This annual report - Taranaki District Health Board

More documents

Recommendations

Info

Table 23. Local Policy Documents and Evidence-Based Reviews Relevant to Immunisation andIncreasing Immunisation CoverageMinistry of Health Policy DocumentsMinistry of Health. 2011. Immunisation Handbook 2011. Wellington: Ministry of Health.http://www.health.govt.nz/publication/immunisation-handbook-2011The Immunisation Handbook provides clinical guidance for health professionals on the effective and safe use ofvaccines. The Handbook contains information on eligibility for vaccines and the diseases covered by the NationalImmunisation Schedule, as well as other vaccine preventable diseases.Ministry of Health. 2011. Targeting Immunisation: increased immunisation. Wellington: Ministry of Health.http://www.health.govt.nz/publication/targeting-immunisation-increased-immunisationIncreased immunisation has been a national health target since 2007. The 2012/2013 immunisation target (available at:http://www.health.govt.nz/new-zealand-health-system/health-targets/2012-13-health-targets) is that 85 per cent of eightmonth-oldswill have their primary course of immunisation at six weeks, three months and five months on time by July2013, increasing to 90 per cent by July 2014 and 95 per cent by December 2014. This report provides a summary of thereasons behind this target, including improvements in child health and reductions in ethnic inequalities in health, and aseries of case studies illustrating best practice in increasing immunisation uptake. Three recommendations are identified:• All children should be enrolled with a general practice as soon as possible after birth.• Parents should be contacted before each immunisation is due.• Immunisation appointments should be made at a time that suits the parents.Ministry of Health. Review of Neonatal BCG Immunisation Services in New Zealand. 2007, Ministry of Health:Wellington. http://www.health.govt.nz/publication/review-neonatal-bcg-immunisation-services-new-zealandThis review evaluated the neonatal BCG immunisation programme. Its objectives were: to describe the neonatal BCGimmunisation services; review tuberculosis (TB) surveillance data and service monitoring; identify any imbalancebetween current policy and services; and make recommendations on the future monitoring of the service. The incidenceof TB over the previous 20 years was found to be stable although increasing rates had been identified in immigrants andrefugees from high-risk Asian and African countries, and recent arrivals from Pacific countries and their contacts. Asurvey of all 21 DHBs indicated a wide variability in how the service was offered in New Zealand. Monitoring was patchyand only a few DHBs collected data on the number of TB risk assessments performed on babies, meaning that coveragerates could not be calculated because the total number of eligible babies was unknown. Three priorities for improving theeffectiveness of service were identified: to institute a systematic approach to delivering the BCG immunisation service inall DHBs; to improve the quality of the monitoring of the BCG immunisation service; and to improve the completeness ofnotification data. The review made a number of recommendations in the areas of contracts, monitoring, new resourcesand surveillance.Cochrane Systematic ReviewsJefferson T, et al. 2012. Vaccines for preventing influenza in healthy children. Cochrane Database of SystematicReviews doi:10.1002/14651858.CD004879.pub4http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004879.pub4/abstractThis review assessed the effects of influenza vaccines in healthy children, with the aims of assessing vaccine efficacy(prevention of confirmed influenza) and effectiveness (prevention of influenza-like illness (ILI)), and documenting adverseevents associated with vaccination. Seventy-five studies (approximately 300,000 observations) were included in thereview. The analysis of vaccine efficacy