Programme National overview of the Rheumatic Fever Programme - - PowerPoint PPT Presentation

Health

Promoting

Schools:

Webinar: Rheumatic Fever and Health Promoting Schools 6th 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

10 20 30 40 50 60 70 80 90 100 1998-99 2000-01 2002-03 2004-05 2006-07 2008-09 2010 Rate per 100,000 Year Pacific Māori Other

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

MOH (Government Priority) Rheumatic Fever Health Promotion Agency The Heart Foundation Auckland Region (ADHB & CMDHB) WDHB Steering Group Child Women and Family PHOs Child and Family Rangatiratanga (Paeds) Home Care for Kids

Health Promoting Schools

Public Health Nurses Schools Partner Providers

• West Fono
• Te Whanau O Waipareira
• Health west
• All care
• Tapuna Hauora

Agencies

• Kids Can
• Heart foundation

Waitemata DHB

Organisational Chart

Baseline Surveys Students Staff Community Identification of RF priority schools (Based on MOH RF scores) Weekly Team Meetings

• Documentation & MOH reporting of project

linked

• Identify & address issues or trends
• Review process & implement improvements
• Treatment barriers identified & addressed
• Antibiotic compliance monitored
• Data analysis of project

Education & Evaluation

• Students
• Staff
• Community- parents, local services &

agencies, GPs

• Heart Foundation RF Curriculum units

implemented into school plan Consent obtained for health checks School based symptomatic throat swabbing programme

• 3 days a week
• Run by Public Health Nurse &

Health Assistant Identification of Strep A throat infection

• Swabs monitored, positives – parents

contacted

• Parents encouraged to take child to GP
• Follow up phone call to check child has

been to GP & correct dose of antibiotics

• btained
• If barriers identified, antibiotics given with

instructions (under standing orders)

Method

Developed educational resources

Keep community informed & address gaps Display board for schools & community events RF Chatterbox Educational game for students to play with whanau Surveys, factsheet, presentations, evaluation forms Health check consent form Newspaper articles

Panel discussion!

How could HPS best support the National Rheumatic Fever Programme?

(refer guidelines for discussion)