Ngā mahi ora ā Rēhia (Diabetes prevention and intervention programme)

Abstract

Ngā Mahi Ora a Rēhia was designed to address the epidemic of type 2 diabetes within Māori communities. The philosophy underpinning the programme is contained in the name, Ngā Mahi Ora a Rēhia. In Māori traditions Rēhia is the atua (god) of recreation, pleasure and enjoyment. By placing the programme under the auspices of this atua, a Māori health provider organisation called Ngā Kākano, based in Te Puke, Aotearoa-New Zealand, accentuates and promotes the programme as positive and enjoyable within an holistic paradigm. The word ‘ora’ is significant because it reinforces the Māori wellness approach to wellbeing.

Grounded in the community's tribal knowledge base of whakapapa (genealogy) and traditions, recreational (physical exercise) activities centre on mahi a toi (arts song and dance) associated with Rēhia. Similarly, healthy eating is shaped by the relationship with Papatūānuku (earth god) to promote gardening and the consumption of natural, as opposed to processed food. Participants are taught to prepare healthy food that is also palatable. The influence of Rēhia emphasises te reka, the sweetness of the food.

The effective management of disease to achieve the highest level of wellness possible typifies the Māori approach to diabetes intervention. Government reporting and monitoring records provides evidence that all of the participants engaged in the programme are meeting the minimal HbA1c readings <8 standard. Considering that the majority of participants when first enrolled on the programme record HbA1c readings in double digits - this is a significant improvement in terms of health gains.