Better results for tamariki

15 June 2017

Polly AC
Drs Polly Atatoa Carr, Nina Scott and Bridgette Masters-Awatere, working to improve health outcomes for tamariki Māori.

A new study involving University of Waikato and Waikato Hospital staff will evaluate if an organised holistic approach improves health and wellbeing outcomes for Māori children admitted to hospital.

The Health Research Council-funded study, worth $933,933 over three years, was one of 51 announced in the latest round of HRC funding. Dr Nina Scott (Waikato, Ngāti Whatua), a public health physician at Te Puna Oranga – Māori health, Waikato District Health Board, will lead the study, working with public health physician Associate Professor Polly Atatoa Carr and community psychologist Dr Bridgette Masters-Awatere from the University of Waikato, public health physician Dr Peter Sandiford, and a Waikato District Health Board team.

The study follows on from a health screening tool developed in 2015 called ‘Harti Hauora Tamariki’ which was piloted at Waikato Hospital to improve access to health and social services for Māori children admitted to hospital and their whanau, and which is still being used.

The Waikato district has about 29,000 Māori children, more than any other district health board in New Zealand. The tool was based on whānau ora concepts and contains a set of screening questions that place whānau at the centre of service delivery, which requires the integration of health, education and social services.

It was developed by Te Puna Oranga and Waikids – Waikato District Health Board’s child and youth services – and has been used to assess more than 5000 children and their whānau/families admitted to Waikato Hospital and Dr Scott says there is widespread interest in the tool from other services, hospitals and DHBs.

Taking an holistic approach

The tool includes protocols to follow up on any identified area of need, such as enrolment with education and health providers, rheumatic fever prevention, quality quit smoking interventions for whānau, access to appropriate housing, and safe sleep devices like wahakura.

One of the drivers for the development of the tool was the recognition that a large proportion of tamariki Māori aged zero to four who were admitted to hospital were being readmitted – usually with similar illnesses, within months of going home.

“We like to think that hospitals provide the best care, especially for our children, and that the health sector will do what’s required to ensure tamariki Māori do not have to return to hospital with the same or another preventable condition within a few weeks or months,” says Dr Scott.

“Unfortunately, hospital and health sector staff don’t yet have the tools to consistently provide essential and basic preventative health care and every year hundreds of tamariki Māori are being hospitalised with preventable illnesses, then re-hospitalised with similar diseases – we are not yet adequately treating the root causes of disease.”

For this new study, a randomised controlled trial has been designed to determine to what extent the tool is making a difference to Māori children’s wellbeing in the district.

Dr Atatoa Carr says the new study will show the effects of follow-up actions from Harti Hauora Tamariki screening and the effects on child health outcomes, including hospital re-admission rates, whānau wellbeing and whānau satisfaction with care. “It’s crucial to know this information before we further develop the tool and roll it out on a wider scale.”

Dr Masters-Awatere says interviews with nurses and Māori whānau will help identify barriers to both providing and accessing preventative care. “It will also help to gain insights into the effects of the tool, which will provide valuable information for the development of future health and social policy and services,” she says.