Well Child Tamariki Ora Programme: Moving Forward. Well Child Symposium: Wellington 10th November 2017

Transcription

1 Well Child Tamariki Ora Programme: Moving Forward Well Child Symposium: Wellington 10th November 2017

2 The Well Child Tamariki Ora (WCTO) Programme Delivers universal services for children from birth to five years of age Aims to: increase protective factors and reduce risks that impact on children s health, development and wellbeing provide early identification and referral to targeted specialist health, education and social services for children and families/whānau with additional needs. The WCTO Schedule 13 Scheduled Core Contacts plus Additional Contacts delivered based on need Delivered as an integrated packaged of three parallel streams: Health education and promotion Health protection and clinical assessment Family/whānau care and support. These streams incorporate the key public health concepts of supportive environments, disease prevention and health promotion.

3 Overview of Well Child Tamariki Ora Programme

4 National snapshot of 0-4 year olds in 2016 Total 0-4 years population by ethnicity and DHB 2016 (StatsNZ data) Other Maori Pacific Total 0-4 years population by level of deprivation and DHB 2016 (StatsNZ data) Q1 Q2 Q3 Q4 Q5

5 Where are our babies being born? Total number of Babies delivered for each fiscal year July to June for by DHB of domicile Highest numbers of babies born in Northern Region Around twice as many babies are being born into area of high deprivation than low and this will be cumulative over time

6 Māori and Pacific are overrepresented in the high deprivation statistics Mums identifying as Indian also show a marked gradient towards high levels of deprivation Where are our babies being born?

7 Snapshot of enrolment/non-enrolment across WCTO providers for 2016

8 Snapshot of WCTO enrolment 2016 Percentage of babies born in 2016 enrolled in WCTO Services by DHB 100.0% 95.0% 90.0% 85.0% 80.0% 75.0% 70.0% Number of Babies born 2016 not enrolled in WCTO Services by DHB

9 Key messages from research

10 Science and Clinical Advances what does this mean for WCTO Programme? Need an increased focus on: healthy brain development both in utero and in the early years and the critical function of childhood self-control for positive life outcomes WCTO Programme has a critical and cost effective role in promoting infant and parental mental and physical health and supporting the development of parenting skills and attributes Current WCTO programme schedule, service models and structure do not lend themselves to ready adaptation to respond to the evidence and emerging government priorities

11 Key messages from research from the Auckland Co-design Lab - From the Southern Initiative 1. Children s wellbeing depends on adults wellbeing 2. Toxic stress: the cumulative and prolonged weight of risk factors can rob parents of bandwidth and derail child development 3. For both parents and children, reducing immediate environmental stress makes a difference 4. Vulnerability can and does change 5. The dual importance of building executive function and offering biodegradable support 6. Putting people at the centre: applying whānau-centric and co-design approaches can unleash potential and build bandwidth 7. Protective factors can build resilience and help to balance the risk factors

12 We need to enable children to move from one stage of development to another without burden Professor Sir Peter Gluckman

13 An example of what clients are telling us Source: Quality Review of the 4-6 Week Check; Litmus 2012 (page 53)

14 WCTO Provider Development

15 Moving Forward: ensuring a fit-for-purpose service Total NZ 0-4 year olds Statistics NZ s population projections to 2037 Population Year What is the value proposition going forward? From both the government and consumer point of view How is the role and focus of WCTO changing? How can we deliver flexible services that better fit the needs of our diverse families/whānau? What does a well integrated WCTO service look like and how can we achieve it?

16 What we are hearing from Providers Putting science/research into practice Child development and the role of parenting and the environment is increasingly seen as key to ensuring a good start to life. It is important to work with women at the preconception stage WCTO is important but we need more role clarity and a workforce with high competency in psychosocial skills and child development theory and practice There is frustration at not knowing what happens to referrals from WCTO services Tackling inequity/proportionate Universalism Increased levels of homelessness increases the effort and cost required to find families Providers do what they can to target their efforts to those most in need but can be hampered by the structure of the contracts Providing a whānau ora service to high need families delivers the best results Increasing levels of provider collaboration is making a real difference in meeting the needs of families Role clarity and knowing when to refer on Who is using WCTO services? Improvements needed totransition of care from LMCs to WCTO and supporting whanau choice Complexity of need is increasing with more families requiring more time with services Building relationships and working in partnership is key to supporting families Better consumer insights into the value of WCTO are required to guide service improvements Provider Development Workforce is a key issue induction, ongoing training and professional development, post grad certificate, competencies Funding and contracting arrangements don t support the flexibility required to tailor services to different families need or incentive better collaboration and integration Information systems and ability to share data needs to improve