Background
Rheumatic heart disease (RHD), a complication of untreated Strep A infections, is a major global health concern. In Fiji, sub-optimal treatment adherence due to limited access and awareness increases the RHD burden. Heart Heroes Fiji (HHF) developed Veituberi, a culturally-based approach combining nurturing support and motivational interviewing. This patient-led approach uses lived experience to improve engagement and adherence, while working through existing health, indigenous community structures and youth networks.
Approach
Veituberi, meaning "to guide and assist," represents an indigenous concept emphasizing nurturing relationships and empowering growth. HHF implements veituberi through three interconnected pathways:
Implementation relies on a network of champions, volunteers, and family members with shared lived experiences. This approach emphasizes cultural connection and awareness of community wisdom. The program includes regular upskilling for volunteers, coordination with local healthcare providers, and feedback from community members to improve effectiveness.
Significance
Veituberi demonstrates a culturally-sensitive approach integrated with healthcare. Unlike Western medical approaches, veituberi builds trust by speaking the local language, both literally and figuratively. Veituberi uses existing community networks, and seeks to build a sustainable system that improves RHD prevention, management, health policies and patient outcomes.