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RESEARCH ARTICLE (Open Access)
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He Aroka Urutā. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Māori and Pasifika communities: a qualitative study

Katharina Blattner https://orcid.org/0000-0002-4041-3390 1 * , Lynne Clay https://orcid.org/0000-0003-2181-1120 2 , Rawiri Keenan https://orcid.org/0000-0001-8312-8525 3 , Jane Taafaki 4 , Sue Crengle 5 , Garry Nixon 6 , Kiri Fortune 7 , Tim Stokes https://orcid.org/0000-0002-1127-1952 8
+ Author Affiliations
- Author Affiliations

1 Department of General Practice and Rural Health, Dunedin School of Medicine, And Va’a O Tautai, Centre for Pacific Health, Division of Health Sciences, University of Otago, PO Box 82, Omapere 0444, New Zealand.

2 Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

3 Te Ati Awa/Taranaki, Medical Research Centre, University of Waikato, Hamilton, New Zealand.

4 Va’a O Tautai, Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand.

5 Kāi Tahu, Kāti Māmoe, Waitaha, Ngai Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand.

6 Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

7 Te Ātiawa, Kāi Tahu ngā iwi, Ngai Tahu Māori Health Research Unit, Division of Health Sciences of Otago, Dunedin, New Zealand.

8 Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

* Correspondence to: Katharina.blattner@otago.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care https://doi.org/10.1071/HC23171
Submitted: 8 December 2023  Accepted: 31 January 2024  Published: 20 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

From a coronavirus disease (COVID-19) pandemic perspective, Aotearoa New Zealand (NZ) rural residents formed an at-risk population, and disparities between rural and urban COVID-19 vaccination coverage have been found.

Aim

To gain insight into factors contributing to the urban–rural COVID-19 vaccination disparity by exploring NZ rural health providers’ experiences of the vaccine rollout and pandemic response in rural Māori and Pasifika communities.

Methods

Rural health providers at four sites participated in individual or focus group semi-structured interviews exploring their views of the COVID-19 vaccine rollout. Thematic analysis was undertaken using a framework-guided rapid analysis method.

Results

Twenty interviews with 42 participants were conducted. Five themes were identified: Pre COVID-19 rural situation, fragile yet resilient; Centrally imposed structures, policies and solutions – urban-centric and Pakehā focused; Multiple logistical challenges – poor/no consideration of rural context in planning stages resulting in wasted resource and time; Taking ownership – rural providers found geographically tailored, culturally anchored and locally driven solutions; Future directions – sustained investment in rural health services, including funding long-term integrated (rather than ‘by activity’) health services, would ensure success in future vaccine rollouts and other health initiatives for rural communities.

Discussion

In providing rural health provider perspectives from rural areas serving Māori and Pasifika communities during the NZ COVID-19 vaccine rollout, the importance of the rural context is highlighted. Findings provide a platform on which to build further research regarding models of rural health care to ensure services are designed for rural NZ contexts and capable of meeting the needs of diverse rural communities.

Keywords: COVID-19, equity, health services, health systems, Indigenous health, Māori health services, Pacific communities, primary health care, rural health.

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