In New Zealand, acute rheumatic fever (ARF) remains a significant health problem with persistent ethnic inequities. Māori children 5-15 years of age in Northland have some of the highest ARF rates nationally. This study explored Māori whānau experiences of ARF, including pathways to primary healthcare and barriers and facilitators for diagnosis of ARF.
The study applied a qualitative kaupapa Māori approach including eight whānau, two individual interviews and participant observations with 36 participants.
Barriers to accessing primary healthcare included: geographic distance, unavailability of appointments, cost, poor trust and rapport between health providers and whānau. Good rapport, communication and trust with health professionals facilitated utilisation of services. Barriers to diagnosis were lack of throat swabbing and inappropriate prescription of antibiotics. Access to primary care, having health professionals follow sore throat guidelines and trust in health professionals facilitated diagnosis.
Health services could better support ARF diagnosis through the development of an effective quality improvement strategy for sore throat management, promoting free rapid response throat swabbing for high-risk populations, and exploring options of self-swabbing. Training and evaluation targeted at rapport building should also be established for health professionals to facilitate primary healthcare utilisation.