Abstract
New Zealand (NZ) has accepted a formalised annual quota of refugees for resettlement since 1987, offering individuals displaced by war, disaster, persecution, or political instability a new place to call home. Refugee resettlement to the Southern region of NZ is a more recent phenomenon, commencing in 2016. The Southern health system responded by introducing a Cross Cultural Navigator (CCN) role to facilitate former refugees’ access to and use of appropriate healthcare. Existing research has identified high health needs among former refugee populations, including those accepted for resettlement in NZ, as well as significant barriers that prevent or restrict access to healthcare. There is no existing research on the CCN role in the Southern region and very limited research is available that identifies and explores the role either internationally or within other regions of NZ. Therefore, this research seeks to address this knowledge gap to understand and describe the CCN role for former refugees in the Southern region of NZ.
Case study design was applied to the research, utilising qualitative data collection methods of document analysis and semi-structured interviews to inform understanding of the role. The research utilised an interpretative methodology within a feminist paradigm including a participatory approach to the research process. Two feedback meetings with participants were held and a research advisor from the wider CCN team was invited to be involved in the research as an advisor, to uphold this approach. A scoping review of existing empirical evidence about CCN-type roles in international or NZ literature was conducted before the interviews to help identify key knowledge gaps that could be addressed. The document analysis also identified knowledge gaps and supported the development of a timeline for the CCN role in the Southern region. Interview data was thematically analysed and identified four key themes: The Person in the Role, The Gap, Bridging and Looking to the Future. Each theme outlines key findings relating to i) what makes an effective CCN, ii) why there was an initial and ongoing need for the role in the Southern region, iii) what CCNs do to support former refugees, and iv) future aspirations for the role. The findings of the scoping review, document analysis and thematic analysis were used to develop a ‘Bridging the Gap’ model of the CCN role, which is presented in this thesis.
The research findings identified the CCN role as an asset to the Southern health system as they work to facilitate good health outcomes for former refugees by promoting access to and use of health services. Furthermore, CCNs support health providers in the provision of culturally responsive heath care. The findings of this research identified that bicultural understanding, bilingualism, understanding of refugee experiences and knowledge of the NZ health system allow CCNs to ‘bridge the gap’ between former refugees and health providers. Following this research, it is recommended that the provision of CCN services be introduced to all regions of NZ where former refugees are resettled.