Freins d’accès aux services de santé en Polynésie française : approche qualitative

INTRODUCTION: Accessibility to biomedical services is a complex challenge in French Polynesia. The territorial configuration of multiple dispersed islands, combined with the centralization of specialized care pathways in Tahiti, or beyond, entails mobility that can be constraining and exacerbate inequalities in access. AIM OF THE STUDY: In this context, the article seeks to identify the different types of constraints faced by users throughout their care pathways in French Polynesia, based on a qualitative and inductive approach centered on their ordinary experience. RESULTS: The methodological approach we have adopted made it possible to analyze users’ experiences regarding the accessibility of healthcare services and to identify a plurality of constraints, both structural and relational, influencing access to biomedical care. The (sometimes prolonged or repeated) distance from home for therapeutic purposes entails variable costs and constraints for users residing outside the Papeete urban area. They are required to mobilize different private resources (family relationships, economic capital) to offset these constraints and cover needs not supported by the social protection system, particularly in order to access specialized services. Individuals with the least economic and social resources may forgo biomedical care due to the lack of accommodation solutions at the place of treatment or the excessive costs associated with their stay. Family relationships emerge as an important condition for both the use and non-use of healthcare services in French Polynesia, but their role is ambivalent—sometimes facilitating, sometimes hindering access. CONCLUSIONS: Economic resources and family relationships constitute social determinants of access to biomedical services in French Polynesia and may lead users to forego care.