title: Cultural democracy: the way forward for primary care of hard to reach New Zealanders.
abstract: The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.
authors: Massey University, Albany, Auckland, New Zealand.
authors: Sitaleki A
authors: SA
authors: Finau
authors: Eseta
authors: E
authors: Finau
mesh_terms: D003469:Culture; D003695:Delivery of Health Care; D003709:Democracy; D006291:Health Policy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D008507:Medically Underserved Area; D009520:New Zealand; D010139:Pacific Islands; D011320:Primary Health Care / Q000458:organization & administration*; D011634:Public Health; D019035:Rural Health Services / Q000458:organization & administration*