Maori Solo Mothers' Healthcare Access: Experiences, Barriers, and Complexities of Access

Abstract

Aims: The aim of the present research was to better understand any issues, barriers and facilitators experienced by Māori solo mothers with access to and through healthcare within New Zealand, in taking care of their personal health. Design: Essentially exploratory, the qualitative study employed a general inductive design within an overarching Kaupapa Māori approach. Methods: Kaupapa Māori methodology informed the study design, participant recruitment, and data collection processes through cultural protocols, consultation and supervision. The recruitment strategy employed flyer distribution and snowballing techniques to purposively recruit seven Māori solo mothers. Data collection was digitally-recorded semi-structured interviews with each participant. Transcribed interview data underwent general inductive thematic analysis to identify commonalities and patterns in participants’ experiences. Emergent themes were categorised and developed from analyses across accounts. Findings: Major themes emerged that capture and describe participants’ experiences and encounters in accessing healthcare. Common experiences elucidated barriers, facilitating factors, cultural complexities and issues, and access inequities. The major barrier to access is cost, which limits poverty-driven options. Other barriers are: waiting times; low quality healthcare; prioritising children’s healthcare; difficulties with childcare and/or transport; lack of low-cost health services; and unhelpful attitudes of health professionals. Factors facilitating access include: access to regular GPs; 'caring' healthcare; convenient access to local, low-cost and organised services; and connectedness of social and health services. Complexities and issues emerged that complicate and hinder access: contemporary cultural issues; cultural and personal barriers; lack of healthcare options; stigmatisation and marginalisation, and need for Māori health professionals and culturally-safe healthcare. Conclusions: The research generated meaningful knowledge of barriers, complexities, and issues impacting participants’ healthcare experiences and access. Factors and strategies facilitating access to healthcare illuminate ways to improve access to services. Findings promote understanding of Māori solo mothers’ experiences of healthcare, elucidate the sociopolitical, cultural and personal complexities influencing access, and illuminate socioeconomic inequities underpinning access options and uptake of health services. It is recommended that the access issues be addressed and barriers to access be removed at policy, funding and practice levels to improve health outcomes and provide equitable healthcare access for Māori solo mothers.