Mens perception of health and health services on the Island of Niue: a qualitative study

Abstract

Background Men on the small Pacific island of Niue suffer from a range of health conditions but underuse health services. This study aimed to understand why. Very little is known about how men living in Niue view health and wellbeing. Knowing more would help to target services to meet men’s needs. Methods Qualitative face to face interviews were undertaken with a convenience sample of twenty men in Niue aged between 26 and 75 years. Data were analysed using a general inductive approach to identify recurring themes. Ethical approval for the study was obtained from the University of Auckland Human Participants ethics committee. Results The men interviewed had good knowledge of healthy and unhealthy behaviours. They believed that day to day activities such as working on plantations, fishing, and consuming healthy foods helped them to stay healthy and happy. They identified unhealthy diets as a major contributor to high blood pressure, high cholesterol, diabetes and gout. Traditional medicine was commonly used by older men in preference to formal healthcare services. All of the participants had a good knowledge about the health services available in Niue, but most said that conceptions of masculinity, pride and stubbornness influenced them not to visit doctors. They found it easier to speak about health issues with professionals who were able to communicate in the Niuean language. There was a consensus that providing health promotion workshops and exercise programmes in local villages would be beneficial. Conclusions This small study did not aim to generalise to all men in Niue, but it suggests that there is scope for local communities and health services to work together to improve men’s health. The consistency of findings suggests that men in Niue know what constitutes unhealthy behaviours, but they may not feel comfortable visiting health services for support. This may be because they do not trust health services, do not think it would be ‘manly’ to visit such services or are afraid to be diagnosed with illnesses and become a ‘burden’. Positively, men are open to taking part in health promotion workshops and exercise programmes in villages, and this could help to develop more acceptance of positive health behaviours.