Health Initiatives for Increased Immunisation in New Zealand

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Running head: INCREASED IMMUNISATION
Increased immunisation
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1INCREASED IMMUNISATION
Table of Contents
Summary......................................................................................................................................2
Brief introduction to the topic..........................................................................................................2
Key aspects of the recommendation................................................................................................2
Rationale supporting proposal.........................................................................................................2
Background of the topic...............................................................................................................3
Target group and description of the health initiative..................................................................3
Critical discussion to support the initiative..................................................................................4
Recommendation and future scope..............................................................................................5
References....................................................................................................................................7
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Summary
Brief introduction to the topic
The current topics access the health scenario of the Bay of Plenty (BOP) province of New
Zealand with reference to increased immunisation programs. The study and the regional statistics
shows that the region is comparatively low with respect to the availability of primary health care
services. This is particularly found in the Maori and Pacific ethnicity and could be attributed to
low economic condition and lack of sufficient knowledge. These people are low on the
immunisation rates which possess a greater risk to the surrounding population as a whole. The
greater rates of immunisation have been found to lower the risk of transmission of highly
contagious infections.
Key aspects of the recommendation
In this respect, a number of recommendations have been suggested for the target
population group such as the promulgation of sufficient amount of health literacy channels with
special emphasis upon immunisation programs. Additionally, sufficient policies and
documentation could also help in highlighting the exact figures about the deprived population.
The documentation also helps in formulating important policies and procedures which can
provide future assistance to the target population.
Rationale supporting proposal
The proposal has been drafted in accordance with the national immunization register
which notices a sharp gap in the immunization rates of the overall New Zealand population and
the BOP residents in particular.
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Background of the topic
The current topic focuses on the concept of the importance of governance structure and
policies in ensuring optimum health services for individuals, communities and families living
within a region. For the current study, the governance structure of New Zealand has been taken
into consideration. In this context, a target population size has been selected for the
implementation of a particular health initiative within the population. The health initiative
chosen for the current study is increased immunisation. The topic has been further narrowed
down by focussing upon a particular region within the New Zealand continent. The region
chosen over here is the Bay of Plenty (BOP) which is a large open bay located on the Northern
coast of New Zealand’s northern island. It stretches from the Coromandel Peninsula in the west
to cape way Runaway in the east and spans for over 259 km open coastline. The current topic
focuses on the health and immunisation requirements of New Zealand. As per reports and
evidence, poverty and lack of sufficient knowledge are some of the factors which hold back
majority of the population from getting immunised.
Target group and description of the health initiative
The three major areas have been identified in the BOP which requires rapid immunisation
such as children less than 2 years including premature babies and neonates, pregnant women,
immune-compromised patients. The New Zealand health department plans to achieve 95 %
vaccination rates (Ashton, 2015). In this respect, effective policy implementation helps for
arching an overall target of 95 %. This helps in reaching a stage known as ‘herd immunity’,
through a gap of 5% remains. This could be attributed to several factors such as poverty, lack of
education or other serious health conditions where an individual cannot handle a vaccine. This is
particularly relatable in context of an individual receiving treatment for cancer care.
The government of New Zealand aims for the achievement of a 100 % immunised
populations. However, a number of challenges are faced where the population is not aware of the
health benefits of vaccination. The Bop region is far from reaching the 100 % immunization
rates due to two particular groups of people the deprived and the objectioners ("About the
Ministry", 2017). As commented by Palmer et al., (2016), the objectioners not only risk the
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4INCREASED IMMUNISATION
health prospects of their own children but of the community as a whole by and large. A number
of health initiatives are undertaken by the New Zealand Government over here. These are
maintaining a national immunization register introduced in 2005 to provide 80% coverage to
children aged six months. The register helps in keeping track of the important vaccination doses
to be delivered to the children. As mentioned by Le Menach et al., (2014), active documentation
helps in preventing missing of vaccine doses. Additionally, implementation of evidence-based
communication approaches can also help in educating the parents sufficiently about the
vaccination and immunisation programs and their benefits (Harris, Cormack & Stanley, 2013).
Reports and evidence suggest that 5 % of the parents are still unsure about the benefits providing
vaccination can do to the health of their children.
