Kahu Taurima | Maternity and Early Years

Kahu Taurima is the joint Te Aka Whai Ora and Health New Zealand | Te Whatu Ora approach to maternity and early years (pre-conception to 5 years old, or the First 2,000 Days of life) for all whānau in Aotearoa New Zealand.

The name ‘Kahu Taurima’ has many connections to maternity and early years. ‘Kahu’ speaks to the korowai of services and support that wraps around whānau as well as an alignment with He Korowai Oranga, ‘Taurima’ speaks to caring, nurturing, and fostering our most cherished pēpi, tamariki and whānau.

The tohu (logo) is intended to reflect hapūtanga, protection, development, and growth. It also represents the connection between māmā and pēpi.

As a priority in Te Pae Tata, the interim New Zealand Health Plan 2022-2024, this programme of change will shift system settings, redesign the model of care and service delivery models to ensure health is making its greatest contribution to intergenerational wellbeing.

The Kahu Taurima team will work with whānau, communities and service providers across the country to design and commission new integrated, culturally tailored services and programmes for all maternity and early years.
For a child’s first 2,000 days from conception to five years old, Kahu Taurima will:

• remove barriers and silos in the existing universal service model
• integrate our primary care, community, and specialist services to improve quality, safety and equity of outcomes
• deliver well connected, easy to navigate, culturally affirming health services for all whānau, no matter who they are, and where they live
• provide wrap-around services and extra support for whānau when needed.

In Aotearoa we have more than 60,000 babies born each year - so over 60,000 opportunities to support a healthier future for whānau.

Evidence shows that by investing in whānau antenatally and in the early years of life we can make the biggest difference to lifelong, and intergenerational, wellbeing. Most brain development happens in the early years and is influenced by the environment in which tamariki are nurtured.

Mātauranga Māori, along with conventional published evidence, supports investment in and for the first 2,000 days so every child gets the strongest start to life. This means we must support families welcoming and raising babies during these first 2,000 days.

What whānau have said

• Whānau have told us they want to receive well connected, easy to navigate, culturally affirming services that give them positive experiences.
• Parents tell us they experience racism, discrimination and ablism in service delivery. Particularly if they are young, Māori, Pacific, or an ethnic minority.
• Parents and whānau want to feel they have access to the right learnings on their maternity and early years journey. 
• Disabled parents and whānau welcoming babies with impairments want to be affirmed and be free of discrimination and ablism when they access care. 
• Parents and whānau who experience distress or bereavement during their maternity and early years journey want support that improves their wellbeing. 
• Rural whānau want clear pathways to access to primary and specialised maternity and early years care.

What is known about how to support whānau to thrive?

A model of care that delivers integrated services and has the flexibility to simplify or intensify services, depending on what matters to whānau, can improve equity of outcomes.

The Kahu Taurima approach is drawing learnings from reviews including Well Child Tamariki Ora, pilot programmes including Nursing Family pilot, and reviews from the Health Quality and Safety Commission which recognise and demonstrate different ways of working to achieve improved outcomes for whanau.

Our workforce and providers require support to make their best contribution and be fulfilled by their work. This means removing barriers and supporting the growth of connected teams. When whānau are satisfied with their care, work satisfaction increases. When care providers feel valued and supported, whānau receive sensitive and excellent care.

To support the transformation, the Kahu Taurima team will commission new, integrated, interprofessional, culturally tailored maternity and early years’ service delivery models. These models will contribute to achieving consistency in national service delivery while enabling local tailoring to support whānau aspirations and goals. To do this, we will work with whānau, communities, partners, and service providers across the motu.

All publicly funded maternity and early years health services, from conception to five years old, are included in the reform. This includes primary, community, hospital and specialist services and supports, such as but not limited to community midwifery services, Well Child Tamariki Ora services, antenatal care, Sudden Unexpected Death in Infancy (SUDI) prevention, smoking prevention, Before School Checks, early years social work, kaiāwhina services, primary maternal health, and health promotion for whānau.

Kahu Taurima will also work with general practice, hauora Māori partners, Pacific providers, childhood immunisation services, specialist obstetric and paediatric services, specialist maternal and child mental health, ultrasound, and other diagnostics, to ensure they are able to support improved outcomes.

Services for all whānau

Whānau will be able to access care from pre-conception through to their child’s fifth birthday from interprofessional and connected teams who reflect the communities they serve. The model of care these teams work within, will be designed to ensure the health and wellbeing needs of whānau are being addressed, including a maternal mental health pathway.

The new service model will have the flexibility to simplify or intensify services, depending on what matters to whānau. This will be achieved through training, leadership development, improved and consistent pathways for specialist care, and well-connected teams across the health and social system.

Te ao Māori solutions

Developing more te ao Māori solutions is essential to increase the range of options available to whāanau to ensure they have culturally responsive, safe and accessible care.

Te Aka Whai Ora will commission Hauora Māori Partners to deliver maternity and early years services where mātauranga Māori sets the foundations of hauora Māori. By having more Hauora Māori Partners who provide a range of care that is culturally responsive, whānau are more likely to access the support they need and talk about any health concerns with a trusted provider, at an early stage.

Pacific solutions

Through a dedicated Pacific model of care, more Pacific fanau will have access to integrated maternity and early years care that is designed alongside pacific fono and clinical providers.

Enhancing care for Tāngata Whaikaha | Disabled People

Providers of maternity and early years care to disabled parents and parents welcoming babies with impairments will have the knowledge, skill and resources to provide the best possible care that aligns with the ‘Enabling Good Lives’ principles.

Localities

Kahu Taurima will enable localities as they are established, allowing whānau have a greater say in the services that work for their communities.

Resetting funding and commissioning of maternity and early years services will allow localities to organise services using their local strengths and aspirations. More whānau will have access to te ao Māori and Pacific solutions and integrated, whānau-centred care and support in communities, with those services being determined, delivered, and governed by Māori.

Timeline

Over the next two years (2023 and 2024), the Kahu Taurima team will:

• Establish the change programme for Kahu Taurima
• Prototype new models of care in the community with rapid learning and evaluation
• Develop the ‘Services for All’ model of care alongside Māori and Pacific models of care
• Develop and agree new integrated service delivery arrangements for existing programmes and services

We know there are already some great examples of excellence in the sector, where the Kahu Taurima approach is thriving, and we’d love to hear about them.

If you have an example of working as part of an integrated team, providing culturally responsive care or just generally working in a different way to achieve outcomes – let us know.

Or if you’ve got a question about Kahu Taurima, please email us on kahutaurima@health.govt.nz.