The barriers and enablers for men in accessing community health services in Western Sydney : a qualitative research study

Abstract

Suicide claims five to six men a day in Australia, (ABS, 2016). This statistic alone is cause for concern, and accompanied by other statistics on men's health is a compelling rationale for research into men's health. Health differentials between men and women occur in almost all health issues affecting men, and men continue to die about five years earlier than women. They have the poorest health outcomes within the population, particularly men from low socioeconomic areas, and this is linked to a lack of accessibility to primary health care services (AIHW 2007) (NSW Health 2000). The focus of this research is an investigation of this lack of access for men to community health services (CHS) in Western Sydney, through an exploration of the experiences of two groups of research participants: phase one, five focus groups with men from within the community, and phase two, ten, semi-structured interviews with health service providers from two local area health districts. A qualitative, phenomenological and interpretive approach from a human perspective of discovery and explanation was used to conduct a two-phase study that presented two viewpoints, lay and professional, on the issue of access for men. Obtaining two perspectives provides a more comprehensive and nuanced view of the problem of access and is seen as one of the strengths of this study. Both phases of the study involved asking a series of questions of the participants to elicit discussion and opinion, and the data obtained was subjected to a comprehensive process of thematic analysis (Alhojailan, 2012). This research has presented the verbatim voices of men as putative clients of CHS and the voices of the health service personnel responsible for service provision at community health level. These voices collectively are a powerful demonstration of the dire need for a concerted effort at State and Federal level of policy makers, Ministers of Health, Senior health service administrators and frontline service staff, need to ameliorate the inequalities of men's health by addressing the problems of access for men to CHS. There is a need to adopt a different and salutogenic framework for men's health, to see beyond the simplistic notion of putting the onus of access solely onto male behaviours, and an acceptance that there are positives in masculinity and the male gender, and build on these to provide a practical and pragmatic, men friendly approach to service delivery in CHS. This research therefore has implications for policy and practice within the local health districts. It is anticipated that a report from this study be distributed to the management of the community health services in the two local health districts of Western Sydney featured in this research. Recommendations for future research include evaluations of existing male health policies and strategic plans to assess their implementation and effectiveness, and the inclusion of male health as a discrete topic in the educational and training of health professionals. The voices of the men in this study send a powerful message that the pejorative view of men be strongly rebutted and the health service providers' comments require executive action on the issues of under resourcing and a lack of senior management support for men's health.

Date of Award	2017
Original language	English