Author: Ekta Kumar

Between reproductive rights and sex selection in New Zealand’s abortion reforms: practitioner dilemma in institutionalising ‘choice’ and ‘agency’

ABSTRACT

In 2020, the New Zealand (NZ) Parliament voted to decriminalise abortion.

Although NZ’s abortion law formally opposes sex selective abortions, there is considerable complexity in the gender politics of ‘choice’ and ‘agency’ in multi-ethnic societies, and interpretations of reproductive rights for ethnic minority women and for the girl child, respectively.

This paper explores these complexities through the perspectives of reproductive and maternity care practitioners who are situated at the interface of legal systems, health service provision, and delivery of culturally sensitive care. Thirteen practitioners were interviewed as part of this study. The analysis highlights strains in framings of ‘reproductive choice’ (underpinned by western liberal notions of rights) and ‘gender equality’ (abortion rights that acknowledge the complexity of cultural son-preference) for ethnic minority women. These tensions are played out in three aspects of the post-reform landscape: (a) everyday practice and accountability; (b) consumerism and choice; (c) custodianship and gender rights. The findings point to the limitations in operationalising choices for ethnic women in health systems wherein trust deficit prevails, and cultural dynamics render complex responses to abortion.

They also highlight reconfigurations of client-expert relationships that may have implications for practitioners’ abilities to advocate for ethnic women’s rights against cultural influences.

Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review

Abstract

The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds.

Asian Public Health in Aotearoa New Zealand October 2021

Asians in Aotearoa New Zealand have a diverse variety of ethnicities, backgrounds, and cultures, and thus have diverse health needs. Asians are NZ’s fastest growing ethnic group it was recently announced that the Asian population is projected to reach 26% by 2043. So it’s increasingly important that their health issues are not overlooked.
Although the health of Asians in NZ appears to be generally good there are in fact many unique health issues. This includes the particular health needs of different Asian ethnicities and subpopulations, including youth, women, older people, new migrants, and refugees and asylum seekers.

Utilisation of services is particularly concerning. Major barriers include racism and discrimination, English language proficiency, cultural ifferences, lack of awareness of services, and lack of appropriate services. Where appropriate services are available there
is insufficient capacity.

However, this does give rise to many opportunities a national plan or strategy would give a consistent approach to Asian health for the whole of NZ and could provide a good framework for more targeted services, increased culturally appropriate workforce increased engagement and accessibility, and an improvement in Asian inclusive public health research and data collection. Addressing mental health for Asians in NZ is a key priority.