Critical discussion to support the initiative
The bay of plenty harbours the Maori and Pacific ethnicity people who had been most
deprived in receiving supportive care. This could be attributed to a number of factors such
poverty and limited access to health care services. These people do not get timely access to
health care services due to remote location. As per reports and evidence, the Maori people are
more connected to their spiritual faith and beliefs. The cultural beliefs and paradoxes possessed
by such people often limit them from approaching the basic health services (Harvey, Reissland,
& Mason, 2015). The current health scenario with respect to the Maori and Pacific ethnicity can
be discussed with reference deprivation of health care services.
The deprivation could be attributed to a number of causes such as relatively high cost
charged by the general physicians, which prevent them from consulting about the vaccination
requirements of their children. Additionally, lack of support and unavailability of health care
centres within near location also contributes towards the immunisation targets not being met
(Clark, Templeton & McNicholas, 2013). As per the health reports two in five (39%), Maori
residents have experienced unmet need for access to primary health care services (Filoche et al.,
2013). The rates have been comparatively higher in women and children. As commented by
Turner, Charania, Chong, Stewart, & Taylor (2017), inadequately vaccinated children have often
been seen to contradict more lethal and serious health conditions in the future. The child
immunisation records as presented by the national immunisation register shows that in 2014 and
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5INCREASED IMMUNISATION
at the age of 8 months, 88.9 % of Maori children had completed the required doses of
immunisation compared to the herd immunity target of 95 % ("About the Ministry", 2017). As
per the recorded data by 2 years of age 91.9 % of the Maori children aged 2 years were
vaccinated compared to the overall New Zealand score of 92.8% (Hobbs et al., 2017). Therefore,
consecutive gaps were recorded which calls for more awareness and support from the parent of
the government.
Further data collection and analysis puts more emphasis upon exact documentation along
with placing more stress upon communicating the exact health information. However as argued
by Blakely et al., (2014), the government has been implementing sufficient reforms on its part
for improving the health condition of the Maori women and young girls. Provided the
deprivation of health advocacy and knowledge the government decided to introduce free of cost
Human papillomavirus immunisation (HPV) programs for young girls till the age of 20 ("About
the Ministry", 2017). This was done to reduce the risk of cervical cancer and other HPV related
disease later in life. On the contrary, the rates covered for the Maori people living in BOP were
much higher compared to the New Zealand mainland (Phillips et al., 2017). Therefore, on
comparing the represented data we can decipher that a combined participation of the local and
the federal level government agencies are required to achieve maximum possible health targets.
Recommendation and future scope
The current study focussed upon the different loopholes within the health care system of
the New Zealand government. In this respect, special reference has been given to the people
residing in the bay of plenty region and who have limited access to health services. The
unavailability of sufficient health care services had been further divided based upon particular
group people such as the deprived and the objectioners. The proposal highlights the issues faced
by the different groups of people. A large portion of the population is still sceptical about the
health benefits of the vaccine. Thus, in my opinion, incorporation of sufficient health advocacy
strategies by the New Zealand government, Department of health could be beneficial.
Additionally, poverty and high cost of health services are other hindrances in the equitable
distribution of health services. Therefore, the management team of local and regional health care
services need to conducts surveys highlighting the barriers faced by the Maori and the Pacific
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ethnicity people dwelling in BOP in availing the healthcare services. In this respect, the data
could be collected with the help of conducting with the help of an SBAR tool (S-situation, B-
background, A-assessment and R-recommendation.
The data collected could be compiled into government health reports, which helps in
focussing upon some important issues such as provision of primary and basic health care services
along with effective vaccination programs. The management of the local healthcare team should
also lay stress upon timely home visits to the people dwelling in the countryside. The federal and
the local health care agencies could also provide free vaccinations to the below poverty level. For
further scoping of the project sufficient funding and support is required from the local and
federal level government. The survey data focussing upon the various health requisites can be
used to draft a report. The report could be forwarded to the concerned government health
departments for the allocation of sufficient amount of funds and tender.
