{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T15:15:11Z","timestamp":1783264511788,"version":"3.54.6"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We know that many refugees arrive in host countries, including Aotearoa New Zealand, with complex health needs and are at risk of poorer outcomes. Little attention has been paid to the expectations and understandings of care that they bring with them and how these shape their health experiences. Many refugees come from hospital\u2010based healthcare systems with direct, timely access to specialists, tests and procedures but resettle into primary care systems where GPs act as gatekeepers to public and private specialists and nonemergency hospital services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/Methods<\/jats:title>\n                    <jats:p>Refugee health literature often focuses on provider perspectives. With two recent projects, we explored refugees' experiences of healthcare and access to medicines in southern New Zealand. The first gathered refugees' experiences of healthcare through 20 open\u2010ended interviews. The second project followed five refugee households over a year through in\u2010person interviews, video calls and texts. Both generated extensive qualitative data, analysed and coded thematically by research teams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Discussion<\/jats:title>\n                    <jats:p>Both studies found that refugees felt significant dissatisfaction with healthcare in New Zealand. This stems in large part because refugees' expectations of healthcare are shaped by previous experiences of healthcare overseas. New to a primary care system, refugees described it as strange and slow and were openly frustrated by its more limited access to tests, referrals and follow\u2010up\u2014features that previously signified care. Different prescribing practices (namely, more frugal, with a perceived over\u2010reliance on painkillers) also sowed scepticism of GPs. Waitlists deepened doubts about the system's ability to care for them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Different experiences and understandings of care, formed overseas, contribute significantly to refugees' dissatisfaction with healthcare in New Zealand. Listening to their perspectives and understanding how and why their expectations are not being met is an important step in improving refugee healthcare provision and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PPIE<\/jats:title>\n                    <jats:p>Our methodological approach prioritised relationship\u2010building and responsiveness; we spent significant time building relationships with service providers who work with refugees and interpreters before beginning. Service providers helped develop our research and interview questions and facilitated recruitment. As early themes emerged during interviews with refugees, they were integrated into subsequent interviews for participants to verify or refute. In the first study, we brought early findings to community partners and two participating households for validation. One household continued into the second project. The longitudinal approach of the second study fostered sustained participant engagement. Both studies centred the underrepresented voices of refugees themselves, aiming to bring their perspectives to practitioners and, in doing so, contribute to improving refugee healthcare experiences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70492","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:36:57Z","timestamp":1779269817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expectations Shaped Elsewhere: Refugee Experiences of Healthcare in Aotearoa New Zealand"],"prefix":"10.1111","volume":"29","author":[{"given":"Molly","family":"George","sequence":"first","affiliation":[{"name":"Social Anthropology Programme University of Otago Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Va\u2032a o Tautai \u2013 Centre for Pacific Health University of Otago Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauralie","family":"Richard","sequence":"additional","affiliation":[{"name":"General Practice and Rural Health University of Otago Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Norris","sequence":"additional","affiliation":[{"name":"Va\u2032a o Tautai \u2013 Centre for Pacific Health University of Otago Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13365"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/1177083X.2021.1947330"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2731-0"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY12068"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13411"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp08X376104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp15X683977"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X702209"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY20285"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034323"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1065-z"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015981"},{"key":"e_1_2_11_14_1","volume-title":"What the Refugee Resettlement Strategy Covers [Online]","author":"New Zealand Immigration","year":"2025"},{"key":"e_1_2_11_15_1","volume-title":"M\u0101ngere Refugee Health Service (MRHS) [Online]","author":"Healthpoint Limited","year":"2025"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31238-3"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198729"},{"key":"e_1_2_11_18_1","unstructured":"\u201cGeneral Practice\u201d [Online] Medical Council of New Zealand accessed May 25 2025 https:\/\/www.mcnz.org.nz\/registration\/scopes-of-practice\/vocational-and-provisional-vocational\/types-of-vocational-scope\/general-practice\/."},{"key":"e_1_2_11_19_1","volume-title":"Ng\u0101 Kaitaka Ronguo\u0101 i r\u014d whare t\u0101kuta: Pharmacists in General Practice Final Report [Online]","author":"Royal New Zealand College of General Practitioners","year":"2023"},{"key":"e_1_2_11_20_1","unstructured":"\u201cHealth Improvement Practitioners in New Zealand\u201d [Online] Te Pou accessed May 25 2025 https:\/\/www.tepou.co.nz\/initiatives\/integrated-primary-mental-health-and-addiction\/health-improvement-practitioners-in-new-zealand."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmad096"},{"key":"e_1_2_11_22_1","unstructured":"\u201cPrescriptions\u201d [Online] Te Whatu Ora accessed May 25 2025 https:\/\/info.health.nz\/conditions-treatments\/medicines\/prescriptions#:~:text=Prescription%20charges aged%2065%20years%20or%20over."},{"key":"e_1_2_11_23_1","volume-title":"OECD Health Policy Studies","author":"OECD","year":"2020"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1071\/HC24078"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY24096"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14020125"},{"key":"e_1_2_11_27_1","volume-title":"Qualitative Data Analysis: A Methods Sourcebook","author":"Miles M. 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