Tāmaki Innovation Campus

The Tongan way

Dr Malakai Ofanoa is working to provide Tongan communities living in urban areas with positive ways to address health and well-being issues.

How to best help our Pacific Island population is a question that has long exercised Malakai Ofanoa, but he’s taking heart from the apt acronym TONGAN.

Dr Ofanoa is a lecturer in Pacific Health at the School of Population Health, and his PhD thesis completed in 2010 at Tāmaki, spawned the framework of a now-working model to address Pacific health issues. He sought to adapt a well-proven New Zealand community development/health promotion model to use with Tongans living in urban areas, giving them positive ways to address health and well-being issues.

TONGAN, piloted in Mangere’s Tongan community, means Talking, Organisation, Needs Assessment, Goal Setting, Action and Negotiated Evaluation. These steps are the framework for an approach to setting up and running empowerment-based community projects, where the community itself is in control.

Dr Ofanoa says the possibility that this model might work with Tongans was especially interesting since its philosophy of empowerment and self-determination was different from the background of many Tongans.

Philosophically it matches a generic use of empowerment as one initiative to improve health and welfare, but the Tongan community, with its frequent lower incomes and poor employment histories, have found the bottom-up TONGAN approach more acceptable to their needs.

“Through ‘talking’ (Talanga) we use dialogue to identify the real needs, and then work directly to achieve each step through a set of carefully prescribed stages,” he says. “It’s an approach that can adapt to other Pacific Island communities with their very diverse cultures in other parts of New Zealand and perhaps also for other Pacific and migrant groups both in New Zealand and elsewhere.”

Dr Ofanoa said the health issues facing Pacific Island nations meant non-communicable diseases such as diabetes, stroke and heart disease were a priority, with the population’s high propensity for risk factors. To get to the crux of the matter, he says it is important to understand what would motivate a community to address their own health matters on an on-going basis.

The TONGAN model trial had to first find a home, eventually building a centre for the resources and workers that meet community needs. Now well established, he says the centre is working well with considerable community input.

Dr Ofanoa is part of the Pacific Health staff within the School of Population Health and is working on expanding the group’s services. Currently they cover teaching for undergraduate and postgraduate study, and research in public health areas as well as community engagement.

The group was invited to visit the Otago Medical School and other places in the Pacific Region as part of a growing collaboration and hopes a reciprocal visit will add to the base knowledge of Pacific Island issues within the healthcare system.