Introduction
Method
Inclusion/Exclusion Criteria
Search Strategy
Migrant* or refugee* or "undocumented migrant*" or "ethnic minorit*" or "first generation migrant*" or "second generation migrant*" or immigrant or "newcomer*" |
AND Healthcare or "health care" or "general practitioner " or doctor* "health system" or "health service*" or "health professional*" or "primary health care*" or "health promotion" or "health behaviour*" or " or "health program*" or "health policy*" or "health project*" or ambulance |
AND Barrier* or facilitator* or access* or equit* or inequt* or hinder* or enable* or unsuccess* or success* |
AND "New Zealand" or NZ or "Aotearoa NZ" |
Migrant* or refugee* or "undocumented migrant*" or "ethnic minorit*" or "first generation migrant*" or "second generation migrant*" or immigrant or "newcomer*" |
AND Healthcare or "health care" or "general practitioner " or doctor* "health system" or "health service*" or "health professional*" or "primary health care*" or "health promotion" or "health behaviour*" or " or "health program*" or "health policy*" or "health project*" or ambulance |
AND Covid-19 or coronavirus or 2019-nCoV or SARS-CoV-2 or CoV-19 |
AND Barrier* or facilitator* or access* or equit* or inequt* or hinder* or enable* or unsuccess* or success* |
AND "New Zealand" or NZ or "Aotearoa NZ" |
Data Extraction
Data Analysis and Synthesis
Results
Characteristic of the Included Studies
Author & article | Aim/Research question | Type of study | Sampling approach | Sampling size | Findings | Recommendation |
---|---|---|---|---|---|---|
Kennedy, Kim, Moran, and McKinlay (2021) Qualitative experiences of primary health care and social care professionals with refugee-like migrants and former quota refugees in New Zealand. Australian journal of primary health, 27(5), 391–396. https://doi.org/10.1071/PY20285 | To examine the experiences of primary care professionals, finding key themes for successful care | Exploratory qualitative study | Purposive | 12 healthcare workers | Similarities exists between refugee-like migrants and former quota refugees Barriers still present affecting the delivery of core health and support services | Migrants, especially family members of former refugees, may have similar health and social experiences to former refugees. Health and social care professionals should take these experiences into account when planning and providing care |
Richard, Richardson, Jaye, and Stokes (2019) Providing care to refugees through mainstream general practice in the southern health region of New Zealand: a qualitative study of primary healthcare professionals’ perspectives. BMJ Open, 9(12), e034323. https://doi.org/10.1136/bmjopen-2019-034323 | To explore the perspectives of primary healthcare (PHC) professionals providing care to refugees through mainstream general practice | Qualitative exploratory design with semi-structured interviews | Purposive | Nine general practitioners and six practice nurses enrolled in the Dunedin Refugee Resettlement Programme, in New Zealand | Building meaningful relational connections involved acknowledging refugees’ journeys by getting to know them as people Participants encountered challenges in providing care to refugees with respect to time-limited consultations, variable use of interpreter services, fragmentation of care between agencies and need for improved health infrastructure to ensure a fluid interface between PHC, secondary care and community support services The current business model of NZ general practice was perceived to interfere with value-driven care and discouraged tailoring of care to specific patient groups | Health care professional to advocate for people from refugee backgrounds to influence policy makers to recognise the unique individual, social, cultural and historical factors that affect their health and promote a culture of acceptance that celebrates diversity Mainstreaming of gender in the delivery of these services for culturally appropriate practice, to facilitate relationship building and trust Health service providers to collaborate with non-government organisations that work with migrants and refugees to include establishing an interprofessional team within and across practises, sharing systems and information and investing in skill development and teamwork between practices |
Shrestha-Ranjit, Patterson, Manias, Payne, and Koziol-McLain (2020) Accessibility and acceptability of health promotion services in New Zealand for minority refugee women. Health promotion international, 35(6), 1484–1494. https://doi.org/10.1093/heapro/daaa010 | To examine the accessibility and acceptability of health promotion services for Bhutanese refugee women who resettled in New Zealand | Qualitative | Purposive | 32 Bhutanese women and eight Bhutanese men; 12 individual interviews with health professionals 18 to 82 years and men’s from 26 to 55 years | Bhutanese women were missing some essential health promotion services, such as antenatal education sessions mainly due to language and cultural barriers | To develop health promotion resources in the Nepali language; and to deliver the health promotion sessions by culturally and linguistically competent providers |
