For many Māori and Pasifika people, the westernised health system does not incorporate spiritual or cultural aspects that are important to each individual. He Korowai Oranga, or the Māori Health Strategy, is a framework that has been put in place to support the health of tangata whenua.
Some models and concepts have been created by Māori to help others understand what is important in Māori healthcare so the best support can be offered.
Te Whare Tapa Whā
This model is designed to help people understand Māori health and the concept of the four walls that are the foundations of Māori wellbeing. If one of the four walls is missing or damaged, the person may become ‘unbalanced’ and unwell. Focusing on all four walls that are important to Māori wellbeing may offer better care to whānau and the individual who needs help.
Taha Tinana (physical health)
- The capacity for physical growth and development
- Good physical health is required for optimal development
- Our physical ‘being’ supports our essence and shelters us from the external environment
- This is just one aspect of health and wellbeing and cannot be separated from the aspect of mind, spirit, and family
Taha Wairua (spiritual health)
- The capacity for faith and wider communication
- Health is related to unseen and unspoken energies
- The spiritual essence of a person is their life force. It determines us as individuals and as a collective, who and what we are, where we have come from and where we are going
- Traditional Māori analysis of physical manifestations of illness will focus on the wairua or spirit to determine whether damage here could be a contributing factor
Taha Whānau (family health)
- The capacity to belong, to care, and to share where individuals are part of wider social systems
- Whānau provides us with the strength to be who we are. This is the link to our ancestors, our ties with the past, present, and future
- Understanding the importance of whānau and how whānau can contribute to illness and assist in curing illness is fundamental to understanding Māori wellbeing
Taha Hinengaro (mental health)
- The capacity to communicate, to think, and to feel mind and body are inseparable
- Thoughts, feelings, and emotions are integral components of the body and soul
- This is about how we see ourselves in this universe, our interaction with that which is uniquely Māori, and the perception that others have of us
This concept acknowledges the importance of whānau in health. In traditional Māori health, there are no divisions between the mind, spirit, whānau, and physical world. Te Wheke, the octopus, defines family health according to these beliefs.
The head of the octopus represents te whānau, and the eyes represent waiora (the total wellbeing for the individual and family). The tentacles represent:
- Wairuatanga – spirituality
- Ninengaro – the mind
- Taha tinana – physical wellbeing
- Whanaungatanga – extended family
- Mauri – life force in people and objects
- Mana ake – the unique identity of individuals and family
- Hā a koro ma, a kui ma – the breath of life from forebearers
- Whatumanawa – the open and healthy expression of emotion
The Ministry of Health has developed the Pacific Health and Wellbeing Action Plan 2020-2025 to focus on improving the wellbeing of Pacific people in New Zealand. This plan was informed by and replaces the previous Pacific health plan formed in 2014. It prioritises outcomes and actions for the health and disability sector for Pacific people. It was produced with the guidance and input of Pacific communities in New Zealand to focus on what is needed to help Pacific Island communities thrive.
Fonofale is a Pacific model of health depicting the relationship between family, physical being, spiritual being, mental state, other influences such as sexuality, gender, age and socioeconomic status, culture, time, context and the environment.
- The floor of the fale (house), represents family and the foundations for wellbeing
- The roof represents culture, the values and beliefs which shelter family and the four pou (posts)
- The four pou represent the spiritual dimension, physical dimension, mental dimension, and other dimension
- The spiritual dimension includes the relationship with nature, ancestors, history, language, customs, beliefs, spirits, and religion
- The physical dimension represents biological and physical wellbeing. Food, air, water, and medications can all impact the physical being of a person
- The mental dimension is the health of the mind, thoughts, emotions, and behaviours
- The other dimension includes all other aspects that can directly or indirectly impact health and wellbeing, including gender, sexuality, age, and status in society
- Circling these concepts is the environment, time, and context which can broadly influence the opportunity to flourish physically, spiritually, mentally, culturally, with family, and in other aspects of life
Websites of interest