Utilisation of Primary Health Care services: the perceptions and experiences of South Asian immigrants in Auckland, New Zealand

Abstract

The South Asian community in New Zealand – comprising of migrants from India, Bangladesh, Sri Lanka, and Pakistan – experience high rates of avoidable morbidity and mortality. This trend raises the question about health awareness, behaviours and health care utilisation among the members of this community. Alongside, it also raises questions about the extent to which New Zealand’s health care system addresses cultural diversities in health care. Focusing on health service utilisation of primary health care (PHC), the first point of access for health care, the present research aims to outline the socio-cultural, economic, and contextual factors that influence or present a challenge for health service utilisation behaviours of South Asian migrants. The thesis draws on Berry’s acculturation and Bourdieu’s habitus theories as explanatory frameworks to understand migrant perceptions and utilisation of health care. The study, located in Auckland, employed a qualitative interpretive research methodology. Fifteen participants from India, Pakistan, Sri Lanka, and Bangladesh, were involved in in-depth interviews. A content analysis of the in-depth interviews revealed two main findings. First, South Asians are influenced by their pre-migration experiences with health care in their home countries, which shape their perceptions of services provided by New Zealand PHCs. These expectations meant that they were most satisfied with health care utilisation when they perceived control over health decisions and were dissatisfied with the PHC when it restricted this ability to freely make choices about their healthcare. Second, the promotion of healthy lifestyles messages and support provided by PHC-level services and society are perceived to be inconsistent by South Asians with their ability to live the desired healthy lifestyles. The study recommends that PHC can better support South Asian migrants in their health service utilisation experiences by taking into consideration the particular expectations formed by their pre-existing health knowledge. Further, in order to develop effective health promotion messaging, PHC will need to create partnerships with existing South Asian community groups in ways that promote cultural diversity in messaging and interactions which empower South Asians to experience better health and wellbeing.