Pacific scholar dedicated to improving Women's Health

Dr Karaponi Okesene-Gafa has been acknowledged for her contributions to women’s health with two international awards.

Co-Director of Te Poutoko Ora a Kiwa (Centre for Pacific and Global Health), Dr Okesene-Gafa (Niue, Sāmoa, Cook Islands) was honoured with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Excellence in Women’s Health Award, for her exceptional and enduring contributions to the field.

At the recent Pacific Island Health Research Symposium (PIHRS) held in Fiji early last month, she was also awarded Best Oral Presentation for research (undertaken with a team) into the pre-diagnostic experiences of Māori and Pacific women with endometrial cancer (EC).

A specialist in obstetrics and gynaecology, clinical researcher and lecturer at Waipapa Taumata Rau, University of Auckland, Okesene-Gafa is passionate about advancing the care of women and families in Aotearoa and across the Pacific region.

She hopes the recognition will help create greater awareness of symptoms associated with endometrial cancer. Worryingly, most Pacific women diagnosed were unaware of the symptoms being associated with the disease. Okesene-Gafa says they had variable experiences with specialists when referred, and for many diagnosed late, they experienced feelings of devastation.

“When diagnosed late, many women were shocked and upset. While some experienced culturally safe and empathetic care, others encountered communication challenges and ethnic bias.

“I am grateful to see women’s health elevated into the spotlight, reinforcing the need for Pacific women’s health to be prioritised and valued, especially given the important roles women undertake both in the work and home spaces. We are the heart of the community.”

In partnership with RANZCOG, Okesene-Gafa has played a pivotal role on the Pacific Society for Reproductive Health (PSRH) board. Previously she was Head of Secretariat and is currently ex-officio president.

She and her board members continue to champion initiatives that strengthen regional capacity, support workforce professional development, and promote culturally responsive care.

Okesene-Gafa has also worked to grow Pacific clinical capacity in women’s health, collaborating with RANZCOG to increase Pacific trainees in obstetrics and gynaecology. As part of a broader workforce initiative, she has been instrumental in developing pathways that support Pacific doctors to become obstetrics and gynaecology specialists - ensuring representation, equity and long-term impact in the region’s healthcare systems.

During Okesene-Gafa’s presentation in Fiji, she shed light on the disproportionate burden of endometrial cancer among Pacific women.

The research used Kaupapa Māori and Talanoa methodologies and included in-depth interviews with 25 women (12 Māori and 13 Pacific, aged 29–71) diagnosed between September 2022 and June 2024.

Pacific women are often diagnosed at later stages due to systemic barriers, including multiple general practitioner visits and difficulty accessing diagnostics and specialist care in a timely manner.

This was particularly true for Pacific women who had not reached menopause, who found living with heavy menstrual bleeding difficult to manage and very uncomfortable. Those who had post-menopausal bleeding (usually over the age of 50 years) were referred and managed appropriately.

Most diagnosed Pacific women knew their symptoms were not normal but were unaware that they could be associated with endometrial cancer; participants were also not aware of the associated risk factors.

The research also emphasised the importance of faith, family support and culturally appropriate care in shaping positive care experiences. The importance of fertility was highlighted, as having EC with no children was heartbreaking for some.

She says cultural influences around the taboo of the topic prevented discussion of issues such as heavy menstrual bleeding, which could also serve as a barrier to accessing care.

The findings call for greater awareness, timely access to diagnosis and treatment, and culturally safe care pathways to improve outcomes for Pacific women.

Award winning doctoral thesis

Okesene-Gafa’s awards follow on from her award-winning doctoral thesis research at the University in 2023, which led the Healthy Mums and Babies trial. The study tested a culturally tailored dietary intervention for pregnant women with high BMI in South Auckland.

Delivered by community health workers, the programme reduced total pregnancy weight gain by 2kg in the intervention arm of the trial and was well received by participants.

Okesene-Gafa’s work continues to highlight the importance of inclusive, community-based approaches to improving women’s health in multi-ethnic populations.