Healthcare Access Experiences of Syrian Refugees in Aotearoa New Zealand: A Qualitative Focus Group Study

Despite Aotearoa New Zealand's commitment to equitable healthcare access, significant barriers persist for refugee populations. This qualitative study explored healthcare experiences of Syrian refugees through eight focus groups conducted in Wellington and Dunedin with 85 participants (35 in Dunedin and 50 in Wellington). All were aged 18-60 years, with most residing in Aotearoa New Zealand for four years. Focus groups were conducted separately by gender using Arabic-speaking facilitators to respect cultural practices. Data were analysed using Braun and Clarke's thematic analysis approach. Four major themes emerged: healthcare needs of refugee communities, barriers to healthcare access, positive healthcare experiences, and system-level challenges. Housing emerged as a fundamental health determinant, with poor conditions contributing to respiratory problems and chronic pain, while participants felt unable to advocate for repairs due to their refugee status. Communication barriers included interpreter reliability concerns, dialect mismatches, and a lack of cultural sensitivity from providers. Mental health needs were significant but inadequately addressed, with cultural stigma preventing help-seeking behaviour. Major access barriers included extended waiting times (up to four months for specialists), financial constraints, particularly for dental care, and unmet expectations about immediate care availability. Positive experiences included children's healthcare services, pharmacy services with Arabic-speaking staff, and recognition of the system's equitable philosophy. Findings highlight the complex interplay between social determinants, cultural factors, and system-level barriers affecting refugee healthcare access. Addressing these challenges requires integrated approaches encompassing housing advocacy, cultural competency training, community-based mental health services, and enhanced navigation support to achieve genuine healthcare equity for Aotearoa New Zealand's refugee populations.