Person-centered maternity services in New Zealand: a practice development initiative to improve the health of pregnant women and infants

Abstract

Rationale, aims and objectives: Primary health care and maternity services in New Zealand are delivered via independent self-employed practitioners and separate organisations with no requirement to co-ordinate care. There are disparate immunisation timeliness and rates between ethnic groups. The aim of this practice development initiative is to improve the health of pregnant women and infants. The objectives are to link the general practice enrolled pregnant women with a midwife on confirmation of their pregnancy, record the date of delivery in the general practice notes, enrol the infant with the general practice shortly after birth and so increase the timeliness and rates of immunisations. Methods: Following an initial audit, information is now recorded on the engagement of pregnant women with a midwife in early pregnancy. Contact is made with the midwife and recorded in the general practice notes around the expected delivery date. An invitation to enrol the infant with the general practice is sent to the family four weeks post natal. Immunisation timeliness and rates of infants are audited monthly. Results: Details of the midwife were recorded in the notes of 59 out of a total of 63 pregnant women during 2010, illustrating that the new model of care had been adhered to for the majority of pregnant women. Monthly immunisation timeliness and rates of 94 – 100% were achieved January 2010 – December 2010 in infants six weeks – 6 months old. Conclusion: Primary care can be re-shaped in South Auckland by following international models to facilitate engagement of pregnant women with a midwife and increase immunisation timeliness and rates of infants.