Pātiki and Waharua Kōpito patterns
Pacific Health Service Hutt Valley (PHSHV) is transforming how Pacific people interact with maternity and early years services, creating a village approach to achieve healthy, thriving children and families.
Alongside other healthcare providers around the motu – including Te Ao Marama Pacific and Māori Midwives, Hutt Hospital Maternity Unit and Community LMCs and Vaka Atafaga (a Pacific nurse-led service) – PHSHV is piloting Kahu Taurima, a Health NZ programme to transform our maternity and early years services to ensure every child gets the strongest start to life.
Connecting people with the services they need
Candice Apelu Mariner, General Manager PHSHV, says that Kahu Taurima is a completely different way of looking at the health system and how it can best serve pregnant people, babies, children and their families.
“We started at the very beginning and asked some basic questions: When someone finds out they are pregnant, who do they go to? At different stages of the child’s growth, what are the services that they and their families need? And how can we strengthen continuity of care, and connect services for our pregnant Pasifika, so they can access what they need in one place?
“Sometimes, people need to travel to six or seven different locations to access different services,” continues Candice. “We want to take a holistic view and focus on reducing the number of referrals so that the families can access everything in one place—building a village of service providers around them.”
Candice says that another way of easing the burden of access to separate services is upskilling and better connecting the workforce.
“Workforce is critical to PHSHV, and we’ve implemented new training so our staff can practice at the top of scope. For example, we have Well Child Nurses who are now nurse prescribers who can prescribe medications while they are in the home doing Well Child checks, and who are also fully authorised vaccinators, to ensure the scheduled imms are up to date during the core checks. We also have a Nurse Practitioner service, Dietitian and other social and mental health support services available.”
Cultural complexity and safety
Data shows that around 45 percent of Pacific pregnancies don’t access a Lead Maternity Carer (LMC) before their third trimester.
“Some people don’t know why it’s important to see an LMC early on, some are simply not familiar with the health system, and some don’t know how or where to find one,” says Candice. “That’s why health education is so important alongside a connected health maternity services and workforce.
“We work in close collaboration with the Community midwives at Hutt hospital so we can provide social support, vaccinations and that connection for pregnant Pasifika to LMCs and vice versa. In fact, we co-locate with the LMCs in our office premises.”
Another complexity is the wide range of ethnicities, says Candice.
“We have 16 official Pacific ethnic groups and with that comes many cultural differences and languages. But largely we are all subscribers to collective Pacific values and key principles—those are the things that unite us.
“My team have a role in supporting non-Pacific colleagues and services to be more culturally aware, including for the birth experience. Even something as simple as wearing a lavalava can make a difference, making it more comfortable—we try and educate our non-Pacific colleagues to confidently have the tools to relate and be part of the Pacific village,” says Candice.
“Our dream is that every Pacific person who is pregnant knows what services are available, and has the access they need, and feel empowered to access it wherever they live —all in a culturally safe way.”
