PASIFIKA

NGATEPAERU MARSTERS COLLEGE PASIFIKA REPRESENTATIVE

Tapuaki: a blessing

For the past two years, Pasifika Midwives Aotearoa has provided pregnancy and parenting education services, as defined by the Ministry of Health (MOH) service provision. The curriculum is Pacific focused and called Tapuaki - a Tongan word that encompasses the feeling of being blessed when expecting a pēpi into the whānau.

Auckland University’s Pacific Health Section is located within the School of Population Health at its Tāmaki campus. It was here that Tapuaki was conceived over a decade ago, following a MOH Pacific Grant. Tapuaki had broad stakeholder involvement of Pasifika health professionals: midwives, student midwives, Well Child services, nurses, social workers, obstetricians, paediatricians; the service became known as Taha – Well Pacific Mother and Infant Service. It was an acknowledgement of the fact that within the Pacific, midwives hold dual registration as nurse/midwives and healthcare generally fits within a medical model. This is appropriate, given their context of often working in extremely remote areas and in sole charge.

Tapuaki was designed with a strength-based focus on prevention within Pacific maternal and infant health. It aimed to change attitudes, systems, and behaviours, through social innovation. The curriculum was evidence-based and included the use of engaging tools and resources, improving Pacific families’ access to effective pregnancy education and support services by providing multiple community entry points. The purpose of the classes was to empower Pacific pregnant women of all ages, and their families, to talk about pregnancy and parenting. It allowed them to ask questions, seek advice, and make more informed choices about their care. Tapuaki was both inspirational and aspirational for Pacific peoples.

As is often the case with such innovations, they are largely dependant on funds, which either stop abruptly or are phased out slowly, so much so that only a skeletal image of the original intention is left behind, as political priorities change. Midwifery was seen as one small part of the programme, yet today it is the sole surviving component of Tapuaki. It continues to be a vehicle for advancement of wellbeing, via which pregnant Pacific peoples of all ages continue to gather information and become inspired to actively participate in decision-making regarding their care.

The current facilitators, midwives Lisa Nathan (Te Aupouri/Te Rarawa/Ngāpuhi/ Cook Island Māori) and Fa’anape (Nape) Tafiti (Samoa) periodically refresh the content and discuss ideas to improve engagement. Over the years, Tapuaki classes have predominantly been held in South Auckland, specifically in Manurewa, Otara and Mangere. More recently, Te Puke Otara Community Centre and Ngā Hau Mangere Birthing Centre (NHMBC) have been utilised, with NHMBC proving to be the most successful venue. Classes at NHMBC have reinforced the notion of primary birthing and enabled a deeper discussion about the most appropriate place to birth, in alignment with each woman’s individual health status.

Lisa and Nape utilise the NHMBC birthing rooms as part of their kōrero. They demystify the space by simply introducing ways whānau can make it their own for the precious time they occupy it. Their knowledge of the community as South Auckland-raised residents is invaluable in establishing connections.

NHMBC’s data from 2020 showed 52.4% of wāhine using this facility identified as Pasifika. This statistic challenges the belief that Pasifika women predominantly require secondary care. The myth of healthy Pasifika birthing women is in fact, a reality, and contrary to popular belief, these same women reside in South Auckland.

The wero for midwives, therefore, is to ensure that these women are informed correctly, and that as a profession, we maintain the belief in primary birthing, utilising platforms such as Tapuaki to promote this. With Counties Manukau Health, PHO South Seas Healthcare and Pasifika Midwives Aotearoa collaborating for the betterment of the community, what seems like a drop in the ocean makes the world of difference for each birthing wahine we serve, and her experience contains within it the power to become a catalystic event for the transformation of her wider whānau. square

L-R: Lisa Nathan and Fa’anape (Nape) Tafiti.