Understanding migrants' primary healthcare utilisation in New Zealand through an ethnographic approach

Abstract

Health inequalities between migrants and host populations in many western countries, including New Zealand, have been associated with low healthcare utilisation. This research used an ethnographic approach based on participant observation and semistructured interviews to examine Asian migrants' use of primary health services in New Zealand. Participant observations were undertaken in migrant organisations, and clinical and domestic settings. In addition, semi-structured interviews were conducted with 23 migrants from India, South Korea and Mainland China, and six with New Zealand healthcare professionals. Migrants used a variety of strategies to negotiate New Zealand's healthcare system. These were influenced by their knowledge of it, their experience with healthcare systems in their home countries, language difficulties, structural barriers, divergent understandings of health and the extent of their local support networks. Social networks were found to play fundamental roles in migrants' healthcare strategies and, if promoted through community development, could increase the utilisation of primary health services and reduce health inequalities in New Zealand and other host countries.