and effectiveness included 17 RCTs, 19 cohort studies and 11 case-controlstudies. Evidence from RCTs found that live attenuated vaccines had an overall efficacy 80% (RR 0.20; 95% CI 0.13 to0.32). The overall risk difference (RD) for those aged 2 to 16 years was -0.16 (95% CI -0.20 to -0.11) indicating that sixchildren aged two to 16 need to be vaccinated with live attenuated vaccine to prevent one case of influenza (infectionand symptoms). There was no usable data for those aged two years or younger. Inactivated vaccines had lower efficacy,and in children aged two years or younger were not significantly more efficacious than placebo. The RD for children agedsix or older was -0.35 (95% CI -0.54 to -0.15), indicating that 28 need to be vaccinated to prevent one case of influenza.There was no evidence of effect of vaccination on secondary cases, lower respiratory tract disease, drug prescriptions,otitis media and its consequences or socioeconomic impact. There was weak single-study evidence of the effect ofvaccination on school absenteeism. Meta-analysis of safety outcome data was not feasible due to variability in studydesign and presentation of data and safety comparisons could not be made. Specific brands and situations have beenassociated with serious side effects (cataplexy, narcolepsy and febrile convulsions). The authors conclude that whileinfluenza vaccines are efficacious in preventing cases of influenza in children older than two years of age, there is littleevidence available those aged under two years, making current recommendations to vaccinate healthy children from sixmonths of age in the USA, Canada, parts of Europe and Australia surprising. The authors also caution that trials includedin the review are industry funded, and their content and conclusion should be interpreted with this knowledge. Such trialswere found to be published in more prestigious journals and cited more than other studies independently frommethodological quality and size while studies funded from public sources were significantly less likely to reportconclusions favourable to the vaccine in a systematic review of 274 influenza vaccine studies published up to 2007 [83].Immunisation Coverage - 166
Soares-Weiser K, et al. 2012. Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD008521.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008521.pub2/abstractRotavirus is the commonest cause of diarrhoea-related deaths in children under five years, and is a common cause ofdiarrhoea-related hospital admissions in high-income countries. The World Health Organization (WHO) recommendsvaccination for all children, as deaths due to diarrhoea account for more than 10% of all deaths. This review assessedthe effectiveness of rotavirus vaccines approved for use for preventing rotavirus diarrhoea. Secondary objectives were toassess the efficacy of rotavirus vaccines on all-cause diarrhoea, hospital admission, death, and safety profiles. Fortythreetrials were included in the review (190,551 participants), 31 of which assessed RV1 (Rotarix, GlaxoSmithKlineBiologicals) and 12 assessed RV5 (RotaTeq, Merck & Co., Inc.). Compared to placebo, RV1 was associated with a 70per cent reduction in all cases of rotavirus diarrhoea in the first (RR 0.30, 95% CI 0.18 to 0.50) and second year of life(RR 0.30, 95% CI 0.21 to 0.43), and an 80 per cent reduction in severe episodes during the first (RR 0.20, 95% CI 0.11to 0.35) and second year of life (RR 0.16, 95% CI 0.12 to 0.21). RV5 was associated with reductions of over 70 per centin any rotavirus diarrhoea (RR 0.27, 95% CI 0.22 to 0.33) or severe cases (RR 0.23, 95% CI 0.08 to 0.71) in the firstyear, and approximately 50 per cent (RR 0.51, 95% CI 0.36 to 0.72 for all rotavirus diarrhoea and RR 0.44, 95% CI 0.22to 0.88 for severe cases) in the second year. Both vaccines were associated with reductions in severe diarrhoea from allcauses in the first year of life (RV1: RR 0.58, 95% CI 0.40 to 0.84; RV5 RR 