|Well Child atlas single map (updated using September 2016 data)|
The Well Child/Tamariki Ora Atlas is an online tool that gives clinicians, patients and providers a clear overview of how early childhood health services work for children and their families.
Well Child/Tamariki Ora (WCTO) is a series of free health assessments and support services offered to all New Zealand children from birth to five years.
Reviews of WCTO in 2007/08 and 2012 identified variable clinical practice, service quality and health outcomes, and recommended that an evidence-based quality framework be developed to ensure the programme consistently achieves its aims.
In response, the Ministry of Health and sector expert advisors worked in partnership to draw on research from New Zealand and internationally to develop the WCTO quality improvement framework.
The framework’s three high-level aims focus on family/whānau experience, population health, and best value for the health system’s resources. It also sets quality indicators to monitor health system performance, driving improvement in WCTO services and supporting the programme to give children a strong foundation for ongoing healthy development.
The targets presented in this Atlas are not Health Quality & Safety Commission targets, but Ministry of Health targets for the quality indicators. These targets were set using existing national targets, where available, or by agreeing them with the Ministry of Health’s expert advisory group.
The Atlas features easy-to-use maps, graphs and tables that pull together data on the 27 quality indicators. They show how services are performing in different parts of New Zealand, and identify areas where improvements are needed to better support children and their families/whānau.
Data sources and method
The quality indicators draw on existing national data collections, such as the Ministry of Health’s PHO Enrolment Collection, the National Immunisation Register, the National Maternity Collection and the B4 School Check information system. They also use data from Plunket and the Ministry of Education.
Where available, count data is provided on the tables, and confidence intervals are calculated.
Targets for the quality indicators either reflect national targets set by other monitoring frameworks and processes or were developed by the Ministry of Health’s expert advisory group. Targets presented on the atlas pages are for December 2014.
Wide variation was observed for the following indicators (in order variation):
- Indicator 27: Children with a body mass index (BMI) >98th percentile are referred (range = 26.3–86.2 percent)
- Indicator 23: Children assessed by parental evaluation of development status (PEDS) as Pathway A are referred for care (range = 23–78.7 percent)
- Indicator 21: Children started the B4 School Check by 4 ½ years (range = 48.6–96.6 percent)
- Indicator 5: Preschool children enrolled with oral health services (range = 61.3–100 percent)
- Indicator 20: Children living in a smoke-free home at four years old (range = 61.8–100 percent)
- Indicator 16: Children are caries-free at five years (range 34 – 68 percent)
- Indicator 19: Mothers were smoke-free two weeks postnatal (range = 68.9–97.3 percent)
The following indicators have means which are significantly below the June 2016 targets:
- Indicator 1: Babies enrolled with a primary health organisation (PHO) by three months of age
- Indicator 3: Babies receive all Well Child/Tamariki Ora core contacts in their first year
- Indicator 5: Children are enrolled with child oral health services
- Indicator 23: Children assessed by parental evaluation of development status (PEDS) as Pathway A are referred for care
The variation may indicate that the outliers have issues with data quality or it may be a true variation, in which case we recommend local analysis to explore the reasons for the variation.
The following indicators were close to meeting the June 2016 target for many DHBs:
- Indicator 8: Children under six years have access to free primary care
- Indicator 9: Children under six years have access to free after-hours primary care
- Indicator 10: Children are seen promptly by specialist services
- Indicator 17: The burden of dental decay is minimised
- Indicator 18: Child mental health is supported
- Indicator 24: Children with a lift the lip (oral health) score of 2-6 are referred
In this latest report all district health boards (DHBs) achieved 100 percent for the following indicators and as there is no variation are not presented on the Atlas:
- Indicator 22: Children with an abnormal SDQ-P score are referred
- Indicator 25: Children with an untreated vision problem are referred
- Indicator 26: Children with an untreated hearing problem are referred.