Children's health programme success | Hawkes Bay News | Local News in Hawkes Bay

Good planning, using established community relationships and health partnerships, along with dogged determination, have helped carve out a successful children's health programme in Hawke's Bay.

The Ministry of Health's B4SC programme, launched three years ago, aims to identify health, behavioural and social developmental issues in at-risk 4-year-olds which, if not treated, may impact on their learning and educational opportunities.

The first five years of life are critical for future health and wellbeing and evidence suggests early childhood intervention programmes have a higher success rate in younger children.

When the Hawke's Bay Primary Health Organisation (PHO), now called Health Hawke's Bay, won the contract to deliver B4SC services for the region, a clinical advisory group (CAG) was formed, said Hawke's Bay paediatrician Russell Wills.

"Everyone agreed, if they were going to do it - they would do it properly, and the programme wouldn't start until the team were ready and a good framework was in place.

"We looked at the community as a whole and how we think in Hawke's Bay - the family networks involved and our ability to access homes."

The Hawke's Bay programme is successful because of the collaborative partnerships formed between service providers and registered nurses and then using social services connecting with these families - Birthright, Family Works, the Napier Family Centre, Special Education, Child Youth and Family, which are all successful entities in their own right, Dr Wills said.

Crucial to this is the strength of the programme database.

"We are aware when children haven't received their checks, and the Health Hawke's Bay staff are relentless at following up to make sure they get their checks.

"The B4SC team won't give up until the check is complete, every attendance referred on and every need met.

"Our motto, 'no child left behind - no parent stands alone', these are the core values of the programme."

Some families often live very busy and chaotic lives and don't prioritise preventive care.

Dr Wills recalls the case of a community worker who made 11 attempts to find a child, before finally catching him at home.

"The nurse zipped straight around and spent two hours with the family, found a number of things that needed doing for him and is now making sure he gets them all done."

Over three years we have learnt a lot about how you get in touch with these "hard to reach" families, who often lead mobile lives or may have major social issues.

"This is a nurse-led service, so it's important the nurses, where possible, are known to the families and the families trust the relationship.

"Making a promise and keeping it - that's how you build trust.

"And by using Maori and Pacific Island nurses who are well connected in these communities and can take the service to their own homes and marae."

Dr Wills calls them the heroes; the people in the heat of it - the nurses and others who work in the programmes.

"I'm so proud of the way they connect with these very poor families and gain their trust and get them to the referral agencies," he said.

Recognising the importance of engaging families and communities, Health Hawke's Bay contracted a community support worker to work closely with the contracted independent nurses who link these services with high needs families.

Being able to reach the poorest fifth of children has contributed to the success.

Three years ago, three quarters of the children in this bracket were visited.

The figure has risen 5 per cent annually and reached 85 per cent last year.

Intervention is not restricted to the child.

If a parent's behaviour is adverse to a child's development the parents are supported and offered help, maybe parenting courses.

"It's not all bad parenting. There are all sorts of reasons kids have severe behaviour disturbances - some kids have a difficult temperament or suffer from foetal alcohol exposure [from their mother drinking alcohol while pregnant], or they may have been raised by multiple families and been in foster care."

The check is voluntary and families are entitled to say no. But once you reach them, very few parents refuse help and are almost happy to have their children looked at, Dr Wills said.

The proof of the programme was the high number of children who had been referred on to specialists, particularly with development and behavioural issues.

"When we follow these children through to school entry, at 5 years old, they no longer have the problems, because of the interventions put in place in the previous year.

"Seeing the right kids, finding the right things and putting them right are what we do," he said.