Exploring the health visiting service from the view of South Asian clients in England: a grounded theory study

The fact that health inequalities disproportionately affect the minority ethnic population is not new and projections are that the minority ethnic population will continue to increase. The importance of early intervention and the key role that health visitors can play in attempting to reduce health inequalities is well documented as is the requirement for health providers to establish culturally sensitive services. To date, much of the research has focused on the perspectives of healthcare professionals caring for minority ethnic clients in hospital-based settings and little is known about the perspectives of minority ethnic clients regarding the health visiting service (HVS). The aim of this study was to explore the perspectives of South Asians regarding their experiences with the HVS. The study was conducted in a small town in the South of England between March and June 2013. A qualitative study using a grounded theory approach was used to capture the perspectives of this group regarding their interactions with the HVS. The sample consisted of 15 participants and data were collected through audio-recorded semi-structured interviews and analysed using constant comparative approach. Three key categories were identified: 'understanding the health visitor's role', 'sensitivity of services' and 'the significance of family'. While clients valued one-to-one support from health visitors, there was some evidence of poor communication and ethnocentric tendencies within the service. It was found that South Asian clients distinguish between health and parenting advice, being more likely to accept health advice from their health visitor and more likely to accept parenting advice from their family. The findings, although limited in their generalisability, offer important insights into how South Asians perceive the service and will equip health visitors with a better understanding of how best to improve the experience of South Asian clients accessing the health visiting.