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Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

Gender disparity is a global phenomenon where females outnumber male participants. It has been observed that males are the early leaver from higher education, thus reflecting a severe concern about social instability. Malaysia is a prominent example where females outnumber males in higher education. In this context, this paper aims to examine the effect of individual, social and financial factors on the higher education self-efficacy of male and female students. It develops a comprehensive understanding of gender-based decision factors in pursuing higher education.

The hypothesis was formed based on a comprehensive literature review following the hypothetico-deductive positivist approach. These hypotheses were tested based on a sample of 250 respondents. A multiple regression analysis was deployed to test the relationship between the dependent variable and its predictors.

The results suggest that male and female students’ self-efficacy depends on five determinants, i.e. family influence, peer influence, career expectancy outcome, gender roles and institutional factors. Male students tend to be influenced more by these five determinants than females. Additionally, male students with better financial backgrounds are more likely to have higher self-efficacy, whereas gender roles negatively affect male and female students’ self-efficacy for higher education.

The breakout of COVID-19 resulted in the selection of limited students in Malaysia. Due to restricted movement orders, it was impossible to reach out to the students for data collection. Future research could include a broader area to include multiple other regions of Malaysia. For a broader aspect, the study could be conducted in other areas/countries where the problem of less male participation exists.

The relationship between higher education self-efficacy is assessed with social, financial and institutional factors for male and female students. It will enable the stakeholders and policymakers to make better decisions in increasing the self-efficacy of students to attain equity in higher education institutions.

The finding of this paper will assist in increasing male participation in higher education institutions to avoid any social instability.

This paper contributes to the literature in understanding the causes of gender gap reversal, focusing on Malaysian higher education institutions. It also provides empirical evidence to look at potential factors that affect the higher education self-efficacy of male and female students.