Meli Nakauvadra Tanuku,
Bachelor of Arts Counselling (Education), Fiji National University Fiji,
Adimaitoga Tauyavunilotu William Rabuku,
Assistant Lecturer (Science) Fiji National University,
Dr. R. K. Prajapati,
Course Coordinator- Counselling, Sarvesh Chand, Facilitator IT –
University of the South Pacific

Abstract

The study assesses the degree of counselling for families with disabled individuals in Fiji and its cultural beliefs and practices, as well as how information technology (IT) is used to deliver interventions. Disability in most Fijian communities is viewed through a sociocultural and spiritual lens, which brings stigma and an emotional burden for families. This research addresses the following:

1. Analysing views on disability within Fijian society.
2. Evaluating psychological and emotional burdens on families.
3. Evaluate the current limitations on the use of guidance in counselling families of individuals with disabilities.
4. Assessing how technology supports counselling services
5. Recommending culturally appropriate counselling services that are enabled by IT systems.

The study adopts a mixed-method approach that combines qualitative data from interviews and questionnaires with families, counsellors, and community leaders, as well as external data from other studies. This study is based on the Health Belief Model and the Technology Acceptance Model. The findings show considerable deficiencies present in existing support systems, made worse by prevailing cultural stigmas and accessibility issues. Using technology to enhance counselling and instruction without geographical restrictions is a significant focus of this research. The study ends with practical ways of providing culturally responsive counselling services aided by appropriate technologies, particularly to persons with disabilities and their families in Fiji.

Introduction

The islands of Fiji are located in the South Pacific Ocean and are famous for the rich diversity of its people, with cultural practices centered around the tenets of community and spirituality (Narayan, 2020). For people with disabilities, the perception and stigma of disability introduces challenges within Fijian society. (Prasad & Prasad, 2019).

Fijian culture and religion often explain certain conditions such as disability as being the result of the sins of one’s ancestors or caused by evil spirits (Ravuvu, 2018). These beliefs can cause discrimination and limit assistance which in turn heightens the pressure and emotional stress on caregiving families (Kumar et al., 2020). In addition, growth in the region’s population and its archipelagic characteristics present major logistical issues for providing counselling services especially in remote areas of the country (Singh & Karan, 2021).

This research is based on two theoretical frameworks: The Health Belief Model (HBM) which analyses the impact of personal beliefs towards health concerns, especially for accessing counselling (Rosenstock, 1974). It includes the components of perceived susceptibility, severity, benefits, barriers, cues to action and self-efficacy. The Technology Acceptance Model (TAM) investigates the process through which a user comes to accept and use a given technology (Davis, 1989).

The objectives of the research are:

• Investigate societal values and perceptions concerning disabilities and how these relate to the usage of counselling services.
• Evaluate the emotional and psychological effects on family members such as parents and siblings in a family with a disabled person.
• Evaluate the current availability and effectiveness of counselling services in Fiji.
• Look at the influence of information technology in making counselling support more accessible and efficient.
• Suggest ways of providing counselling services that are culturally congruent and make use of IT.
  
  

Literature Review

Attitudes towards disability

The multicultural society of Fiji includes Indigenous Fijians also known as iTaukei, Indo-Fijians and other minority ethnic groups. Each of these sections has its own cultural and religious practices which affect how disability is viewed (Nainoca, 2019). Most often, disabilities are blamed on supernatural forces, such as accusations from someone who has been wronged or God working in vengeance (Hopf et al., 2017). Such viewpoints can cause stigma, prejudice and ostracism not only of the person in question but also their relatives and other people associated with them (Williams & Tuiwainikai, 2018).

Adverse Social Repercussions

The social stigma attached to disability in Fiji creates limitations in accessing education, employment, and health care (Prasad, 2020). This limits their support seeking behavior around the family, in turn making them indifferent and feeling ashamed (Thornicroft et al., 2016). Internalising these issues could be detrimental to the family as a unit and to the health status of all its members.