0.49, 95% CI 0.40 to 0.60 (one trial only))and RV1 was associated with a reduction in second year of life (RR 0.49, 95% CI 0.40 to 0.60). RV5 showed nodifference with placebo in the second year of life. When tested against placebo the vaccines gave similar numbers ofadverse events, including intussusception, and other events that required discontinuation of the vaccination schedule.The authors conclude that the data support the WHO recommendations to include rotavirus vaccination in immunisationschedules, particularly if there is a high burden of diarrhoeal deaths in children younger than five years.Jacobson Vann JC & Szilagyi P. 2009. Patient reminder and recall systems to improve immunization rates.Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD003941.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003941.pub2/abstractThis review assessed the effectiveness of patient reminder and recall systems in improving immunisation rates, andcompared the effects of various types of reminders in different settings or patient populations. The review included 47RCTs, 16 of which examined routine vaccinations for children and four which examined influenza vaccinations in highrisk children. Overall increases in immunisation rates ranged from 1 to 20 percentage points. Reminders were effectivefor childhood vaccinations (OR 1.47, 95% CI 1.28 to 1.68) and childhood influenza vaccinations (OR 2.18, 95% CI 1.29to 3.70). The one study assessing the effect of reminders on adolescent vaccinations in an urban setting found they wereineffective (OR 1.14, 95% CI 0.98 to 1.31). Unstable telephone numbers were problematic in this study, which usedautodialed calls. All types of reminders (postcards, letters, telephone or autodialed calls) were effective. Person-topersontelephone reminders were the most effective (OR 1.92, 95% CI 1.20 to 3.07), but also the most costly.Scott A, et al. 2011. The effect of financial incentives on the quality of health care provided by primary carephysicians. Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD008451.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008451.pub2/abstractThis review expanded on the review below (Guiffrida et al., 1999) by including the effect of target payments and all othertypes of incentive payments, including pay-for-performance schemes and multifaceted schemes, on primary health care.Such schemes are popular internationally (for example the Quality and Outcomes Framework in the UK) despite littleevidence of their success in improving the quality of primary health care. Seven studies were included in the review, twoof which (controlled interrupted time series analyses) included childhood immunisation among their outcomes. Overall,the different financial interventions had modest and variable effects on the quality of health care provided by primary carephysicians (PCPs). One of the studies which assessed childhood immunisation rates identified a statistically significantimprovement in rates but this was due to a sharp fall in rates in the control group. The authors conclude that there isinsufficient evidence to support or not support financial incentives. More rigorous trials are needed which also examineunintended consequences.Uman LS, et al. 2009. Psychological interventions for needle-related procedural pain and distress in children andadolescents. Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD005179.