Health is one of the key areas affecting a child’s development, with repercussions for almost every other area of life including education, employment, justice and family connectedness. In order to identify priorities for action in child and youth health, the Children’s Commissioner contracted a review of child and youth health strategic documents published from 2000 to 2005. This review was undertaken by Auckland University of Technology (AUT).
The review produced by AUT signals that there are significant areas of concern in Aotearoa New Zealand concerning the extent to which our children enjoy their right to good health and health care. These concerns can be summarised as:
• Evidence of poor health, with unacceptable rates of certain conditions and causes of death, illness and impairment.
• Evidence of disparities in health status, indicative of determinants of health which lead to systematic disadvantage for some groups of children and young people.
• Evidence that children and young people are often unable to access appropriate and affordable health services.
Action to enable every New Zealand child to enjoy their right to good health and health care will require commitment from the highest level, with an appropriate allocation of vote health, commitment of resources and personnel, recruitment and retention of a skilled workforce, and recognition of the real health challenges facing our children and youth.
Methodology
This review was confined to published reports or articles. An initial search for publications was undertaken using the Multisearch search engine using the keywords “child health and New Zealand” and the key issues identified in the Blaiklock report e.g. “SIDS” with a limiter of post 2000 publications. In addition, the following websites were accessed to identify and locate relevant post 2000 publications: Ministry of Health, All District Health Boards, Ministry of Youth Development, and New Zealand Health Information Service. Other child health associated websites were also accessed, however most made reference to publications already identified. Over 80 publications were located and these were reduced to 48 publications with direct relevance to the review. The research team recognise that this is by no means an exhaustive list of the relevant publications and the research team is aware that there may be many other publications and reports which may have been relevant which have not been included. However given the time constraints and the fact that reoccurring themes were emerging, it was felt that these documents were representative of the current research, debate and discussion around child health issues in New Zealand post 2000. Multisearch (Health Care) undertakes a search of all of the following databases: AHMED, CINAHL, Healthbusiness Full Text, Health Source Nursing/Academic, Infotrac One File, Proquest Health and Medical Complete, PsycINFO, PubMed, Springer and land University of Technology library catalogue. Each article was reviewed by a member of the research team, specifically identifying the key issues, common themes, evidence of effective strategies, where progress is or is not being made, and the gaps or areas still requiring action. These publications were then brought together, themes identified and then discussed in relation to the earlier Blaiklock (2000) paper. The following section outlines the key issues as identified in this review.
Key Results
Recommendations:
1. Advocacy for continued action on addressing the inequalities in health outcomes for New Zealand children. This should include action in relation to relation to:
• Socio-economic policies which impact on children’s health.
• Avoidable hospitalisation.
• Full implementation of the Children’s Agenda.
2. Advocacy for a health service which is responsive to the needs of children, including:
• Full implementation of the Child Health Strategy.
• Implementation of the Health and Disability Standards (Children and Young People) across all health services which provide care to children.
• The development of a Child Health Strategy and Action Plan for all District Health Boards and Primary Health Organisations which are measurable and have within them a plan for ongoing evaluation.
• Programmes and strategies to ensure that the views of children and youth are considered at all levels of the health care service including policy and planning.
• Services that are acceptable and accessible to children, youth and their families.
3. Advocacy for a less fragmented and more co-ordinated approach to health care delivery to children, including:
• Full implementation of the Child Information Strategy.
• Strategies which ensure seamless delivery of services across primary, secondary and tertiary services in all areas of New Zealand.
• Strategies which ensure a co-ordinated whole child approach to health care.
• Greater co-operation and co-ordination of strategies and actions between government ministries, District Health Boards, Primary Health Organisations and other organisations whose work affects children’s health.
4. Advocacy for a healthy environment for the children of New Zealand, including:
• Strategies related children’s diet and exercise.
• Family violence and violence against children.
• Immunisation programmes.
• Strategies that ensure the psychosocial wellbeing of children.