Module 2: Enablers of wellbeing Flashcards
What is the Oxford definition of indigenous
People inhabiting or existing in a land from the earliest times or from before the arrival of colonists
What is the UN understanding of indigenous
Self identification, historical continuity, strong link to land and natural resources, distinct language, culture and beliefs, non dominant groups of society
What is UNDRIP
Legally non binding resolution passed by the UN in 2007. Overarching principles: the rights of indigenous peoples to the full enjoyment of all human rights, non discrimination, self determination and autonomy, maintenance of indigenous institutions and the right to a nationality
How does UNDRIP relate to health
Indigenous people have the right to be actively involved in developing and determining health, right to their traditional medicines and health practices, access to all social and health services. Equal right to the highest attainable standard of physical and mental health
What is dichotomy
Us and them separation
What does article 1 of the treaty say
The chiefs give governance of their lands to the Queen of England (not sovereignty)
What does article 2 of the treaty say
Maori will sell land to the Crown when happy to sell and with price. Give sovereignty/control to the Crown over their taonga
What does article 3 of the treaty say
The Crown gives to Maori all rights and privileges of British citizens
What is tino rangatiratanga
Maori self determination (in the design, delivery and monitoring of health and disability services)
What is active protection
Crown required to act to achieve equitable health outcomes for Maori
What is kaupapa Maori
Maori centred: by maori, for maori. Crown obliged to ensure that all health and disability services are provided in a culturally appropriate way
What is indigeneity
A quality of a person or group’s identity that links them to specific places with knowledge of and respect for original ways.
What is matauranga maori
Maori knowledge: all branches, past, present and still developing. Foundation to all things Maori, passed down through generations (e.g purakau)
What is the Te Kore-Te Po-Te Ao Marama narrative
Te Kore: the nothing/void
Te Po: the dark or night
Te Ao Marama: the world of light, with it came knowledge and understanding
Who is Hine-ahu-one
The first woman, created from soil/earth (papatuanuku). Life breathed into her (tihei mauri ora)
What is Tawhaki/Pou whenua
Ascended to highest heaven, had to overcome challenges and chant the right karakia on the way. Brought knowledge to earth
How can the maori worldview be described
Holistic, collectivist, non homogeneous, informed by whakapapa (humans come after papatuanuku, so should respect it)
What are some enablers of wellbeing for Maori
Language, connections (iwi, hapu, whanau, place), traditional knowledge (matauranga maori: purakau, whakatauki)
What do enablers of wellbeing ensure
Create a sense of belonging, social support you can go to, pride, knowing who you are, identity, sense of security and stability. Know you’re safe or where you can go to be safe
What are the pacific islands divided into
Micronesia, melanesia and polynesia (geographic)
What is an atoll
Low island
What are the three types of political status in the pacific
Dependencies (don’t possess political independence), compact of free association (international agreement), independent states
What are the common values of pacific cultures
Respect, service, collectivism, family, spirituality, holistic approach to wellbeing
How does family differ in Pacific culture compared to western culture
Much more extended, not just nuclear
What is hauora
Hau: breath/air
Ora: alive/healthy
A holistic view of health
Pre Europeans, what did Maori think caused sickness
Breaches of tapu
What are the 4 walls of Te Whare Tapa Wha
Taha wairua (spiritual), tinana (physical), hinengaro (mental and emotional) and whanau (social). Good starting point for understanding Maori health, quite simplistic
What is Te Pae Mahutonga
Maori model of health using the southern cross and two other stars. A health promotion model aiming to improve access to Te Ao Maori, environmental protection (e.g access to drugs, alcohol), healthy lifestyles and participation in society. Prerequisites to these are leadership and autonomy
What is the Meihana model
Waka on a voyage to hauora, created after Te Whare Tapa Wha, focussed on clinical practice. Double hulled (patient and whanau) to be more stable. Planks hold it together (tinana, hinengaro, iwi katoa (support services), wairua, taiao (physical environment)), waves push it on (ahua, whenua, whanau, tikanga), wind pushes it back (marginalisation, racism, colonisation, migration) (wind and waves added in 2014)
What 4 themes are common across the 3 Maori health models
Whanau, tinana, hinengaro, wairua
What is Te Mana Ola
Pacific health strategy 2023: population health prioritising disease prevention, health promotion, good health and wellbeing. Better understanding needs of pacific people, enabling them to exercise authority over their health and wellbeing. Ensuring that services are reaching pacific peoples, wherever they live. Growing and supporting strong pacific health leadership and workforce
What constitutes the pacific perspective of health
Harmony with the cosmos, environment, peoples and self: to obtain an overall balance of peace
What is the pacific definition of health
Links and relationships between nature, people, nonliving and living things. Very holistic.
What is Ola Manuia
Living well or in wellness. Highlights on the range of factors that impact on pacific peoples’ health. Collective approach requiring more effective collaboration within the health and disability system and between the health system and the social, housing, employment and education sectors
What are the key values of pacific health models
Respect, reciprocity, family, spirituality, holism and community focus, relational space (mental and spiritual dimension)
Why do we need pacific health models
Cultural misunderstanding and unconscious bias have contributed to the state of pacific health. Pacific health models are preferred by pasifika peoples and produce better health outcomes than other models. Need them to acknowledge cultural norms in treatment.
What are some pacific health models
Kakala, Tivaevae, Te Vaka Atafaga, Fonofale
What are the 5 values in the Tivaevae (patches) model (Cook Islands)
Collaboration, respect, reciprocity, relationships, shared vision
What are the aspects of the Te Vaka Atafaga model (Tokelau)
Environment, family, spirituality, mental, social systems, physical body
What is talanoa
A form of narrative inquiry developed from pacific people’s oratory tradition. Intermingling of emotions, knowledge, experience and spirits of researcher and knowledge giver
What is the fonofale model
Pan pacific (incorporates values and beliefs of Samoans, Cook Islanders, Tongans, Niuans, Tokelauans and Fijians) model encompassing foundations of life including family, cultural values and beliefs, spiritual, physical, mental and other aspects. Foundations are interrelated and health is about maintaining balance between these foundations
What is the structure of the fonofale model
Foundation: family
Roof: culture
4 posts (pou): connect family and are continuous with each other
Surroundings
What are the pou making up the fonofale model
Physical, spiritual (belief system), mental, other (e.g gender, age, SES)
What are the surroundings impacting the fonofale model
Time, context, environment
What were the themes discovered by the study done on pacific people to develop and end product relevant to their needs
Health and wellbeing must be family centred. A desire to live longer and be healthier. Sub themes: family support, overcoming barriers, addressing social justice
What are important mortality risk factors for pacific islanders (as seen by influenza pandemics and epidemics)
Previous exposure and degree of epidemiological isolation
What contributes to low vaccination rates amongst pacific islanders
Past experiences to vaccinations, cultural norms (e.g if chief does), language barrier, low health literacy, poorly communicated incentive programmes
What is traditional medicine (TM)
Incorporates a holistic approach which engages a patient’s mental, emotional, physical and spiritual wellbeing
What challenges to indigenous health services face
Underfunded (less per head, insecure: can’t conduct long term projects, funded only for specific tasks), expected to operate under western, business style conditions (performance indicators, financial goals/expectations, difficult to justify intangible outcomes)
