Services for All Whānau: Creating a Better Future for Tamariki and Whānau

The Well Child Tamariki Ora (WCTO) programme has been a cornerstone of child health and development services in Aotearoa for many years, supporting pēpi and their whānau through the critical early years. Originally designed to provide universal health and development checks, the programme has evolved over time to address emerging health challenges. Recent reviews have highlighted areas where improvements can make services more equitable, accessible, and whānau-centred.

A new approach is being tested through the Services for All Whānau prototype. This initiative allows us to trial key enhancements in real-world settings before considering broader implementation.

Supported by The Southern Initiative, Health New Zealand - Te Whatu Ora continue to work with six community-based Services for All Whānau prototype partners to test changes to the Child Growth and Development Schedule. This process allows us to gather valuable feedback and understand how best to implement an improved universal WCTO service model.

The Services for All Whānau prototypes will conclude at the end of June 2025. By piloting these changes on a smaller scale, we can refine our approach before considering a national rollout as part of the Kahu Taurima integrated maternity and early years services.

The WCTO programme has supported the health and development of tamariki and their whānau in Aotearoa. However, recent evidence reviews have identified areas where the programme can be enhanced to better meet the diverse needs of all families. Key findings from these reviews include:

• Need for early identification and intervention: early detection of developmental delays and health issues is crucial for effective intervention. The current schedule may miss opportunities for timely support, particularly in the critical early years.
• Equity gaps: disparities exist in health outcomes among different populations, indicating a need for a more inclusive and culturally responsive approach within the WCTO services.
• Integration of services: families often navigate multiple services with limited coordination. Improved integration between maternity, primary care, and WCTO services can provide more seamless and effective support for whānau.

• Universal 3-year-old check: the prototypes are testing replacing the Before School Check (B4SC) with a comprehensive engagement at age 3. This check covers social, emotional, and behavioural (SEB) development, growth monitoring, and oral health.
• Additional support at age 4 for those who need it: the prototypes are testing offering tamariki with identified concerns at age 3, an additional check at age 4, with continued support available until they start school if needed.
• New developmental assessment tool: the prototypes are testing a new Child Growth and Development tool using the Ages and Stages Questionnaire 3 (ASQ-3) in place of the Parents’ Evaluation of Development Status (PEDS) as the primary screen for developmental concerns. This guided kōrero approach is being tested for use at ages 9-12 months, 18-24 months, and 3 years.
• Maternal mental health conversations: a discussion on maternal mental health is being incorporated into every core engagement in the prototypes, with workforce training to ensure parents receive appropriate support.
• Expanded scope for health workers: nurses, kaimahi, and kaiāwhina are being supported to deliver brief interventions, immunisations, and other public health or clinical services as needed.
• Stronger integration and early engagement. 
• Improved referrals from Lead Maternity Carers (LMC) to WCTO providers.
• Earlier or additional engagements for whānau needing extra support.
• More flexibility in early core engagements to build relationships and assess needs holistically.

The insights from the prototypes will inform enhancements to the WCTO programme, aiming to create a more proactive, equitable, and integrated system of care for all tamariki and their families.

In the next few months, the focus will be on transitioning to the revised PEDS (PEDS-R) as the neurodevelopment tool. PEDS is no longer available from July, thus the need to transition to PEDS-R. Retaining PEDS is needed as an interim step while we plan the transition to ASQ-3.

The prototyping will continue until June 2025, findings and whānau insights from this work will inform system design. This will help to determine the final design of the Child Growth and Development Schedule. 

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