Sexual and reproductive health services in New Zealand primary care settings: A mixed-methods survey.

Abstract

New Zealand's recently released Women's Health Strategy aims to provide accessible, equitable care which prioritises prevention, early intervention and areas of unmet need. An example of such care is the management of common sexual and reproductive health (SRH) issues by appropriately trained primary care practitioners in the community. The aim was to identify primary care SRH program initiatives currently operating in New Zealand, how they are accessed and funded, whether they have been co-designed using mātauranga (knowledge) Māori principles and whether any have undergone formal evaluation. A mixed-methods electronic anonymous survey of primary care practitioners and secondary care obstetrics and gynaecology clinical directors was distributed in April 2023. Qualitative analysis of free text answers was undertaken. Few funded SRH services are available in community settings in New Zealand. Access and eligibility criteria to those which exist varies by region. A lack of co-design and governance was reported, along with difficulties in access to skills training and specialist advice. The current SRH landscape in New Zealand appears fragmented and lacks an overarching strategic focus. To achieve the aims of the Women's Health Strategy, a suite of core community-based SRH programs should be developed and formally evaluated, focusing on equitable access, integration and specific outcomes. These should be co-designed using mātaurangi Māori principles.