Media Releases

Action on immunisation of New Zealand's ‘hard-to-reach' children

1 December 1999

The National Health Committee (NHC) is delighted the principal recommendation in its package of advice on immunisation of New Zealand's ‘hard to reach' children has been accepted and is now a performance expectation of the Health Funding Authority (HFA).

“Raising our immunisation coverage to levels that will be protective for both the individual child and the whole community is probably the most cost-effective treatment available in the health sector,” says Colin Tukuitonga, a member of the National Health Committee, Senior Lecturer at the University of Auckland and an Auckland GP.

In its Review of the wisdom and fairness of the Health Funding Authority strategy for immunisation of ‘hard to reach' children – publicly available today - the NHC recommended that: The achievement of 90% coverage in all population groups by July 2003 is made a performance expectation within the accountability arrangements between the Minister of Health and the HFA – and puts forward a range of strategies to achieve this.

The National Health Committee does not underestimate the resources and energy the HFA will have to put in to achieve what it has signed up to. But the combined benefits of protecting children's health and the country's health dollars make a clear case for immunisation being one of the highest priorities of all available, says Dr Tukuitonga.

“The NHC's review shows that we need to change the way we deliver immunisation to ‘hard-to-reach' children. Conventional delivery does not work for everybody in New Zealand. Not everybody can bring their child to the doctor at an arranged time,” Dr Tukuitonga says.

The review shows that there are pockets around the country where immunisation of ‘hard to reach' children is a success. Te Hapua in the Far North – which took its immunisation level from 50% to over 90% in two years – Rotorua where the Rotorua General Practice Group and Tipu Ora operate, the Porirua Basin Medical Services Group and other providers in Porirua and the Newtown Union Health Service in south Wellington – all with levels around 90%.

The features these successful services have in common are: provider commitment; a locally developed, systematic approach; good information systems; well developed teams; culturally appropriate workers or the ability to link with appropriate community workers and a capacity to visit children at home.

“Outreach services - that is services that go to people - are the most important single action that can be taken to improve immunisation rates,” says Dr Tukuitonga. “But there are at least a dozen others - including performance incentives and increased payments - listed in the NHC's report as strategies for the HFA to consider to get better results with the immunisation of ‘hard-to-reach' children.”

The NHC is confident that the strategies it has suggested to the HFA to achieve 90-95% immunisation coverage are valid. “However, it is up to the HFA to decide how it goes about it – what matters most is that it has agreed to reach the target by 2003,” says Dr Tukuitonga.