PASIFIKA: TAPU ORA KUA MUA, KA MURI

NGATEPAERU MARSTERS TAPU ORA NATIONAL CO-ORDINATOR

Tapu Ora:

kua mua, ka muri

The Cook Island kama’atu, or whakatauki, ‘Kua mua, ka muri’ beckons a backward glance to inform the way forward. The Pasifika workforce initiative Tapu Ora is built on that premise; a reflection of what supported tauira to successfully complete their study and register as midwives.

Fuimaono Dr Karl Pulotu-Endemann, esteemed Pasifika health advocate and activist, gifted the name Tapu Ora to acknowledge the sacredness of birth and bring the midwifery tauira journey into alignment with that sacredness.

Tapu Ora is partnered with Te Ara Ō Hine, the Māori arm of the national workforce initiative. It’s been 15 months since the fanfare of its launch, so what has happened between then and now?

What began as a humble collaborative proposal between AUT and Counties-Manukau DHB over a decade ago, provided the blueprint for Tapu Ora. It’s now a strategic reality to be rolled out across every midwifery school in Aotearoa. The main focus is a Pasifika liaison (PL) role, to provide wrap-around support including: pastoral care; academic support; clinical expertise; and connections to internal student services or external community-based ones. Students’ feedback states the Pasifika liaison role was more valuable than receiving putea; the PL was accessible and most importantly, understood Pasifika cultural nuances.

The five midwifery schools organised stakeholder meetings to hear the voices of tauira, midwives, educators and the community health sector before defining the liaison role. The feedback laid the foundation for a job description, and was unanimous in stipulating that the role be carried out by a midwife. Other valuable information was shared about recruitment strategies, student learning and connectedness between stakeholders, to strengthen the kaupapa of Tapu Ora.

The three main objectives that underpin Tapu Ora māhi are recruitment and retention of Pasifika midwifery students, as well as successful completion of the programme. However, the main purpose is to increase the Pasifika midwifery workforce, with equity at the heart of the initiative. Having a service that reflects, understands and improves outcomes for the Pasifika community is key. Many Pacific peoples reside in the most socially deprived areas in Aotearoa and experience the poorest health outcomes. Are in-roads being made towards making a real difference?

Since April 2021, PL roles within all five institutions have doubled to four, with two more appointments pending. The extensive consultative process has delayed appointments, and tertiary institutions have the same staffing tensions as clinical areas, with chronic midwifery workforce shortages. There are approximately 50 Pasifika students throughout Aotearoa. The irony is inescapable; we need midwives to support and educate student midwives, to help alleviate our current situation.

Complementary to the liaison role are peer mentors and a capped hardship fund available to all students, which has helped tauira with petrol, hospital parking and some living costs.

Now, with stakeholder meetings completed, job descriptions developed, and more Pasifika liaison roles nearing appointment, the real work begins. The goal is to retain and graduate all 50 students over the next three years and to keep the workforce pipeline filled and fuelled.

This brief reflection paints a colourful picture of Pasifika midwifery potential. A more robust and extensive review of Tapu Ora is expected in the future.

Kia manuia. square