Counselling Services in Fiji

Counselling services available at present are few and mostly found in major towns, leaving many rural and outlying areas unprovided for (Kido & Narayan, 2019). In addition to this, the effectiveness of these programs is affected by the unavailability of trained personnel and cultural incompetence (Singh, 2017). Furthermore, in relation to this, also the social attitudes towards the accessibility of mental health services tend to inhibit people seeking such services (Kishore & Prasad, 2021).

Information Technology in Healthcare

Information technology has universally regarded its ability to enhance access to and outcomes from healthcare (World Health Organization, 2020). In the Pacific region, for instance, the use of telehealth services has helped to solve locations issues to an extent, though there are still hurdles concerning the infrastructure as well as digital skills (Gupta et al., 2020). Venkatesh & Davis (2000) provide the Technology Acceptance Model that guides on the aspects of health care which influence the use of IT services in health facilities.

Methodology

Research Design

The study is both exploratory and descriptive, seeking to provide an understanding of family experiences as well as the role of information technology in counselling services, and thus uses both qualitative and quantitative methods.

Data Collection

Primary interviews, focus groups, and surveys were conducted across urban and rural areas of Fiji, including 25 families, groups of community leaders and counsellors, and 50 health specialists.

Secondary data was collected from non-governmental reports, academic journals, and government documents.

Examining Data

Qualitative Data: NVivo software was used for performing thematic analysis referring to cultural beliefs, emotional issues, and attitudes towards IT, where patterns and themes were identified (Braun & Clarke 2006).

Quantitative Data: SPSS software was used to perform descriptive statistical analysis to summarise the survey results in terms of major patterns and relationships between variables.

Possible Benefits and Challenges

Through using telehealth services, rural areas could be connected to primary health care which encourages privacy and anonymity by reducing the stigma associated with accessing services. Culturally appropriate educational materials can also be provided digitally.

However, a lack of internet connection, digital skills, and the cost of devices are barriers to the roll-out of further counselling services.

Discussion

The integration of theoretical models into counselling practices enhances the effectiveness of interventions, particularly for families of individuals with disabilities. The Health Belief Model (HBM) underscores the importance of addressing cultural beliefs that shape health perceptions and help-seeking behaviors, thereby improving engagement in counselling programs. Similarly, the Technology Acceptance Model (TAM) highlights the necessity of designing user-friendly digital solutions that align with perceived usefulness, ensuring successful adoption.

Cultural sensitivity plays a crucial role in counselling, necessitating the incorporation of religious and traditional perspectives in treatment approaches. Engaging community leaders in interventions fosters acceptance and reduces stigma, making counselling more accessible. Technology further serves as a transformative tool, as evidenced by successful implementations like Project ECHO in India and teledentistry in the Pacific. In Fiji, telecounselling platforms and mobile applications could provide crucial support by overcoming geographical barriers.

However, effective implementation requires addressing technical challenges, including infrastructure development, digital literacy training, and supportive policy frameworks. Ethical considerations, such as data privacy and cultural appropriateness, must be prioritized to ensure trust and minimize unintended societal consequences.

To enhance counselling services, recommendations include the development of culturally tailored programs, IT-enabled solutions, and comprehensive training initiatives. Government support through subsidized internet access and public-private partnerships is essential for sustainability. Additionally, advocacy efforts should leverage social media and success stories to combat stigma, while ongoing monitoring and evaluation ensure continuous improvement in service delivery.

Conclusion

This paper explores different factors which influence the effectiveness of counselling services for families with disabled members in Fiji, such as cultural and emotional stigma. Technology can be used to incorporate and improve the reach, efficiency and acceptability of services as an enabler in the country.

The research positions culture and user acceptance as factors that need to be taken into consideration in interventions, using the Health Belief Model and the Technology Acceptance Model. Practical strategies are given to stakeholders to help them understand how to encourage support for people with disabilities and their families.

