title: Talking about TB: multicultural diversity and tuberculosis services in Waikato, New Zealand.
abstract: OBJECTIVE
  To explore the diversity of opinion amongst different refugee and minority group representatives about tuberculosis, and to examine the provision of services and their effectiveness in the Waikato Health District, New Zealand.
  
  
  METHODS
  Open-ended qualitative interviews with the representatives of seven minority populations were undertaken. The interviews focused on the cultural differences in the approach of minority populations to health issues and on the accessibility of health services to these population groups. Participants expressed their opinions about how health services, and more specifically about how tuberculosis (TB) health services could be improved.
  
  
  RESULTS
  Important cultural differences between the minority populations were elucidated by community representatives that may determine the interpretation of symptoms and timing of presentation at medical services, the appropriate cultural processes to be followed in the consultation, and adherence to prescribed treatment.
  
  
  CONCLUSIONS
  The absence of health services oriented towards specific minority and refugee groups, and communication difficulties with healthcare providers, are important cultural barriers to TB control in Waikato. Recognition of the diversity of these populations, and the cultural and structural barriers that they face in accessing health services in Waikato and other similar health districts in New Zealand, is needed. The development of strategies is required to reduce barriers to TB treatment so that patients from diverse cultural backgrounds can be diagnosed early and effectively treated.
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: Clif
authors.initials: C
authors.lastname: van der Oest
authors.forename: Richard
authors.initials: R
authors.lastname: Chenhall
authors.forename: Dell
authors.initials: D
authors.lastname: Hood
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
mesh_terms: D001291:Attitude of Health Personnel; D002160:Cambodia / Q000208:ethnology; D002681:China / Q000208:ethnology; D003142:Communication; D003219:Confidentiality; D018864:Cultural Diversity; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration; D006798:Housing; D006801:Humans; D007407:Interviews as Topic; D009520:New Zealand / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010679:Philippines / Q000208:ethnology; D011287:Prejudice; D036301:Qualitative Research; D012998:Somalia / Q000208:ethnology; D014376:Tuberculosis / Q000208:ethnology* / Q000517:prevention & control*; D014378:Tuberculosis Societies / Q000706:statistics & numerical data*