16  •  2023  •  Developmental Observer

French Polynesia is an ‘overseas collectivity’, part of the 
French Republic, located in the South Pacific Ocean, 
8000km from Australia and Chile and 4000km from Ha-

waii. It comprises 118 islands of which 76 are inhabited. These 
islands, with their heavenly landscape, extend over a maritime 
surface equivalent to Europe. It has approximately 280,000 
inhabitants, with a majority of Polynesians ‘maohi’ (65%) and 
metis/mixed ‘demis’ (16%), a minority of Caucasians ‘popâa’ 
(12%) or Asians (5%), mostly from Chinese origin. This 
population is young: 36% under 20 years old. The Polynesian 
language (Maori) remains widely used in daily life. The artistic 
heritage is rich in particular songs, dances, and the very old art 
of tattooing.

Culturally the child exists from procreation and not only 
from birth. There is a close continuity between the mother and 
the child: only one body. Massage, breastfeeding, skin to skin 
are major elements of traditional Polynesian care, the expression 
of bodies and emotions. The nuclear family is a recent concept. 
Traditionally, the child is cared for at the beginning by the 
mother and then by the clan. The child can be designated 
"faamu" and then change his/her caregiver, on the decision of 
the grandmother or the group, in the event of failure of the 
mother, or traditionally to support grandparents. The child can 
also be given to a sister, a cousin, or a loved family member 
because this woman has no child. However, the infant must 
remain in contact with his original family. This tradition has 
been disrupted by European adoption of international children 
causing a break with the biological parents and a change of 
family name, creating loyalty issues for the developing child.

The French Polynesia Hospital (CHPF) is a modern 
hospital that opened in 2010. The neonatology department 
includes 24 intensive care beds and six neonatal beds within 
the maternity unit. It is the only level three neonatal center 
in Polynesia. It stays in a relationship with the maternity 
units or perinatal centers in Papeete, the capital, or in other 
archipelagos (Society and the Marquesas Islands), some over 
1400km from the CHPF. 

The French Polynesia Hospital
The neonatal care team includes six neonatologists, a nurse man-
ager, 30 nurses and 19 assistant nurses, a psychologist, a therapist, 
a breastfeeding consultant, and a milk-bank manager. The NICU 

cares for preterm and full-term newborns and their families. 
Newborns who require urgent neonatal surgery are transferred 
to Auckland NICU (New Zealand) or Paris (France). The entire 
population has health insurance.

The former medical directors, Dr. Micheline Papouin and 
Phippe Kuo († 2019) were the initiators of the implementation 
of family-centered developmental care in the unit. The training 
began in 2004 with the support of the Brest NIDCAP Training 
Center (Dr. Nathalie Ratynski, Pr. Jacques Sizun). That year, all 
medical and nursing staff benefited from a short training (two 
days), ‘Introduction to developmental care’ focused on brain 
development, the importance of the early environment, the 
crucial role of parents, and system change. This training was 
renewed in 2005 and 2012.

Global Perspective on Developmental Care

French Polynesia

Jacques Sizun. French NIDCAP Center, Toulouse, France

DOI: 10.14434/dov16i3.36570



2023  •  Developmental Observer •  17  

Developmental care training group in 2018
In 2019, Dr. Ratynski started FINE 2 training, mainly via video 
conference and email exchange due to the COVID pandemic. 
Three neonatologists and three nurses have thus become FINE 
2 certified.

One of the challenges in maintaining an optimal quality of 
developmental care is the high turnover of the nursing team. 
This underlines the need to train professionals very regularly. 
The current project is to train a trainer (Temara Mariteragi) 
to achieve certification both in NIDCAP and Baby Friendly 
Hospital Initiative. 

ISSN: 2689-2650 (online) 

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