The Best Start Whanganui project involves co-design research into the best model for ensuring access for hapū māmā to early pregnancy care including smoking status and support to quit.

The early pregnancy assessment uses the Best Start tool developed by the National Hauora Coalition as part of the 2040 Equity Generation project.

Findings from the research will be available to any health organisation in New Zealand and it is anticipated the research will help with implementation of Best Start in all regions. The report on engagement with hapū māmā who smoke will be of interest to Stop Smoking Services.

The research activity is sequential in three modules: Collaborative service design (Hapū Māmā Village) ; Clinical team competency; and Wrap-around social services, all aimed at improving equity of access and continuity of quality, safe and effective care for Hapū Māmā

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Module 1 Hapū Māmā Village

Module 1. Hapū Māmā Village Collaborative service design

The Hapū Māmā Village is a co-design  process which will develop the service delivery model from both hapū māmā and service perspectives. The findings of the Hapū Māmā Village module will then inform the Clinical Team (module 2)  training and related needs assessment; and the Wrap Around (module 3) review of pathways of care and hapū māmā community agency support.

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Module 2 Clinical Team  

Module 2. Clinical Team Capacity and Capability Building    

In module 2 the competency and capability requirements of implementing Best Start will be addressed. This includes a relevant literature review, a training analysis, and the development of clear clinical processes for safe management of early pregnancy risks,  as well as role definitions for general practitioners, nurse practitioners, practice nurses, midwives, and secondary care services to ensure early pregnancy care is provided within a safe, equitable and effective system. The Clinical Team module will align with localisation of an early pregnancy care Health Pathways update.

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Module 3. Wrap Around Social Services Platform

The Wrap Around social services platform explores the management of identified pregnancy-related risk and need. Pregnancy-related risk is currently managed via a series of pathways of care developed during the region’s experience with the earlier pregnancy assessment tool (EPAT). These pathways of care will be reviewed against the experiences of hapū māmā during the project with a feedback loop to adjust referral and management processes. Referral and management gaps will be identified and addressed.  Pregnancy-related need is currently managed on an ad hoc basis without clearly developed referral and management pathways. Support for pregnancy wellbeing services is  known to exist in the community but  engagement with health services is unstructured. Activity during  this module will identify community and NGO services and develop a social services platform to facilitate a wrap-around model of pregnancy care.

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