Outcomes are reported from research that explored Māori and Pacific family experiences of recurrences of rheumatic fever, in an attempt to identify and understand barriers for families accessing secondary prophylaxis and ongoing management of rheumatic fever to inform health service improvements. The research employed Kaupapa Māori, Talanga and Kakala Pacific qualitative methodologies. Data were collected through 38 interviews conducted with 80 Māori and Pacific patients who had recurrences of rheumatic fever or unexpected rheumatic heart disease and their families, as well as 9 individual interviews and 6 focus group interviews with 33 health providers working in rheumatic fever contexts throughout 7 geographic regions. Thematic analysis of the data identified a consistent mismatch between the approach taken by rheumatic fever health services and what is needed by the population looked after by those services. The 3 main areas of service mismatch identified were model of delivery, interpersonal approaches to care and adolescent care.
