Migrants living in low incidence countries, including New Zealand (NZ), are disproportionately affected by tuberculosis (TB). This foreign-born group poses important challenges to achieving the national TB elimination targets. Thus, the aim of this study was to contribute to the understandingof factors that influence the incidence of TB among African migrants living in NZ. We employed a semi-structured interview approach to explore the perceptions of NZ-based African community leaders, health professionals and a non-governmental TB support organisation about the wider determinants of TB. The findings, though not completely generalizable, suggest that many NZ-based Africans endure a difficult process of integration, perceive themselves as least susceptible to TB and have low awareness about available health services. Furthermore, the cost of general practitioner (GP) services, mistrust of health professionals, TB stigma and the NZ immigration policy were indicated as important barriers to TB services. Strategies to address TB among migrants must therefore be more holistic and not be centred on a fragmented approach that overemphasises the biomedical approaches, as the incidence of TB is more likely the outcome of a complex interplay of several underlying factors.

New Zealand Governments have longstanding policy commitments to equal employment practices. Little attention has been paid to ethnic pay disparities in recent years. Informed by a series of official information act requests, we were interested to find out what extent, ethnic pay disparities existed within the core public sector and district health boards (DHBs).  We examined the population proportions of M?ori, Pasifika and Other ethnicities earning over $NZ100,000 over five year intervals between 2001 to 2016, using linear regression analysis.   The analyses showed a statistically significant pattern of ethnic pay disparities across the public sector. There were fewer M?ori and Pasifika staff employed in DHBs than their population proportion. The failure to promote M?ori and Pasifika to the upper tiers of public sector is consistent with definitions of institutional racism. The authors call for more research to understand the dynamics of ethnic pay disparity and the drivers of this disparity.

Summary There is renewed international effort to improve the health and well-being of migrants. For African migrants, theoretical frameworks designed to account for and guide interventions to address the underlying mechanisms that interact to influence health and well-being remain largely underdeveloped. The aim of this study was to address this gap by providing a unique socio-ecological framework with specific entry points for targeted health promotion action aimed at improving the health and well-being of African migrants living in Aotearoa New Zealand. The African Hut model of health was developed through an inductive iterative approach informed by a review of the evidence and semi-structured interviews with key informants. The interviews were conducted in person using one-on-one format and employed to refine initial themes from the literature. A hybrid thematic analysis, involving both inductive and deductive approaches was used to analyse the interview data. The health and well-being of African migrant communities are the outcome of complex interplay of individual, economic, social and structural factors. To protect and promote the health of African communities in Aotearoa requires tailored interventions that centre culture and deliver holistically.

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