Person-centered maternity services in New Zealand: a practice development initiative to improve the health of pregnant women and infants.

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Published: Sep 30, 2011
DOI: https://doi.org/10.5750/ijpcm.v1i3.124

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Karen J. Hoare
Lecturer and Nurse Practitioner, Department of General Practice and Primary Health Care and School of Nursing, University of Auckland, Auckland, New Zealand
Tana Fishman
Senior Lecturer and General Practitioner, Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
Karen Francis
Head of School of Nursing, Midwifery and Indigenous Health, Charles Stuart University, Wagga Wagga, New South Wales, Australia
Jane Mills
Senior Lecturer and Deputry Head of School Cairns Campus, School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Queensland, Australia

Abstract

Rationale, aims and objectives: Primary health care and maternity services in New Zealand are delivered via independent self-employed practitioners and separate organisations with no requirement to co-ordinate care. There are disparate immunisation timeliness and rates between ethnic groups. The aim of this practice development initiative is to improve the health of pregnant women and infants. The objectives are to link the general practice enrolled pregnant women with a midwife on confirmation of their pregnancy, record the date of delivery in the general practice notes, enrol the infant with the general practice shortly after birth and so increase the timeliness and rates of immunisations.Methods: Following an initial audit, information is now recorded on the engagement of pregnant women with a midwife in early pregnancy. Contact is made with the midwife and recorded in the general practice notes around the expected delivery date. An invitation to enrol the infant with the general practice is sent to the family four weeks post natal. Immunisation timeliness and rates of infants are audited monthly. Results: Details of the midwife were recorded in the notes of 59 out of a total of 63 pregnant women during 2010, illustrating that the new model of care had been adhered to for the majority of pregnant women. Monthly immunisation timeliness and rates of 94 – 100% were achieved January 2010 – December 2010 in infants six weeks – 6 months old. Conclusion: Primary care can be re-shaped in South Auckland by following international models to facilitate engagement of pregnant women with a midwife and increase immunisation timeliness and rates of infants.

Article Details

Issue
Vol. 1 No. 3 (2011): September
Section
Regular Articles

References

Hambidge, S.J., Phibbs, S.L., Chandramouli, V., Fairclough, D. & Steiner, J.F. (2009). A stepped intervention increases well-child care and immunization rates in a disadvantaged population. Pediatrics 124 (2), 455-464.

Ajwani, S., Blakely, T., Robson, B., Tobias, M. & Bonne, M. (2003). Decades of Disparity: Ethnic Mortality. Trends in New Zealand 1980–1999 Wellington: University of Otago.

Guyer, B., Hughart, N., Holt, E., Ross, A., Stanton, B., Keane, V., Bonner, N., Dwyer, D.M. & Cwi, J.S. (1994). Immunization coverage and its relationship to preventive health care visits among inner-city children in Baltimore. Pediatrics 94 (1), 53-58.

Cowley, S., (Ed.). (2008). Community public health in policy and practice. Philadelphia: Elsevier.

Ministry of Health. (2010). [cited 2011 6 Jan]. National Immunisation Register. Available from: http://www.moh.govt.nz/nir.

BPAC. (2010). [cited 2010 7 Oct]. Immunisation in children by age two years. Available from: http://www.bpac.org.nz/magazine/2010/july/immunisation.asp.

Grant, C., Roberts, M. & Scragg, R. (2003). Delayed immunisation and risk of pertussis in infants: unmatched case-control study. British Medical Journal 326 (7394), 852-853.

Grant, C., Turner, N. & York, D. (2010). Factors associated with immunisation coverage and timeliness in New Zealand. British Journal of General Practice 60 (572), 113-120.

Ministry of Health Wellington: Ministry of Health. (2010). [cited 2010 7th October ]. Primary Health Care. Available from: http://www.moh.govt.nz/primaryhealthcare.

Ministry of Health Wellington: Ministry of Health. (2010). [cited 2010 7 October 2010]. Primary Health care. Capitation Rates from 1 July 2010. Available from: http://www.moh.govt.nz/moh.nsf/indexmh/phcs-funding-capitation-rates#verylow.

Salmond, C., Crampton, P. & Atkinson, J. (2007). NZDep06 Index of Deprivation. Wellington: Department of Public Health, University of Otago.

Statistics New Zealand. (2009). [cited 2010 8th October]. Manurewa. Available from: http://search.stats.govt.nz/search?w=Manurewa.

Counties Manukau District Health Board. (2007). [cited 2010 26 Nov]. Primary Health Care Plan 2007 - 2010. Available from: http://www.cmdhb.org.nz/about_cmdhb/planning/Primary-Care-Plan/CMDHB-PHCplan-2007-2010.pdf.

Counties Manukau District Health Board. (2008). [cited 2010 26 Nov]. Our localities. Available from: http://www.cmdhb.org.nz/about_cmdhb/overview/Our-Localities/1.1Population-size-composition.htm.

UNICEF. (2001). A league table of teenage births in rich nations. Florence, Italy: Innocenti Research Centre.

Paterson, J., Schluter, P., Percival, T. & Carter, S. (2006). Immunisation of a cohort Pacific children living in New Zealand over the first 2 years of life. Vaccine 24, 4883-4889.

Acheson, D. (1988). Public health in England:the report of the committee of inquiry into the future development of the public health function. London: HMSO.

Department of Health. (2007). Facing the future. A review of the role of health visitors. London.

Jacobson, V. & Szilagyi, P. (2005). Patient reminder and patient recall systems to improve immunization rates. Cochrane Database of Systematic Reviews CD003941. 20 (3).

Nursing Council of New Zealand. (2008). [cited 2010 7 Oct]. Nurse Practitioner - Scope of Practice. Available from: http://www.nursingcouncil.org.nz/index.cfm/1,41,0,0,html/Nurse-Practitioner.

Ministry of Health. Immunisation Handbook. (2011). Wellington: Ministry of Health.

Rosenthal, T. (2008). The medical home: Growing evidence to support a new approach to primary care. Journal of the American Board of Family Medicine 21 (5), 427-440.

Gergen, K.J. (2009). An invitation to social construction. 2nd ed. London: Sage Publications Ltd.

Raskin, J. (2008). The evolution of constructivism. Journal of Constructivist Psychology 21, 1-24.

NHS. (2008). [cited 2010 26 Nov]. NHS Choices. Available from: http://www.nhs.uk/Tools/Pages/NHSTimeline.aspx.

Sia, C., Tonniges, T., Osterhus, E. & Taba, S. History of the medical home concept. Pediatrics 113 (Supplement 5), 1473-1478.

Lantz, P.M., Lichtenstein, R.L. & Pollack, H. (2007). Health policy approaches to population health: the limits of medicalization. Health Affairs 26, 1253-1257.