References

• Arora, S., et al. (2011). Academic health center management of chronic diseases through knowledge networks: Project ECHO. Academic Medicine, 86(11), 1316-1323.
• Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.
• Bray, B. E., et al. (2018). Teledentistry in the Pacific: A model for dental care in remote communities. Journal of Telemedicine and Telecare, 24(9), 652-658.
• Creswell, J. W., & Plano Clark, V. L. (2018). Designing and Conducting Mixed Methods Research (3rd ed.). Sage Publications.
• Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319-340.
• Gupta, S., et al. (2020). E-health: A new perspective on global health. Lancet, 395(10221), 1439-1440.
• Hopf, S. C., et al. (2017). Community views on communication disability in Fiji. Disability and Rehabilitation, 39(11), 1122-1131.
• Kido, M., & Narayan, S. (2019). Accessibility of mental health services in Fiji. Pacific Health Dialog, 21(1), 45-52.
• Kishore, S., & Prasad, R. (2021). Mental health stigma in Fiji: Challenges and solutions. International Journal of Social Psychiatry, 67(4), 362-369.
• Kumar, V., et al. (2020). Disability and social exclusion in Fiji: The reality of being disabled in a developing country. Disability Studies Quarterly, 40(1).
• Narayan, S. (2020). Cultural diversity and social cohesion in Fiji. Journal of Pacific Studies, 40(2), 85-102.
• Nainoca, W. U. (2019). Indigenous Fijian social organization: Vanua, lotu, and matanitu. The Contemporary Pacific, 31(1), 1-31.
• Prasad, B. D. (2020). Social inclusion and disability in Fiji: A situational analysis. Fijian Studies, 18(2), 125-140.
• Prasad, R., & Prasad, S. (2019). The social fabric of Fiji: An analysis of social structures and their impact on disability. Pacific Dynamics, 3(1), 89-103.
• Ravuvu, A. (2018). The Fijian Way of Life. Institute of Pacific Studies, University of the South Pacific.
• Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328-335.
• Singh, A. (2017). Mental health services in Fiji: Past, present, and future. Australasian Psychiatry, 25(3), 272-274.
• Singh, A., & Karan, P. (2021). Telehealth in Fiji: Bridging the health care access gap. Journal of Telemedicine and Telecare, 27(2), 135-142.
• Thornicroft, G., et al. (2016). Undertreatment of people with major depressive disorder in 21 countries. British Journal of Psychiatry, 210(2), 119-124.
• Venkatesh, V., & Davis, F. D. (2000). A theoretical extension of the Technology Acceptance Model. Management Science, 46(2), 186-204.
• Williams, A., & Tuiwainikai, B. (2018). Disability in the Pacific: The case of Fiji. Journal of Disability Policy Studies, 28(4), 217-227.
• World Health Organization. (2020). Global strategy on digital health 2020-2025. WHO Press.

Appendix

Ethical Considerations: consent was sought from all participants. Confidentiality and anonymity were observed. Ethical clearance was obtained from the Ethics Committee of the University of the South Pacific.
Possible Biases and Limitations Selection Bias: While diverse participants were sought, remote community access was a challenge.
Response Bias: Culture may have influenced the responses of the participants, leading them to provide acceptable responses.
Data Reliability: Quality of the secondary source differed; this was addressed by using more than one source.

Biography

Meli Nakauvadra Tanuku is a dedicated advocate for mental health and inclusivity in Fiji, with extensive experience working with the disability community. ​ He has spent several years empowering children and adults with disabilities through his roles as a special inclusive teacher and community mentor. ​ Meli's work spans from Lau to Suva, where he has taught students and facilitated initiatives promoting awareness, understanding, and support for individuals with disabilities. ​ Academically, he holds a Diploma in Counselling from the University of South Pacific, a Diploma in Special Inclusive Education from the College of Excellence USA, and advanced certification in Fijian sign language. ​ Currently, he is completing his Bachelor of Arts in Counselling Education at Fiji National University. ​