Field, McClunie-Trust, Kearney, and Jeffcoat (2020) Language and communication: A vital component of Health for people with Refugee backgrounds. KaiTiaki Nursing Research, 29 (3). ISSN 1179/772x (In Press) | To explore transdisciplinary understandings of the implications of language development for the health and wellbeing of people who have come as refugees to Aotearoa New Zealand To analyse the health implications of an emergent data set from a primary research study with learners who were refugees | Qualitative | Purposive | 60 adults of refugee backgrounds from Somalia, Cambodia, Colombia, Pakistan, Democratic Republic of Congo and Afghanistan. 18 to 64 years old, predominantly female | Key themes developed from the secondary analysis were, complexity of life experience, challenges to living and learning, family responsibilities, challenges to ‘peace of mind’ and mental health, and personal agency Eliciting background narratives about who people are, where they are from, and how migration impacts at all levels of daily life, and consequently on their health and wellbeing, is integral to culturally safe practice with people with refugee backgrounds | Promoting community-level engagement with primary-care services may help to reduce inequalities for refugee populations Nurses to influence policy makers to recognise the individual, social, cultural and historical factors that affect the health of migrants Health services to engage with people with refugee backgrounds in culturally safe and responsive ways, through a diverse health workforce, both at policy development level and at on-the ground service level |
Shrestha-Ranjit, Payne, Koziol-McLain, Crezee, and Manias (2020) Availability, Accessibility, Acceptability, and Quality of Interpreting Services to Refugee Women in New Zealand. Qualitative Health Research, 30(11), 1697–1709 | To examine effectiveness of interpreting services for refugee women in New Zealand | Qualitative | Purposive | 32 Bhutanese women and eight Bhutanese men; 12 individual interviews with health professionals 18 to 82 years and men’s from 26 to 55 years | There are inadequacies and constraints in the provision of a socio-culturally and linguistically effective interpreting service to Bhutanese women | To establish community navigators to facilitate coordinated care that meet the sociocultural and gender-specific needs of Bhutanese refugees To develop health information resources in Nepali language and utilize them to enhance communication with Bhutanese refugees for effective primary health care services To advocate for refugee patients regarding their rights and responsibilities in their host nations |
Shrestha-Ranjit, J. M., Patterson, E., Manias, E., Payne, D., & Koziol-McLain, J. (2017) Effectiveness of primary health care services in addressing mental health needs of minority refugee population in New Zealand. Issues in Mental Health Nursing, 38(4), 290–300. https://doi.org/10.1080/01612840.2017.1283375 | To examine the effectiveness of primary health care services in addressing mental health needs of Bhutanese refugee women resettled in New Zealand | Exploratory Qualitative study Interviews and FGDs | Purposive | In all, 32 Bhutanese women participated with their ages ranging from 18 to 82 years eight Bhutanese men aged 26 to 55 years 12 individual interviews with health professionals | This study has reflected a diversity of viewpoints of service users Sources of mental distress were: Language difficulties Family separation Fragmented services Financial constraints Lack of spiritual and social support networks Language barrier compounded by lack of professional interpreter services Need for cultural awareness and education | Future research to explore Bhutanese refugee women’s experiences related to gender discrimination and its impact on their mental wellbeing after they resettled in New Zealand and other host countries Recommends to address inadequacies found in the findings |
Akhtar, Heydon, and Norris (2021) Bringing Medicine from Pakistan and Self Medication Among Pakistani Mothers in New Zealand. Journal of immigrant and minority health, 24(3), 682–688. https://doi.org/10.1007/s10903-021-01228-1 | To explore the self-medication practices of Pakistani mothers for their children and their reasons for self-medication | Qualitative | Purposive | 23 migrant women (Pakistan) aged 18yrs + | The requirement for a prescription and long waits and delay in GP appointments were the critical factors for self-medication in children. Themes were: Self-Medication for Their Children before taking to the doctor; Bringing Medicine from Pakistan in fear of not being able to manage the children’s illness Reasons for Self-Medication is medicine is heap and easily accessible without a prescription Types of Medicines used for self- medication were antipyretics, anti-allergic, analgesics (NSAIDs), eye and nasal drops, topical steroid creams, and Flagyl® for stomach problems | The Ministry of Health can develop healthcare awareness programs targeting new immigrants about antibiotic resistance and the potential risk of self-medication practice to prevent this self-medication practice and increase utilisation of health care |