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References
About the Ministry. (2017). Ministry of Health NZ. Retrieved 30 October 2017, from
http://www.health.govt.nz/about-ministry
Ashton, T. (2015). Measuring health system performance: A new approach to accountability and
quality improvement in New Zealand. Health Policy, 119(8), 999-1004. Retrieved from:
https://doi.org/10.1016/j.healthpol.2015.04.012 [Accessed on 28 Oct. 2017]
Blakely, T., Kvizhinadze, G., Karvonen, T., Pearson, A. L., Smith, M., & Wilson, N. (2014).
Cost-effectiveness and equity impacts of three HPV vaccination programmes for school-
aged girls in New Zealand. Vaccine, 32(22), 2645-2656. Retrieved from:
https://doi.org/10.1016/j.vaccine.2014.02.071 [Accessed on 28 Oct. 2017]
Clark, R. G., Templeton, R., & McNicholas, A. (2013). Developing the design of a continuous
national health survey for New Zealand. Population health metrics, 11(1), 25. Retrieved
from: https://doi.org/10.1186/1478-7954-11-25 [Accessed on 27 Oct. 2017]
Filoche, S., Garrett, S., Stanley, J., Rose, S., Robson, B., Elley, C. R., & Lawton, B. (2013).
Wāhine hauora: linking local hospital and national health information datasets to explore
maternal risk factors and obstetric outcomes of New Zealand Māori and non-Māori
women in relation to infant respiratory admissions and timely immunisations. BMC
pregnancy and childbirth, 13(1), 145. Retrieved from: https://doi.org/10.1186/1471-
2393-13-145 [Accessed on 30 Oct. 2017]
Harris, R. B., Cormack, D. M., & Stanley, J. (2013). The relationship between socially-assigned
ethnicity, health and experience of racial discrimination for Māori: analysis of the
2006/07 New Zealand Health Survey. BMC public health, 13(1), 844. Retrieved from:
https://doi.org/10.1186/1471-2458-13-844 [Accessed on 28 Oct. 2017]
Harvey, H., Reissland, N., & Mason, J. (2015). Parental reminder, recall and educational
interventions to improve early childhood immunisation uptake: a systematic review and
meta-analysis. Vaccine, 33(25), 2862-2880. Retrieved from:
https://doi.org/10.1016/j.vaccine.2015.04.085 [Accessed on 28 Oct. 2017]
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Hobbs, M. R., Morton, S., Atatoa-Carr, P., Ritchie, S. R., Thomas, M. G., Saraf, R., ... & Grant,
C. C. (2017). Ethnic disparities in infectious disease hospitalisations in the first year of
life in New Zealand. Journal of paediatrics and child health, 53(3), 223-231. DOI:
10.1111/jpc.13377 [Accessed on 29 Oct. 2017]
Le Menach, A., Boxall, N., Amirthalingam, G., Maddock, L., Balasegaram, S., & Mindlin, M.
(2014). Increased measles–mumps–rubella (MMR) vaccine uptake in the context of a
targeted immunisation campaign during a measles outbreak in a vaccine-reluctant
community in England. Vaccine, 32(10), 1147-1152. Retrieved from:
https://doi.org/10.1016/j.vaccine.2014.01.002 [Accessed on 29 Oct. 2017]
Palmer, T. J., McFadden, M., Pollock, K. G. J., Kavanagh, K., Cuschieri, K., Cruickshank, M., ...
& Robertson, C. (2016). HPV immunisation and increased uptake of cervical screening in
Scottish women; observational study of routinely collected national data. British journal
of cancer, vol. 114(5), pp. 576-581. doi:10.1038/bjc.2015.473 [Accessed on 29 Oct.
2017]
Phillips, B., Daniels, J., Woodward, A., Blakely, T., Taylor, R., & Morrell, S. (2017). Mortality
trends in Australian Aboriginal peoples and New Zealand Māori. Population health
metrics, 15(1), 25. Retrieved from: https://doi.org/10.1186/s12963-017-0140-6 [Accessed
on 29 Oct. 2017]
Turner, N. M., Charania, N. A., Chong, A., Stewart, J., & Taylor, L. (2017). The challenges and
opportunities of translating best practice immunisation strategies among low performing
general practices to reduce equity gaps in childhood immunisation coverage in New
Zealand. BMC nursing, 16(1), 31. Retrieved from: https://doi.org/10.1186/s12912-017-
0226-2 [Accessed on 28 Oct. 2017]
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