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Strengthening partnerships through research

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Dr. Tolu Muliaina, USP and Dr. Sione Vaka, AUT.

An ongoing research in Samoa by The University of the South Pacific (USP), Auckland University of Technology (AUT) and the Samoa Culture Centre (SCC) is examining indigenous notions and measurements of sustainable development for Samoa.

The response from one of the 30 participants during the research conducted on 3-14 December 2019, was that Samoa had lost their front line primary health care system, with regards to the measles outbreak that shook the country since last September. A State of Emergency was declared from 15 November-29 December in efforts to contain the virus and improve vaccination rates which were on a record low of 31 per cent at the time. The total shut down on December 4 and 5 witnessed an increase immunisation rates toward 95 per cent, a testament to what genuine partnerships can achieve across sectors, agencies and countries.

According to Dr Tolu Muliaina of USP, the 6-member research team conducted a faafaletui with high chiefs, youths, church representatives, Government officials, representatives of government departments and community leaders to identify possible solutions to promote public health and to achieve Sustainable Development Goal 3: Good health and wellbeing in and for Samoa.

This he said, is a Pacific-led research by Pacific researchers who use culturally appropriate methodologies such as Talanoa, Kakala and Faafaletui “which resonate with our people and they occupy a special place in the qualitative research methods literature”.

“Grounded in phenomenology, faafaletui is a critical weaving and interweaving of ideas and it promotes respectful social relations between participants and researchers. It is a suitable research paradigm as it enables participants to express lived experiences and “no one dares to interrupt another speaker as everyone will have a turn to speak” thus “knowledge flows from its holders to receivers” who continue to tui (probe) further as “different patterns emerged”,” Dr Muliaina explained.

Samoa Cultural Centre, Director, Maulolo, Juliet, Theresa, Vaoiva, Tolu (back) Tuipeā€™a (side)

He added that it is a “a pure democracy concept” for it co-constructs knowledge for local people, a feature that has been missing in research methodologies.

“Faafaletui as a paradigm is an emancipatory process and outcome. It contributes to emerging research methodologies that ensures academic integrity, robustness and rigour,” he said.

Participants attributed the measles outbreak to the breakdown of a community partnership model between the government and local communities, a model, in their view, has worked in the past.

They highlighted the reinforcement of community nursing which was once conducted by Asiasi Komiti or Komiti Tumama (Health Inspection Committees) in villages and/or districts. Then, community nurses are those who live in villages or districts and regularly visit families, keep a register of new-borns and expectant mothers, the number of family members and deliver a holistic primary health care services.

And, “this community nurse would report back to the Ministry of Health after every month, gives them a documentation of the number of infants who have been vaccinated and those who will need to be done in the following month to prepare for the visits, and the pregnant mothers”.

Furthermore, participants said, “the nurse follows up each family according to their matai clans, attend to the sores, warts, vaccinations, inspect our whole surroundings, the toilets, our garden plantations, check pregnant mothers, give advice on what to plant so food will be abundant when the baby arrives”.

Even isolated families and those without transportation, the primary health care service reaches them because “when community nurses do family visits, they are accompanied by the whole inspection committee we call Asiasi Komiti or Komiti Tumama.”

Participants also noted that since the formulation of new primary health guidelines, this community partnership was dismissed. Instead, the Ministry of Women, Community and Social Development brought in their own sui tamaitai (female representative) and sui alii (male representative), who are not trained nurses to perform these roles.

It was noted that the case where two nurses wrongly administered the vaccination to two babies who had fatal deaths last year further contributed to the fear among parents to get their children vaccinated. A government representative indicated that fatalities came predominantly from the most economically/financially disadvantaged in the community. The lack of economic or financial ability to maintain health/hygienic care was a factor that contributed to the fatalities.

Thus, community-based approaches to development should be promoted for they directly benefit communities, their health and wellbeing. First, a community nurse has the knowledge of the aiga (families) within her own constituency and the ‘health for all’ is her priority. Besides, she is also accountable to the Asiasi Komiti or Komiti Tumama whose membership comes from within the village, as well as the Ministry of Health. It is a model that promotes people taking ownership of their health and wellbeing.

The measles outbreak has spread rapidly because “we have lost our frontline primary health care that was effective in the past.” However, not all is lost.

“In fact, the measles outbreak has brought out the best of Samoans at the time when they were at their lowest, but, they know how to fight back and they have been on the road again since then!

“Genuine partnerships between communities and government is key to resilience. With the coronavirus looming, Samoa’s experience of good governance reminds us that it can deter future outbreaks and build stronger, healthier and sustainable communities,” Dr Muliaina said. According to participants, this partnership, will require overlapping SDG4 (Education), SDG6 (Clean water and sanitation), SDG11 (Sustainable cities and communities) between the central government and local village governance and SDG17 (Partnerships) to make this work. It cannot succeed without this integration.

He acknowledged research participants for their gift of knowledge; the Director of the Samoa Culture Centre (SCC), Maulolo Leaula Tavita Amosa, who assisted with the logistics and facilitated our faafaletui; Asiava Atonio Tuipe’a, our Community and Cultural Advisor; colleagues in the Faculty of Health and Environmental Sciences, AUT for the Researchers Investment Fund that made this research possible, our Team Leader, Dr Juliet Boon-Nanai, Equity Pasifika Leader; Dr Sione Vaka, Senior Lecturer in the School of Nursing who was also part of the Pasifika Medical Team from New Zealand and voluntarily offered his service to the vaccination operation on the two-day shutdown and Dr Vaoiva Ponton, Lecturer in the School of Interprofessional Studies.

 


This news item was published on 4 Feb 2020 03:14:10 pm. For more information or any High-Res Images, please contact us on email communications@usp.ac.fj


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