Young, AMcIntosh, CWare, FBest, ETurner, NCharania, NadiaCampbell, ADavis, TAMarsh, SStokes, Tim2026-05-282026-05-282026-04-23Journal of Primary Health Care, ISSN: 1172-6164 (Print); 1172-6156 (Online), CSIRO Publishing. doi: 10.1071/HC260251172-61641172-6156http://hdl.handle.net/10292/21279INTRODUCTION: Childhood immunisation coverage in Aotearoa New Zealand (NZ) is not meeting recommended targets. Enrolment and engagement with primary care are associated with timely immunisation uptake, yet enrolment and immunisation are inequitable, with Māori and Pacific children less likely to be enrolled and receive their 6-week vaccinations on time. AIM: This study aimed to understand healthcare providers' perceptions of barriers and enablers to primary healthcare enrolment from birth and provide recommendations to support enrolment, engagement, and immunisation, particularly for Māori whānau (families). METHODS: This qualitative study, guided by a Kaupapa Māori-aligned methodology, involved interviews and focus groups to explore barriers and enablers to enrolment from the perspective of people working within the NZ healthcare sector (n = 27). Analysis was undertaken using qualitative content analysis. RESULTS: Many participants expressed that the current system was contributing to inequitable enrolment and immunisation of pēpi (infants). Four categories were constructed: health services may not be accessible or practical for whānau; perceived complexity and skill shortages; the need to prioritise communication and engagement; and services must be built on cultural safety and trust. DISCUSSION: Reasons for inadequate enrolment include poorly designed systems, limited resourcing, and inconsistent approaches. Enrolment needs to be simplified, with integrated and automated systems to reduce administrative burden for staff. Flexible whānau-centred practices can help support enrolment, engagement, and immunisation of pēpi.© 2026 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)https://creativecommons.org/licenses/by-nc-nd/4.0/childhood healthcareenrolmentgeneral practicehealth equityimmunisationprimary healthcarevaccination4203 Health Services and Systems4206 Public Health42 Health SciencesPediatric Research InitiativeClinical ResearchHealth ServicesPrimary Health Care8.1 Organisation and delivery of servicesGeneric health relevance3 Good Health and Well Being1110 Nursing1117 Public Health and Health ServicesJournal ArticleOpenAccess10.1071/HC26025