Henrickson, M., & Fisher, M. (2016) 'Treating Africans differently': using skin colour as proxy for HIV risk. Journal of clinical nursing, 25(13–14), 1941–1949. https://doi.org/10.1111/jocn.13212 | To investigate the issues of stigma and microaggressions and their effects on Black African communities | First study- qualitative Second study-Mixed method study | Purposive | First study, interviewed 13 Black Africans living with HIV Second study, surveyed 703 Black African new settlers, and included 131 participants in 23 different focus groups | Participants reported experiences of stigma and microaggressions based on their race, and a lack of knowledge about HIV in non-HIV specialist nurses and other health care workers Participants experienced poor health care and education practices, professional prejudice against colleagues living with HIV and institutional challenges including failure to protect patient confidentiality | Previous recommendations for increased and effective education and training in HIV have not been implemented |
Cassim S et al. (2022) ‘Look, wait, I’ll translate’: refugee women’s experiences with interpreters in healthcare in Aotearoa New Zealand. Australian Journal of Primary Health 28(4), 296–302. https://doi.org/10.1071/PY21256 | To explore refugee women's experiences of interpreters in healthcare in Aotearoa, New Zealand (NZ | Qualitative | Snow balling | Nine women aged between 20-50 years origin included: Eritrea, Afghanistan, Syria, Somalia, and Thailand | Patients asked to pay for interpreters Language discrepancies and different dialects Difficulties in making an appt without a GP Using family members as interpreters Breach of privacy | Achieving equitable healthcare for refugee women entails putting in place accessible and robust communicative infrastructure in NZ |
Cassim, S., Ali, M., Kidd, J., Keenan, R., Begum, F., Jamil, D.,... Lawrenson, R. (2022). The experiences of refugee Muslim women in the Aotearoa New Zealand healthcare system. Kōtuitui: New Zealand Journal of Social Sciences Online, 17(1), 75–89. https://doi.org/10.1080/1177083X.2021.1947330 | To explore the experiences of refugee Muslim women as they accessed and navigated the healthcare system in Aotearoa New Zealand | Qualitative | Snow balling | Nine Muslim women who arrived in NZ as refugees | Various structural barriers to accessing healthcare were identified such as cost and issues with interpreters, as well as instances of othering in the healthcare settings experienced by refugee Muslim women | To tackle inequity in the health system, structural and institutional barriers need to be addressed first, to prompt other levels of othering and discrimination to reduce over time |
Jayan, P., & Dutta, M. J. (2021) Nobody cares about us: COVID-19 and voices of refugees from Aotearoa New Zealand. Communication Research and Practice, 7(4), 361–378. https://doi.org/10.1080/22041451.2021.1994686 | To examine how the refugee communities navigated through the prevailing structural impediments to health during the pandemic | Qualitative | Snowballing | 30 refugees (females and males) from Nepal, Afghanistan, Myanmar, Thailand and Bhutan | Lack of support services, inaccessibility of healthcare services and limitations in mobility | |
Park, C., Loy, J. H., Lillis, S., & Menkes, D. B. (2022) What stops Korean immigrants from accessing child and adolescent mental health services 19. https://doi.org/10.1186/s13034-022-00455-0 | To understand barriers to service access from Korean parents’ perspectives | Qualitative | Purposive | 31 Korean parents of children aged 18 and under | Attitudinal barriers included attribution of mental illness to external stressors or parenting problems, social stigma, denial or normalization of children’s behaviour, fear of family disempowerment, and mistrust of public mental health services | Measures to improve access, for example by countering stigma, are urgently required |
Akhtar, S. S., Heydon, S., & Norris, P. (2021). Access to the healthcare system: Experiences and perspectives of Pakistani immigrant mothers in New Zealand. Journal of migration and health, 5, 100,077. https://doi.org/10.1016/j.jmh.2021.100077 | To explore Pakistani immigrant mothers’ experiences and perspectives on navigating the healthcare system of a new country | Qualitative | Purposive | 23 mothers in Wellington | Lack of knowledge, different expectations, and experiences of healthcare services inhibited their utilization of healthcare. Most mothers treated their children at home before visiting a general practitioner (GP) due to previous perceived unsatisfactory experiences, such as lack of availability of GP appointments for the same or next day, or long waiting times at emergency departments and after-hours medical facilities | Immigrant mothers need to feel they are getting the right services at the right time to ensure and promote better health outcomes. Identifying the barriers and promoting information about the healthcare system can play an essential role in the appropriate use of health services by immigrant mothers |