Child health report fails to gain traction.
Subject: Child health services (Management)
Children (Health aspects)
Children (Management)
Pub Date: 07/01/2010
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2010 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: July, 2010 Source Volume: 16 Source Issue: 6
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Product: Product Code: 8000187 Maternal & Child Health Care; 9105264 Maternal & Child Health Programs NAICS Code: 621999 All Other Miscellaneous Ambulatory Health Care Services; 92312 Administration of Public Health Programs SIC Code: 8099 Health and allied services, not elsewhere classified
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 233291242
Full Text: A major new report on child health in New Zealand contains four key proposals to improve children's health outcomes. The Best Start in Life: Achieving effective action on child health and well-being, proposes strengthening leadership to champion child health and well-being; developing an effective whole-of-government approach for children; establishing an integrated approach to service delivery for children; and monitoring child health and well-being using an agreed set of indicators.

Investment in early childhood low

The report to Minister of Health Tony Ryall, was prepared by the Public Health Advisory Committee (PHAC) ands says New Zealand's investment in the early years is low by international standards, with early childhood spending less than half the Organisation of Economic Co-operation and Development (OECD) average. A 2009 OECD report ranked New Zealand 29th out of 30 countries for child health and safety. The PHAC report refers to the widening gaps in health status for Maori and Pacific children compared to non-Maori and non-Pacific children and points out that children in very low incomes families, children of beneficiaries and of prisoners have worse health than other children.

The Best Start in Life wants overarching legislation that sets out a long-term commitment to improve children's health and well-being to be introduced, would like to see a Minister for Children and a cross-agency Office for Children. It wants the proportion of the health budget spent on services for children aged up to six years to be increased.

It calls for a "whole-of-government" approach to child health and wants all significant government policies to be assessed for their potential impact on children.

An integrated approach to service delivery would mean services would respond to children in an integrated manner so the whole child was treated in the context of their family/whanau, rather than multiple services focusing on separate problems in an isolated manner. This would require a shift from service delivery by separate providers towards integrated delivery. This, in turn, would require a Lead agency, a flexible funding and contracting model that focused on results, workforce

development and improved information systems.

But the Ministry of Health's chief adviser, child and youth health, Pat Tuohy, said the PHAC report made high-level recommendations but gave Little detailed analysis or prioritisation. "The Ministry believes it is better to improve existing services, improve access to them and improve integration between them rather than create new structures and processes. The health sector has already demonstrated that concerted attention to an issue can be very effective. New Zealand has this year for the first time achieved an 85 percent immunisation rate in two-year-olds through its health targets," he said.

Of the 21 recommendations in the report, 15 are already underway to some extent, according to Tuohy. Specific examples include changes to well child/tamariki ora which will increase focus on infant-parent relationships and attachment to prevent maltreatment, as well as training and guidance to enable well-child nurses to effectively identify and refer children experiencing or at risk of maltreatment. Cross-government work programmes include whanau ora which aims to increase integration in health and social service delivery across government and give New Zealand families a more seamless service.
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