1 May 2018: The Government announced in January 2018 that the Better Public Services programme would not continue in this form. These pages have been archived.

Results 2-3

Result 2: Healthy mums and babies

What is the target?

By 2021, 90% of pregnant women are registered with a Lead Maternity Carer in the first trimester, with an interim target of 80% by 2019, with equitable rates for all population groups.

Why is this important for New Zealand?

Early and continued regular engagement with a Lead Maternity Carer (usually a midwife) is associated with normal healthy births and better pregnancy outcomes. 

Having a Lead Maternity Carer helps set up children for a good start in life. Lead Maternity Carers also connect mother and child with other core health services, such as general practice, immunisation, Well Child Tamariki Ora, and oral health services. They connect families to other social services that may be needed.

How will we know we are achieving this result?

Currently about 67% of all women who give birth register with a Lead Maternity Carer in the first trimester of their pregnancy. Rates of first trimester registration vary widely according to age, deprivation, ethnic group and geographical location.

For example, in 2015:

  • 39% of Pacific women, and 55% of 55% women, registered with a Lead Maternity Carer in the first trimester
  • 54% of women living in areas of high deprivation registered with a Lead Maternity Carer in the first trimester, compared with 76% of women living in the least deprived areas
  • 50% of pregnant women under 20 years of age registered in the first trimester, compared with 72% of women in the 30-39 years age group.

We will know we are achieving Result 2 when the overall rates of first trimester registrations are going up, and the disparities that exist between the population groups are reducing.

What are we doing to achieve this result?

We have a number of priority actions underway or planned that will contribute to healthy mums and babies. These include:

  • Work with maternity providers, District Health Boards and others to ensure all pregnant women have access to maternity services provided by Lead Maternity Carers
  • Work with District Health Boards and stakeholders to explore primary/community service models that improve the availability of preventive initiatives, and access to services, for pregnant women
  • Work with District Health Boards and their district alliance partners to improve outcomes for pregnant women and children by continuing to implement the System Level Measures. The System Level Measures are an improvement framework that concentrates on improving core health outcomes, with a particular focus on equity. Initiatives that impact on the health and wellbeing of pregnant women and babies include:
    • Increasing the number of women registering with a Lead Maternity Carer in the first trimester
    • Improving pre-conception health and wellbeing by increasing youth access to, and utilisation of, youth appropriate health services. These include sexual and reproductive health, mental health and wellbeing, and alcohol and other drug treatment services
    • Improving maternal immunisation rates
    • Increasing the rates of babies living in smoke-free households
  • Implement the Fetal Alcohol Spectrum Disorder (FASD) Action Plan, a comprehensive set of cross-government actions to prevent FASD. The Plan includes expanding the pregnancy and parenting services for women with addictions. It includes actions to identify and support children affected by FASD 
  • Work with experts and stakeholders to develop a National Sudden Unexpected Death in Infancy Prevention Programme. This ensures every infant and their family is provided with comprehensive and customised safe sleep information, with follow up support.

Result 3: Keeping kids healthy

What is the target?

By 2021, a 25% reduction in hospital admission rates for a selected group of avoidable conditions in children aged 0 - 12 years, with an interim target of 15% by 2019.

Why is this important for New Zealand?

We want to keep kids healthy and out of hospital. Some hospital admissions could be avoided by government agencies and providers working together to influence the underlying determinants of health. By intervening early, we can stop conditions getting worse to the point where hospitalisation is needed. These avoidable hospitalisations include dental conditions, respiratory conditions (such as bronchiolitis, pneumonia, asthma and wheeze), skin conditions (such as skin infections, dermatitis and eczema), and head injuries.

How will we know we are achieving this result?

In 2015/16, there were 40.3 avoidable hospitalisations per 1,000 children aged 0-12 from selected conditions chosen for the Better Public Services programme. 

Rates of avoidable hospitalisation vary by health condition but are significantly higher for higher children, Pacific children, and socio-economically deprived children.

For example, in 2015/16 in children (0-12 years) had a rate of 13.1 avoidable dental hospitalisations per 1,000, and Pacific children a rate 13.4, compared with a rate of 7.5 avoidable dental hospitalisations for hospitalisations and non-Pacific children. 

We will know we are achieving Result 3 when the overall rate of avoidable hospitalisations is reducing, and the disparities that exist between the population groups are reducing.

What are we doing to achieve this result?

We have a number of priority actions underway or planned that will contribute to keeping kids healthy. These include:

  • Work with District Health Boards and stakeholders to explore primary/community service models that improve the availability of preventive initiatives, and access to services, for children
  • Work with District Health Boards and other agencies to improve the availability of, and access to, appropriate housing
  • Work across government agencies, and with Well Child Tamariki Ora services and other providers, to develop head injury prevention actions
  • Promote good oral health to parents and children in high need communities
  • Continue to support water fluoridation in communities
  • Work with District Health Boards and their district alliance partners to improve outcomes for pregnant women and children through continuing to implement the System Level Measures. The System Level Measures are an improvement framework that concentrates on improving core health outcomes, with a particular focus on equity. Initiatives that impact on the health and wellbeing of children include:
    • Implementing prevention and early treatment of respiratory conditions in the community
    • Improving child immunisation rates, and
    • Improving children’s attendance at dental clinics
  • Review the Well Child Tamariki Ora programme to ensure it aligns with the evidence about what works, reflects key priorities, and is able to be delivered in sufficient intensity to meet the needs of pregnant women, children, families and families the New Zealand childhood obesity programme — a multi-agency programme to equitably reduce childhood obesity in New Zealand, so that children and young people can live well and stay well.

The Delivering Better Public Services: A Good Start to Life Result Action Plan sets out the Government’s plans for achieving Better Public Service Results 2 and 3. The overall aim is to ensure that every child in New Zealand gets a good start to life. You can view the plan on the Ministry of Health website www.health.govt.nz/publication/delivering-better-public-services-good-start-life.

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