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005179.pub2/abstractThis reviewed examined the efficacy of cognitive-behavioural (CB) psychological interventions for needle-relatedprocedural pain and distress in children and adolescents. Twenty-eight trials (1951 participants aged 2 to 19 years),mostly studying vaccinations and injections, were included in the review. The largest effect sizes for treatmentimprovement over control conditions were found for distraction (self-reported pain: SMD = -0.24, 95% CI -0.45 to -0.04),hypnosis (self-reported pain: SMD -1.47, 95% CI -2.67 to -0.27; self-reported distress: SMD -2.20, 95% CI -3.69 to -0.71;and behavioural measures of distress: SMD -1.07, 95% CI -1.79 to -0.35), and combined CB interventions (otherreporteddistress: SMD -0.88, 95% CI -1.65 to -0.12; and behavioural measures of distress: SMD -0.67, 95% CI -0.95 to -0.38). Although there is preliminary support for use of CB interventions to reduce distress associated with needle-relatedprocedures, many of the studies failed to describe randomisation procedures and participants withdrawals/drop-outs andfurther research is required.Immunisation Coverage - 167
Page 4 and 5:
Cover Artwork: Long-tailed Blue But
Page 7 and 8:
LIST OF FIGURESFigure 1. Gross Dome
Page 9 and 10:
Figure 41. Number of Students Invol
Page 11 and 12:
Figure 85. Proportion of Babies Bor
Page 13 and 14:
Figure 127. Relationship Between th
Page 15:
Table 21. Policy Documents Relevant
Page 19:
Table 108. Proportion of Young Peop
Page 23 and 24:
INTRODUCTION AND OVERVIEWIntroducti
Page 25 and 26:
three then reviews mental health is
Page 27 and 28:
Table 1. Overview of the Determinan
Page 29 and 30:
Stream Indicator New Zealand Distri
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43:
Page 47:
47MACROECONOMICINDICATORS
Page 50 and 51:
Expenditure-based Measure of GDPThe
Page 52 and 53:
Gini Coefficient: The Lorenz curve
Page 54 and 55:
CHILD POVERTY AND LIVING STANDARDSI
Page 56 and 57:
After Housing Costs (AHC)Relative P
Page 58 and 59:
Figure 8. Proportion of Dependent C
Page 60 and 61:
14 Items (Enforced Lacks) are inclu
Page 62 and 63:
Local Policy Documents and Evidence
Page 64 and 65:
Other Relevant New Zealand Evidence
Page 66 and 67:
UNEMPLOYMENT RATESIntroductionIn th
Page 68 and 69:
Figure 12. Unemployment Rates by Ag
Page 70 and 71:
Unemployment Rates by Qualification
Page 72 and 73:
Figure 18. Quarterly Unemployment R
Page 74 and 75:
CHILDREN RELIANT ON BENEFIT RECIPIE
Page 76 and 77:
Table 4. Number of Children Aged 0-
Page 78 and 79:
Table 5. Number of Children Aged 0-
Page 80 and 81:
YOUNG PEOPLE RELIANT ON BENEFITSInt
Page 82 and 83:
Table 7. Number of Young People Age
Page 84 and 85:
New Zealand Distribution by Ethnici
Page 86 and 87:
Figure 25. Young People Aged 16-24
Page 88 and 89:
Table 10. Number of Young People Ag
Page 91:
HOUSEHOLD COMPOSITION91
Page 94 and 95:
Data Source and MethodsDefinitionPr
Page 96 and 97:
Figure 29. Proportion of Children A
Page 98 and 99:
Robertson J, et al. 2006. Review of
Page 100 and 101:
Canadian National Occupancy Standar
Page 102 and 103:
Figure 33. Proportion of Children a
Page 104 and 105:
Other Relevant EvidenceMarmot Revie
Page 106 and 107:
106
Page 108 and 109:
108
Page 110 and 111:
Note 2: The number of new school en
Page 112 and 113:
Figure 36. Proportion of New Entran
Page 114 and 115:
Page 116 and 117: Sylva K, et al. 2004 The Effective
Page 118 and 119: Table 15. Enrolments in Māori Medi
Page 120 and 121: Table 16. Number of Students (Māor
Page 122 and 123: Local Policy Documents which Consid
Page 124 and 125: HIGHEST EDUCATIONAL ATTAINMENT AT S
Page 126 and 127: Figure 43. Highest Educational Atta
Page 128 and 129: Figure 46. Highest Educational Atta
Page 130 and 131: Local Policy Documents and Evidence
Page 132 and 133: SENIOR SECONDARY SCHOOL RETENTION A
Page 134 and 135: Participation in Tertiary Education
Page 136 and 137: Midland Region Distribution and Tre
Page 138 and 139: The following section uses informat
Page 140 and 141: Figure 54. Age-Standardised Rates o
Page 142 and 143: Figure 56. Age-Standardised School
Page 146 and 147: TRUANCY AND UNJUSTIFIED ABSENCESInt
Page 148 and 149: Figure 60. Total Unjustified Absenc
Page 150 and 151: Figure 63. Total Unjustified Absenc
Page 152 and 153: 152
Page 154 and 155: 154
Page 156 and 157: 156
Page 158 and 159: Table 22. The National Immunisation
Page 160 and 161: Figure 64. Immunisation Coverage by
Page 162: Figure 67. Immunisation Coverage by
