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In this month's eNews...
  • Introduction from Mark Vella
  • We’ve helped 500 young mums
  • Pasifika set up good defences against COVID-19
  • Increase in Māori use of mental health services
  • Lifting the lip on oral health in kiddies
  • Benefit from whooping cough jab during pregnancy
  • Focus on jobs for school leavers
  • Pasifika leaders inspire at Auckland health fono 
  • Health expo will target South Auckland’s youth
  • Chasing down diabetes

Kia ora <<First Name>>,

While we are a purchasing group for community health services, we go much further than that in healthcare procurement. To ensure our communities stay well, we proactively identify needs and develop health programmes to both anticipate and meet those needs.
This has led to our identification, development and support of services that reduce the strain on the hospital system and other secondary healthcare agencies by providing care in the community.

We highlighted one of these initiatives recently where we have given assessment coordination and support services to over 500 young pregnant Māori and Pasifika mothers and their babies with our Maternity Coordination Service in Counties Manukau. Now, we’re looking ahead to more new programmes for 2020 for all three Auckland wide DHBs.

Our network's health practices are seeing more than 3000 patients a day, or 1 million patients a year. We need to be innovative with how we fund our day-to-day health services to achieve best practice. Agility and capacity are the hallmarks of our PHO model, and we look forward to working with new health minister Andrew Little and the Associate Ministers for Pacific and Māori to keep it working.

Read my latest blog: Future-proofing healthcare delivery though prevention.
Mark Vella
Chief Executive Officer
Total Healthcare Charitable Trust

We’ve helped 500 young mums

Former associate minister of health the Hon Jenny Salesa was on hand at Ōtara Town Centre to help us mark the 500th young mum through our groundbreaking maternity programme.
Total Healthcare funds the programme to address inequities in the care of our high needs population; it targets registered Māori and Pasifika women under 22 years old who live in South Auckland.
“My prediction is that this progamme will expand to other places in Aoteoroa,” Ms Salesa said. In fact, that is what is happening to some extent with the National Hauora Coalition picking up the Best Start to Life assessment tool for use within its collective.
Our maternity coordinator, Bijal Soni, works with each young woman from the time they test positive for pregnancy through to the early years of her child’s development. Only 10% of the support provided is health-related. The rest of the time Bijal is helping young women to negotiate the labyrinth of social, financial and mental health services to access support that is available. 

Read more

Increase in Māori use of mental health services

These past six months have seen a significant upswing in use of our wellness support programmes, including our online virtual consults, among Māori enrolled in our network.

From preliminary analysis of research data, it is apparent that Māori are accessing wellbeing services at higher rates than average than other ethnicities, which is mitigating some of the inequity in access in the past. At the same time, research shows Māori use of primary care services still has some way to go across the Auckland region to reach health targets.
Welcoming the positive results, our lead psychiatrist Dr David Codyre says: “We would like to see similar increases in use of wellbeing services by our Pasifika patients, who currently sit at an average use level.”

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Pasifika set up good defences against COVID-19

Most Pasifika families in our PHO region coped well during the COVID-19 lockdown, according to research conducted by the New Zealand Red Cross.

Total Healthcare’s Lorenzo Kaisara was part of the Red Cross team that looked at how Pasifika communities had prepared for the pandemic and where there were gaps in support delivery. A survey found that most Pasifika had taken the lockdown very seriously, going to great lengths to keep themselves 
and particularly elderly and chronically ill family members safe from infection.
Intergenerational families typically set up bubbles across two or three homes, with members who were essential workers kept well isolated from the rest of their family. Houses were regularly sanitised, typically only one person was designated to do the food shopping, and strict rules were put in place to avoid bubbles being breached.
The key challenge for Pasifika was the isolation from extended family and concern about their welfare and that of their fellow church members. Concerns about security of food supply for the large numbers staying at home and the need to further refine safety planning measures were identified as factors to address in future emergencies.

