to lead to the consumer or their family ‘losing face’?  Tapu Tapu encompasses and signals the cultural, spiritual and relational markers and boundaries for working with Pacific mental health consumers and their families. 1. What does tapu mean in Pacific cultures? How does it define relational boundaries across different Pacific groups? How might it be of relevance to my work as a mental health worker working with Pacific consumers? 2. What is my own level of awareness about Pacific spiritual and customary boundaries between people of different statuses or positions (age, gender, hierarchical status etc) in New Zealand? 3. What is my capability to deal with disclosures or assessments of a breach of tapu? Who do I need to contact to help deal with these matters?  Organisation Knowledge of the organisation and its responsibilities to Pacific people is critical to the worker’s capacity to work effectively with Pacific peoples. 1. How can my mental health organisation support the development and/or maintenance of cultural competencies? 2. What kind of strategies and/or processes need to be set in place in order for the organisation to recognise the importance of Pacific health beliefs? 3. What are my internal and external professional networks and how are these relevant to advancing the needs of Pacific consumers and/or families and/or workers within the organisation?  Lecture Outline Pacific Peoples NZ Health Survey Pacific Health Strategy