Page 165: Figure 71. Immunisation Coverage at
Page 169 and 170: Briss PA, et al. 2000. Reviews of e
Page 171 and 172: Data Sources and MethodsIndicatorPr
Page 173 and 174: Figure 75. Proportion of New Zealan
Page 175 and 176: Proportion Receiving Core Contacts
Page 177 and 178: Figure 81. Proportion of Babies who
Page 179 and 180: The B4 School CheckThe B4 School Ch
Page 183 and 184: Other Relevant EvidenceThe Scottish
Page 185 and 186: 185SUBSTANCE USE
Page 188 and 189: Notes on InterpretationNote 1: The
Page 190 and 191: Maternal Smoking at First Registrat
Page 192 and 193: Figure 86. Proportion of Babies Bor
Page 194 and 195: Table 32. Number of Cigarettes Smok
Page 198 and 199: National Institute for Health and C
Page 200 and 201: 2. Proportion of babies born to mot
Page 204 and 205: Table 37. Number of Cigarettes Smok
Page 208 and 209: Figure 93. Proportion of Year 10 St
Page 210 and 211: Figure 95. Proportion of Year 10 St
Page 212 and 213: TOBACCO USE IN YOUNG PEOPLEIntroduc
Page 214 and 215: Figure 96. Daily Smoking Rates in Y
Page 216 and 217:
2009 New Zealand Tobacco Use Survey
Page 218 and 219:
Source of Tobacco in the Last Month
Page 220 and 221:
Carson KV, et al. 2011. Community i
Page 222 and 223:
Other Relevant PublicationsMāori A
Page 224 and 225:
Other Cochrane Systematic Reviews o
Page 226 and 227:
ALCOHOL-RELATED HOSPITAL ADMISSIONS
Page 228 and 229:
Figure 100. Alcohol-Related Hospita
Page 230 and 231:
Table 45. Listed External Causes of
Page 232 and 233:
Midland Region Distribution and Tre
Page 234 and 235:
Page 236 and 237:
Shults RA, et al. 2009. Effectivene
Page 238 and 239:
238
Page 240 and 241:
240
Page 242 and 243:
242
Page 244 and 245:
Mortality from conditions with a so
Page 246 and 247:
Table 50. Mortality from Conditions
Page 248 and 249:
Figure 105. Hospital Admissions for
Page 250 and 251:
Page 252 and 253:
Table 55. Hospital Admissions for C
Page 254 and 255:
Table 57. Hospital Admissions for C
Page 256 and 257:
Midland Region Distribution by Caus
Page 258 and 259:
Page 260 and 261:
INFANT MORTALITY AND SUDDEN UNEXPEC
Page 262 and 263:
New Zealand Distribution and Trends
Page 264 and 265:
Figure 111. Total Infant Mortality,
Page 266 and 267:
Table 62. Neonatal and Post Neonata
Page 268 and 269:
Table 65. Neonatal and Post Neonata
Page 270 and 271:
Distribution by Ethnicity, NZ Depri
Page 272 and 273:
Figure 116. Sudden Unexpected Death
Page 274 and 275:
Vennemann M, et al. 2007. Do immuni
Page 276 and 277:
276
Page 278 and 279:
with a review of interventions aime
Page 280 and 281:
deprivation in some parts of the wo
Page 282 and 283:
who delay a second pregnancy by two
Page 284 and 285:
Family ViolenceDefinitions and New
Page 286 and 287:
need for multidisciplinary interven
Page 288 and 289:
6 days to determine gestational age
Page 290 and 291:
In New Zealand, information on fact
Page 292 and 293:
post intervention. Engagement in ed
Page 294 and 295:
antenatal care, including two nutri
Page 296 and 297:
throughout pregnancy, birth and the
Page 298 and 299:
Alcohol and Other DrugsNational and
Page 300 and 301:
Zealand had a number of specialist
Page 302 and 303:
in one Cochrane review [274] (see p
Page 304 and 305:
interventions to treat antenatal de
Page 306 and 307:
In ConclusionWhile it is hoped that
Page 308 and 309:
308
Page 310 and 311:
Data Source and MethodsDefinition1.
Page 312 and 313:
Page 314 and 315:
Page 316 and 317:
Page 318 and 319:
Other Systematic ReviewsLouwers ECF
Page 320 and 321:
INJURIES ARISING FROM ASSAULT IN YO
Page 322 and 323:
New Zealand Distribution by Age and
Page 324 and 325:
Page 326 and 327:
Page 328 and 329:
Flood M & Fergus L. 2008. An Assaul
Page 330 and 331:
Note 2: The numbers in this section
Page 332 and 333:
Table 78. Number of Notifications t
Page 334 and 335:
Table 80. Outcome of Assessment for
Page 336 and 337:
Table 82. Number of Notifications R
Page 338 and 339:
Table 84. Outcome of Assessment for
Page 340 and 341:
Data Source and MethodsDefinition1.
