Fijian women living in New Zealand are worse off when it comes to family planning and reproductive health than women back in Fiji, a new study suggests.
The study surveyed hundreds of indigenous Fijian, or iTaukei, women about their awareness and use of contraception.
It found despite far better reproductive services and resources available in New Zealand, the message does not seem to be reaching Fijian women who live here.
Auckland University of Technology public health lecturer Dr Radilaite Cammock spoke to 140 women in New Zealand and 212 in Fiji over the course of the study.
Contraceptive use for Fijian women is low in both countries, but iTaukei women in Fiji were much more likely to be aware of contraception than those in New Zealand, Cammock found.
As well as language barriers, the cost of travel and the importance of speaking with a female about family planning were big factors for the women Cammock surveyed.
Gender roles are carefully defined and sex is a taboo topic for iTaukei, who come from a traditional, hierarchical culture dominated by men, Cammock said.
"Reproduction and sexual health and all those things are quite sacred topics so things around family planning are meant to be treated very carefully. To talk openly about them is disrespectful and they're not used to it - so speaking to a male provider can be quite difficult."
For Cammock, who is iTaukei herself, coming to New Zealand as a youngster was eye-opening.
"You're suddenly exposed to a lot more advanced services, so the assumption is you will have better access and your health will be better, but that's not the case."
The women she surveyed agreed. Pregnancy outside wedlock is seen as shameful in Fiji; in New Zealand the women were stunned to see upbeat TV ads about condoms.
"One younger woman came her to go to boarding school and she was shocked when the girls were changing in the locker room and they were talking about sex. Those conversations just don't happen in Fiji, but here it's normal."
The study, published in the Australian and New Zealand Journal of Public Health, found iTaukei women under 24 had significantly lower odds of using or knowing about contraceptives than older women.
After giving birth, women in Fiji discuss family planning with a medical professional while still in hospital, Cammock said.
While Cammock was initially surprised that Pacific women seemed to be better off in a developing country than in New Zealand, she said Pacific populations are well known to have poor health outcomes here. The study's conclusions were likely to be mirrored in other Pacific Island groups.
She is calling for a wider multi-sector approach to make family planning services more accessible to Pacific minority groups in New Zealand.
Language barriers in New Zealand could be partly to blame, Cammock said. Health pamphlets are often translated into other languages but "some messages you can't write".
"One English word in Fijian may have lots of different meanings, so you really need to rethink the whole content of the message - not just translate it."
Cammock believed many women would be better helped by having someone explain reproductive health to them in their language.