Health Promoting Schools: Webinar: Rheumatic Fever and Health Promoting Schools 6 th November 2013 3pm-4pm
Programme National overview of the Rheumatic Fever Programme • • Ministry of Health – National Rheumatic Fever Programme • Helen Herbert – National Rheumatic Fever Coordinator Health Promoting Schools • • Brief national overview from Cognition Education • Examples of HPS support Rheumatic Fever from: • Waitemata DHB (Gaylene Leabourn and Monique Veza) • Tairawhiti DHB (Raipoia Brightwell) Panel discussion: How could HPS best support Rheumatic • Fever?
Rheumatic Fever Prevention Programme Better Public Services
What is rheumatic fever (RF)? • An abnormal response to an untreated group A strep (GAS) throat infection • Strep A bacteria are widespread and cause about 1 in 5 of all sore throats. Rest are viral. • The more GAS throat infections you have the more you are at risk of having the abnormal reaction which leads to RF • Not all GAS infections cause a sore throat so throat swabbing alone won’t get rid of RF in our communities • Crowded households spread GAS and lead to more throat infections • GAS is easily treated with 10 days of antibiotics • Around 1 in 100 untreated sore throats cause the autoimmune reaction that leads to RF
Ethnicity - key determinant in NZ 100 Māori Pacific Other 90 80 70 Rate per 100,000 60 50 40 30 20 10 0 1998-99 2000-01 2002-03 2004-05 2006-07 2008-09 2010 Year Source: Jackson, C and Lennon, D. Rheumatic Fever in the Auckland Region 1998-2010: Data from the Auckland Rheumatic Fever Register. Paediatric Infectious Diseases Starship Children’s Hospital and Auckland Regional Public Health Service, Auckland. 2011.
Source: Jaine et al 2011. Acute rheumatic fever associated with household crowding in a developed country. Pediatr Infect Dis J; 30(4): 315-319.
Better Public Services Prime Minister March 2012 • “A new results - driven focus for the public service” • Focus on leadership, value for money and results • New ways of working: cross sector and cross agency • Challenging targets “I don’t want easy targets…Because if they are easy targets they aren’t worth doing” • 10 key result areas – includes rheumatic fever. • Aims to • Bring rates for Māori and Pacific to Pakeha levels • Bring NZ rate down to WHO level recommended level • Target is 2/3rds reduction by June 2017 in new cases
$45+ million programme – 3 tranches over 5 years • $20 million school based programme • Over 200 schools • Across 10 DHBs • 50,000 children • $13million community based clinics (including some in secondary schools) • $4 million healthy housing initiatives • $ 6.5 million health literacy, community engagement and communications • $ 2.5 million research, evaluation & co-ordination
Schools Programme • School and parent community awareness raising • Sore throat identification • Sore throat swabbing • Provision of antibiotics free • Follow up of at risk members of the household • Kaiawhina and public health nurses
Health promoting schools and RFPP • Not all schools in high risk areas are covered by the Programme • Most high schools not covered at all • Health behaviour opportunities • Cough and sneeze etiquette • Avoiding crowded sleeping arrangements • Health seeking behaviours for sore throat (in high risk children) • Other education opportunities • Purple Heart by Andrew Fiu • If inquiry identifies that RF is a burning issue in the school community
Health Promoting Schools The purpose of HPS is to improve equity, Whānau well- being, and educational outcomes through evidence informed practice.
Key messages: 1. HPS builds on what schools already do and know 2. HPS responds to the prioritised needs and solutions that have been identified by the whole school community-including whānau 3. HPS focusses on those who are experiencing the greatest inequities 4. HPS delivers solutions in partnership with education, health and social service providers 5. HPS provides a values based approach
Organisational Chart MOH (Government Priority ) Rheumatic Fever The Heart Foundation Waitemata DHB Health Promotion Agency Auckland Region WDHB Steering Group (ADHB & CMDHB) Child Women and Family PHOs Home Care for Rangatiratanga Child and Family Kids (Paeds) Health Promoting Public Health Nurses Schools Schools Partner Providers Agencies • West Fono • Kids Can • Te Whanau O Waipareira • Heart foundation • Health west • All care • Tapuna Hauora
Method Health check Identification of RF priority schools consent form (Based on MOH RF scores) Baseline Surveys Surveys, factsheet, Students Staff Community presentations, evaluation forms Newspaper articles Consent obtained for health checks Education & Evaluation Developed educational • Students • Staff resources • Community- parents, local services & School based symptomatic agencies, GPs throat swabbing programme RF Chatterbox • Heart Foundation RF Curriculum units Educational game for implemented into school plan • 3 days a week students to play with whanau • Run by Public Health Nurse & Health Assistant Keep community informed & address gaps Display board for schools & community events Identification of Strep A throat infection Weekly Team Meetings • Swabs monitored, positives – parents contacted • Documentation & MOH reporting of project • Parents encouraged to take child to GP linked • Follow up phone call to check child has • Identify & address issues or trends been to GP & correct dose of antibiotics • Review process & implement improvements obtained • Treatment barriers identified & addressed • If barriers identified, antibiotics given with • Antibiotic compliance monitored instructions (under standing orders) • Data analysis of project
Panel discussion! How could HPS best support the National Rheumatic Fever Programme? (refer guidelines for discussion)
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