Page 342 and 343:
Family Violence Investigations Wher
Page 344 and 345:
Table 90. Local Policy Documents an
Page 346 and 347:
Stover CS, et al. 2009. Interventio
Page 348 and 349:
348
Page 350 and 351:
350
Page 352 and 353:
oader contextual influences on the
Page 354 and 355:
In addition, Table 112 on Page 414
Page 356 and 357:
Williams SB, et al. 2009. Screening
Page 358 and 359:
Ministries of Education, Health, Ju
Page 360 and 361:
Figure 129. Children and Young Peop
Page 362 and 363:
Table 92. Children Aged 0-14 Years
Page 364 and 365:
Page 366 and 367:
Page 368 and 369:
IN-DEPTH TOPIC: MENTAL HEALTH ISSUE
Page 370 and 371:
this [350]. The review stated that
Page 372 and 373:
psychotic disorders including first
Page 374 and 375:
Social Workers in SchoolsIn 2011 th
Page 376 and 377:
Children or young people with sever
Page 378 and 379:
EpidemiologyThe 2009 review by Meri
Page 380 and 381:
A diagnosis of conduct disorder acc
Page 382 and 383:
programme using a questionnaire. Si
Page 384 and 385:
developmentally appropriate diagnos
Page 386 and 387:
playthings or the environment, appe
Page 388 and 389:
state more than it cost) provided t
Page 390 and 391:
ACCESS TO MENTAL HEALTH SERVICES: L
Page 392 and 393:
Table 97. Children and Young People
Page 394 and 395:
Midland Region DistributionChildren
Page 396 and 397:
ACCESS TO MENTAL HEALTH SERVICES: L
Page 398 and 399:
Table 101. Hospital Admissions for
Page 400 and 401:
Numbers Accessing Services by Diagn
Page 402 and 403:
Table 103. Young People Aged 15-24
Page 404 and 405:
Page 406 and 407:
Page 408 and 409:
Table 108. Proportion of Young Peop
Page 410 and 411:
Page 412 and 413:
Midland Region DistributionAmongst
Page 414 and 415:
Page 416 and 417:
Fletcher A, et al. 2008. School Eff
Page 418 and 419:
New Zealand Distribution and Trends
Page 420 and 421:
Figure 138. Mortality from Suicide
Page 422 and 423:
Figure 139. Mortality from Suicide
Page 424 and 425:
Ougrin D & Latif S. 2011. Specific
Page 426 and 427:
426
Page 428 and 429:
428
Page 430 and 431:
Guide to Community Preventive Servi
Page 432 and 433:
information on all of the events oc
Page 434 and 435:
3. In addition, some providers admi
Page 436 and 437:
as in the majority of the analyses
Page 438 and 439:
APPENDIX 5: THE NATIONAL MORTALITYC
Page 440 and 441:
As a result of these changes, there
Page 442 and 443:
2. Research also suggests that ethn
Page 444 and 445:
APPENDIX 8: POLICE AREA BOUNDARIESF
Page 446 and 447:
Figure 142. Police Area Boundaries
Page 448 and 449:
3. The condition exhibits a socioec
Page 450 and 451:
REFERENCES1. Children's Commissione
Page 452 and 453:
33. Mackay R. 2005. The Impact of F
Page 454 and 455:
71. Ministry of Health. 2011. Immun
Page 456 and 457:
107. ASH New Zealand. 2011. Nationa
Page 458 and 459:
141. Child and Youth Mortality Revi
Page 460 and 461:
175. Pihama L. 2011. Overview of M
Page 462 and 463:
208. King-Hele S, Webb RT, Mortense
Page 464 and 465:
244. Nelson Marlborough District He
Page 466 and 467:
274. Ramsay J, Carter Y, Davidson L
Page 468 and 469:
306. Jewkes R. 2002. Intimate partn
Page 470 and 471:
347. Heflinger CA, Hinshaw SP. 2010
Page 472 and 473:
376. Ministry of Education. 2012. W
Page 474 and 475:
410. Ministry of Health. 2001. New
Page 476 and 477:
443. Zeanah PD, Bailey LO, Berry S.
Page 478 and 479:
480. Weinberg MK, Olson KL, Beeghly
show all

This annual report - Taranaki District Health Board

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?