Harti Hauora is one of the first comprehensive and equity-focused child health programmes, developed and tested in New Zealand that offers opportunistic screening, interventions and follow up packages to children in hospital.
Ditre Tamatea the executive director of Māori Health for Waikato DHB said the tool was conceived to target health priority areas for tamariki (children) that are admitted to hospital. “It was an opportunity to assess a whole range of issues rather than just the presenting problem that had led to their hospitalisation, through our admission process,” he said. “This would result in improved health outcomes for these children and part of the process would be a greater number of referrals back to primary care and community services that often had failed to engage with these tamariki and their whanau when they were in a community setting”.
The idea when first talked about did meet with some resistance as managers debated whether such a concept might be better placed in a community rather than hospital setting said Mr Tamatea but the pilot had proved the concept was successful in implementation and was an example of Waikato DHB’s Māori Health Services and Child Health services working together for the benefit of all tamariki, Māori and non-Māori alike.
Dr David Graham – clinical unit leader for Child Health endorses the programme, stating “We know that children who are admitted to hospital are far more likely to be missing out on important routine healthcare such as immunisations, dental care and GP enrolment, so their time in hospital is a really good chance to address these things. It also means their whānau get to hear about important preventative health strategies like safe sleeping and car seats, and we can often help with issues like quitting smoking and healthy housing. The programme is all about systematically making the most of opportunities to improve child health for more of our vulnerable children and whānau.”
Project managers Jade Chase (Maori Health) and Tracy Jackson (Waikids Rural & Community Health) piloted the tool in the Waikids Medical ward at Waikato Hospital earlier this year. “We know children and young people that present often to hospital may not be engaged in primary and community health services and we see this as an opportunity to facilitate this,” said Ms Jackson, who credits the success of the pilot to the wards’ leadership, its educators and clinical staff, particularly nurses, who championed the concept amongst their colleagues.
The data already shows how effective and essential the tool is. There have been vast improvements in checks and follow up actions by staff across many health areas. For instance, a file audit showed that prior to Harti Hauora, only 4.5 per cent of children had their oral health enrolment status confirmed compared to 90 per cent of children during the pilot. What is more significant is that of this percentage, 68 per cent were not enrolled and therefore required a referral to Community Oral Health Services for enrolment.
A similar trend was noted across other health areas.
“It makes you think – what would have happened to these kids if Harti Hauora didn’t exist?” said Ms Chase.
“The pilot has proved a success and is an example of Waikato DHB’s Māori Health and Waikids services working together for the benefit of all tamariki Māori and other vulnerable children” said Mr Tamatea. He feels there is scope to apply the concept of Harti Hauora Assessment in other areas such as women’s, men’s and kaumatua (elderly) health and potentially, primary care.
“Though the concept would need more resource, there is no doubt in my mind that the extension of the programme into other areas would bring great benefit.”
Mr Tamatea would like to thank all Maori Health (Te Puna Oranga) and Waikids staff involved in the pilot for their work in bringing the vision of Harti Hauora into a working reality.