Lifting the lip on oral health in kids

Our provider group Tāmaki Health will be working to improve oral health in children in 2020
Due to COVID-19, about 2000 Auckland children have had to have tooth extractions deferred this year. In many cases, their poor dental self-management goes hand in hand with poor nutrition and obesity, and so Total Healthcare is making oral health a new clinical target across our provider network.
“Widening the clinical focus to include ‘lifting the lip’ in child patient exams to identify dental caries is a logical fit since general practice is the gateway for patients to access more services,” Total Healthcare general manager Kate Moodabe says.
“As part of this, we will be looking to cross-match patient data with the Auckland Regional Dental Service so we can keep a check on who is enrolled for dental care and who is accessing it.”
Read more

Benefit from whooping cough jab during pregnancy

Another new clinical target across our PHO region for 2020 will be building the numbers of pregnant women who receive Boostrix vaccinations.
Evidence suggests that women who receive this whooping cough vaccination in their second or third trimesters will pass the benefit onto their newborns.
Currently, in our region we have 3531 women who are pregnant, and as at June 30, 2020, coverage was 42%, so plenty of room for improvement.

Focus on jobs for school leavers

South Auckland’s Tangaroa College has tackled the uncertainty of the job market for school leavers in 2021 with a practical transition programme in which Total Healthcare and Local Doctors Ōtara played a key role.
Just under three-quarters of the school’s year 13 cohort goes straight from school into the workplace. This led Tangaroa’s teachers to work with MSD to develop opportunities across a range of industry sectors that would give the students – 83% Pasifika and 14% Māori – an edge in the competitive post-lockdown job market, as well as a formal accreditation for their participation to enhance their employability.
Donzaleigh Levi and Zakariah Tulua spent time observing and assisting our women’s health coordinator Fagaiofu Sisifo and our men’s heart health promoter Nick Cudilla, before spending time with the health coaching and nursing team at Local Doctors Ōtara. The initiative’s success can be measured by the fantastic enthusiasm and support from the students.

Pasifika leaders inspire at Auckland health fono

Last week, the PHO attended the two-day Pan Pasifika Fono in South Auckland, which featured some fantastic presentations focussed on achieving equity for the health and wellbeing of Pasifika. 
Mark Vella, who attended alongside Total Healthcare's general manager Kate Moodabe and community liaison officer Lorenzo Kaisara, says the event left him feeling "imbued with hope." 
“There were so many inspirational young leaders there, who are determined that Pasifika will lead better lives.”

"It was also a good reminder that while we have made some gains in breaking down access, we should never stop asking ourselves how we can do better to serve our Pacific population and who can we partner with to do better.” 

Lorenzo says he was proud that Total Healthcare PHO attended the fono. “Total Healthcare was the only PHO to attend.”

Chasing down diabetes

November is Diabetes Month in New Zealand and Total Healthcare and Local Doctors are again to the fore at community awareness events in our region.

Diabetes NZ ran a Family and Whānau Fun Day at Ōtara Town Centre on 7 November, and are holding a second Fun Day at Ōtāhuhu Pool and Leisure Centre on 14 November.
Our health promotion teams are being kept busy offering free diabetes checks as well as free contraception and highlighting the importance of regular cervical cancer screening.

Health expo will target South Auckland’s youth

COVID-19 has put the spotlight on the health of the Pasifika community across Auckland.
Auckland regional data shows diabetes rates of nearly 60% for Pacific people over 65 years of age, compared with 48.2% of Māori, 13.8% of Asian and 1% of European adults (Pacific Health Review).

The glaring stats are the catalyst behind the Ōtāhuhu Fitness and Health Expo on 28 November being led by Auckland Council. Total Healthcare and Local Doctors will be onsite offering free blood pressure checks, highlighting risk factors for CVD, and providing information about women’s and child health.
Our community liaison manager Lorenzo Kaisara will help MC the day-long event at the Ōtāhuhu Pool & Leisure Centre, which aims to put youth, in particular, face-to-face with information and support from health and fitness providers from across the city.

Working together to improve health outcomes

Total Healthcare contracts Tāmaki Health as its management support organisation to provide medical and management services required in the PHO/DHB contracts across Auckland. Tāmaki Health providers include Local Doctors and White Cross networks.

We are a substantial, responsive, innovative provider of Pasifika primary healthcare.

Total Healthcare is the largest primary healthcare provider to Pasifika patients in the Counties Manukau DHB area. Our network health provider teams are made up of a diverse range of ethnicities representative of our patient populations. Our PHO board is chaired by Willie Ropata and over 50% of our board members are Pasifika. Our provider's director of clinical quality is Dr Richard Hulme of Samoan descent and our community liaison manager is Lorenzo Kaisara, also Samoan.
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