The Ma'ala Framework: Re-imagining Diabetes Care through Tongan Epistemology
Tracks
Ballroom 1 - In-Person Only
| Monday, October 12, 2026 |
| 2:05 PM - 2:25 PM |
| Ballroom 1 |
Overview
Janina'ofa Galewski-Tangataevaha, University Of Waikato
Three Key Learnings
1. Integrating CGM with culturally-grounded Kaiāwhina support produces superior clinical and wellbeing outcomes for Tongan adults.
2. Tongan epistemology provides a rigorous foundation for clinical health research when treated as a coherent cultural system.
3. Re-indigenising health technology requires building from Indigenous knowledge systems outward, ensuring communities hold authority over the entire process.
Presenter
Miss Janina'ofa Galewski-Tangataevaha
Phd Candidate
University Of Waikato
The Ma'ala Framework: Re-imagining Diabetes Care through Tongan Epistemology
Presentation Overview
Tongan adults in Aotearoa New Zealand face disproportionately high rates of Type 2 diabetes (T2D), yet health interventions rarely account for the cultural, relational, and systemic realities of Tongan life. This presentation shares findings from a six-month pilot study combining continuous glucose monitoring (CGM) technology with Kaiāwhina support for Tongan adults living with high-risk T2D. In this context, a Kaiāwhina is a non-regulated health worker who provides holistic, culturally-safe navigation and advocacy to ensure clinical care aligns with a patient’s life.
We introduce the Ma'ala Framework, a research methodology grounded in the epistemology of the plantation (ma'ala) and the values of anga fakaTonga (the "Tongan way" of life, encompassing respect, humility, and communal obligation). The framework consists of four phases mirroring the plantation cycle:
• Tōta'u (Planting): Entering the community and establishing relational trust.
• Huo Ngoue (Cultivating): Delivering the intervention through sustained Kaiāwhina support and CGM education.
• Ūtuta'u (Harvesting): Harvesting clinical data (HbA1c via blood samples) and qualitative insights through Talanoa interviews.
• Polopolo/Vahevahe (Knowledge sharing): Returning knowledge to the community before wider dissemination.
Results showed clinically meaningful reductions in HbA1c and improved self-management. Participants identified the Kaiāwhina relationship which were rooted in deep community ties like church and fitness programmes, as the catalyst for understanding their health data in culturally meaningful ways.
We introduce the Ma'ala Framework, a research methodology grounded in the epistemology of the plantation (ma'ala) and the values of anga fakaTonga (the "Tongan way" of life, encompassing respect, humility, and communal obligation). The framework consists of four phases mirroring the plantation cycle:
• Tōta'u (Planting): Entering the community and establishing relational trust.
• Huo Ngoue (Cultivating): Delivering the intervention through sustained Kaiāwhina support and CGM education.
• Ūtuta'u (Harvesting): Harvesting clinical data (HbA1c via blood samples) and qualitative insights through Talanoa interviews.
• Polopolo/Vahevahe (Knowledge sharing): Returning knowledge to the community before wider dissemination.
Results showed clinically meaningful reductions in HbA1c and improved self-management. Participants identified the Kaiāwhina relationship which were rooted in deep community ties like church and fitness programmes, as the catalyst for understanding their health data in culturally meaningful ways.
Biography
Janina'ofa Galewski-Tangataevaha is a PhD candidate in Health Sciences at the University of Waikato. Her doctoral research examines how continuous glucose monitoring technology and Kaiāwhina wrap-around support can improve Type 2 diabetes outcomes for Tongan adults in Aotearoa New Zealand, introducing the Ma'ala Framework as a Tongan-centred research methodology. She previously completed a secondment at the Ministry of Health within the Office of the Chief Science Advisor and Pacific Health team, and holds a Masters focused on rural Pacific health. A longstanding member of the Tongan community in Hamilton, she leads fitness programmes through Mo'ui Lelei Inc.
