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Informing the review of the Well Child Tamariki Ora programme

Poipoia te kakano, hei puawai
Nurture the seed so that it may flourish

Why was the project important? 

The first 1,000 days of a child’s life lay the foundations for their entire future. The Well Child Tamariki Ora (WCTO) Programme aims to nurture pēpi, tamariki and whānau around them from birth to five years. Enhancing the health and development of tamariki makes a significant contribution to a child’s lifelong health, wellbeing, education and social outcomes.

In 2019/2020, the Ministry reviewed the Well Child Tamariki Ora programme to ensure it was delivering the best possible outcomes for all tamariki and their whānau.

As part of the review, the Ministry commissioned Litmus and our Māori partners to do a literature review and qualitative research with whānau Māori to inform the review.

The process we took and the people we worked with

We worked with our Māori partners to complete the literature review and the research. The qualitative research gained insight into whānau Māori moemoeā for pēpi/tamariki health and wellbeing, and the support and interventions that enable their aspirations. We worked with Māori community connectors to enable whānau Māori to take part in the research. Sixty-four whānau Māori and 11 Māori leaders across six locations participated in the research. Whānau Māori feedback demonstrated the current WCTO programme design and delivery does not enable whānau Māori moemoeā of pae ora.

The literature review identified the design features of indigenous models of care for child health and wellbeing, which increase enrolment, engagement, participation and retention over time to improve equity outcomes for indigenous peoples. The literature highlighted the need for the programme to be based on mātauranga Māori, to have Māori governance and leadership, to work in partnership with communities and be culturally safe.

What we delivered 

We delivered two reports to the Ministry of Health that demonstrated the need to redesign the WCTO programme to enable the Ministry of Health’s expression of Te Tiriti o Waitangi. The Ministry of Health used the reports’ insights and other work to inform the review findings. The review found the WCTO programme was not meeting the changing and complex needs of whānau, it was inequitable and was not well integrated into other health, social and early learning services.

The review recommended the WCTO programme be designed, delivered and resourced to promote equity for pēpi, tamariki and whānau who are Māori, Pacific, have disabilities, are in state care or have high needs. The review recommended transforming the WCTO programme to a whānau-centred system of integrated early years services and support. The change also needs to retain and strengthen the universal components to support the health and development of all New Zealand tamariki.