Photo: AFP
A highly successful immunisation programme for pregnant Māori and Pasifika and their babies in South Auckland had its funding cut earlier this year, amid warnings of a looming whooping cough epidemic.
Officials declared the epidemic just over three weeks ago, as cases spiked to levels not seen since 2018.
The Counties Manukau Maternal and Immunisation programme vaccinated 2500 hapū māmā against whooping cough in two years to the end of April, helping to nearly double coverage for local Māori mums-to-be, from 17.5 percent to 36 percent.
Papatoetoe midwife Judith Johnston-Niuelua from Niu Life Midwives - one of the organisations delivering the programme - said vaccination against whooping cough in pregnancy was the best protection for vulnerable newborns.
"They are most at risk because they are too young to be immunised themselves.
"In some ways, those antenatal vaccinations are babies' first immunisation, and because the family is already connected, they're more likely to get their babies immunised on time."
Under the programme, they were able to offer extended hours and drop-in clinics with no appointments necessary.
"Niu Life midwives was head and shoulders above anyone else in the country for immunisation in pregnancy. They were pretty amazed with what we were able to achieve - we're talking 100 or more women a month."
Niu Life also delivered the highest number of antenatal influenza immunisations in New Zealand in the 2023 flu season and the highest number to Pacific pregnant people, while the Papakura clinic recorded the second highest number and Pukekohe scored among the top 10.
Data seen by RNZ shows in the last 10 months of the programme, the team at six sites gave nearly 5000 vaccinations of all kinds to those who were pregnant and their whanau, including 775 children under five - mostly Māori and Pasfika.
Another Niu Life midwife Linda Burke said the secret to their success was being able to provide a one-stop shop.
"Pacific women, a lot of them don't drive. So they would have to wait for their husbands to come home from work to bring them.
"The vaccinator we had - who was an ex-midwife - would stay behind so that those mothers and those babies would be covered.
"And that was our success, taking the service to the people."
But most of this work stopped abruptly at the end of June, when money from the Covid-19 Response and Recovery Fund ran out.
Health New Zealand knocked back a bid for slightly more than $560,000 a year to keep the programme going.
A limited service continues at three sites - including Niu Life - where public health nurses hold two clinics a week, between 9am and 2pm, by appointment only.
Johnston-Niuelua said unfortunately that did not work for many families.
In her opinion, Te Whatu Ora's whooping cough awareness campaign also missed the mark.
Firstly, people were not watching live television or listening to the radio.
"Then, advertising the fact that people need to go get vaccinations - from where? From an over-stretched primary health service? They're not going to sit around sick people.
"Why would you have hapu māmā sit around sick people to wait for vaccination?
"It makes no sense at all."
Last year's Immunisation Taskforce made 54 recommendations to fix what it called the "dire" state of childhood immunisation.
A new plan calls for at-risk children to be targeted, plus growing the pool of vaccinators.
However, the taskforce chair - leading Māori paediatrician Owen Sinclair - said while the government said immunisation was "a priority", it was not actually investing in services.
"What they are doing is cutting, slashing the budget for everyone and then stepping back and saying 'You've got to square your books'. So people have no choice but to cut services, they have to do it.
"I think they [the government and Te Whatu Ora] are being a bit disengenuous."
The College of Midwives is lobbying for midwives to be able to claim the same fee as GPs and pharmacists for providing immunisations.
Chief executive Alison Eddy said it seemed like "a silly admin problem" that should be easily resolved.
"It's a no brainer, it just flies in the face of common sense that we are losing these really valuable services."
A service in Christchurch - similar to the Manukau programme based at a clinic with a number of midwives - had been funded by Health NZ at the discretion of regional managers, she noted.
"And it's taken a lot of advocacy and hard work to get that services established.
"It shouldn't be that hard, given this is a priority, it should be really straight forward for these services to be established when they are viable and really effective."
Health NZ said a national taskforce was "focused on supporting immunisation services at primary birthing units and enabling independent lead maternity carers to claim for immunising hapū māmā".
In a written response to RNZ, National Public Health Service national director Dr Nick Chamberlain, said the Covid-19 response and recovery fund came to an end on 1 July 2024, and as a result some additional antenatal immunisation services paid from the fund had ended.
"These include nurse-led clinics at Pukekohe Hospital, Nga Hau Māngere and the community hub at Ōtara. We are working at pace with Hauora Māori and Pacific providers to restart these services in 2025."
The immunisation clinic at Botany Downs Birthing Unit had continued, while immunisations were on offer to hapū māmā and whānau at both Papakura Birthing Unit and Niu Life two days a week.
Te Whatu Ora was also trailing after hours immunisation clinics at Pukekohe Hospital and Manukau Health Park Saturday Clinics.
"There has been additional national funding to increase immunisation this year in healthcare settings including general practice, pharmacies, Whānau Awhina Plunket and through Hauora Māori and Pacific providers."
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