The Maternity Action Plan

The Maternity Action Plan (MAP) was developed in 2018 based on consultation with the maternity sector about what needed to be done to improve the maternity system in Aotearoa New Zealand.

The MAP includes initiatives to strengthen national and local maternity quality and safety programmes, support workforce sustainability and better support women and whānau.

It is part of the Programme of Action for the Government’s Child and Youth Wellbeing Strategy and is a significant step in improving the wellbeing of women, pēpi and whānau.

In Budget 2020, the Ministry received $35 million over four years to support the maternity sector through expansion of the MAP. This funding has been used for urgent, practical actions to enhance the stability and sustainability of the maternity sector.

MAP initiatives which are being progressed or have been completed in the last 12 months include the items below.

Updates to the Primary Maternity Services Notice 2021, which significantly change the way primary maternity care is funded:

  • An additional $85 million will be paid over four years to Lead Maternity Carers, which includes self-employed midwives
  • The changes will better recognise the lead maternity care provided to women with complex social or clinical maternity care requirements and those belonging to groups over-represented in the most concerning outcomes.
  • The additional funding also addresses remuneration for time and travel required to provide lead maternity care - particularly, but not exclusively, in rural areas.

Strengthening of the DHB Maternity Quality and Safety Programme (MQSP) across the country to improve health outcomes for mothers and babies. Additional funding has been provided to enable at least one MQSP Coordinator to work in every DHB to ensure maternal quality and safety is prioritised, and to enable  quality improvement projects and equity funding for DHBs with the most need. The total expenditure on this programme is now $5 million per annum.

The promotion and support of Rautaki Whakamana Whāngote, our Breastfeeding Strategy.

Clinical Midwifery Coaches - this programme funds experienced midwives working in New Zealand’s DHBs to provide clinical support to other midwives.

  • Funding of $5 million ($3.8 million from the Government and an additional $2.2 million from DHBs) has been committed to support this initiative over the next three years
  • At least one clinical coach will be available at each DHB
  • DHBs with multiple hospitals, higher birth rates and/or tertiary levels of care may receive additional coaching support.

Funding to support Return to Practice programmes - this aims to make it easier and more attractive for former midwives to refresh their practising certificates and return to this rewarding career. Funding is available to cover the educational and professional costs associated with the programme.

Te Ara ō Hine - Tapu Ora - a wrap-around programme supporting Māori and Pasifika midwifery students to complete their studies successfully and increase the number of Māori and Pasifika midwives in New Zealand.

The Government committed $6 million which will be used over four years to ensure there is at least one person at each school of midwifery providing lead pastoral and academic support, and to actively recruit new Māori and Pasifika midwifery students.

The programme also provides financial assistance to the Māori and Pasifika student midwives enrolled in the programme, to support them through their studies, including a discretionary hardship fund to provide additional support.


Refocusing the Maternity Action Plan 2021-2023

The health landscape has shifted significantly since 2018.

The findings of the Health and Disability System Review have been released, and Whakamaua – The Māori Health Action Plan has provided us with a roadmap to address the longstanding issues driving inequities in outcomes. We also know more about the breadth of action needed to support maternal, child and youth wellbeing.

The Ministry is refocusing the Maternity Action Plan for its final two years, so it has a greater focus on equity, and aligns with the approach being taken to transform Well Child Tamariki Ora. We also need the maternity sector to be well placed for the changes ahead through the health and disability system reforms.

The new Maternity Action Plan will be developed through a Te Tiriti o Waitangi based partnership and will work to deliver our aspirations for equitable health and wellbeing outcomes.

Actions underway

  • To better support whānau experiencing the loss of a baby, early work is underway on a bereavement pathway. Results from next year’s triennial consumer survey, which will include the bereaved parents survey, will support the development of this pathway.
  • The Ministry is completing a stocktake of DHB and contracted maternal mental health services, which will be published by the Ministry later in 2021. This will help us identify further areas for improvement in maternal mental health.
  • The Maternity Ultrasound Advisory Group has been reconvened to provide advice to the Ministry to ensure all pregnant women have equitable access to high quality, clinically appropriate maternity ultrasound services.

Maternity Action Plan 2019-2023

The Maternity Action Plan (MAP) is the Government’s programme of work to strengthen and transform New Zealand’s maternity system.

The MAP is part of the current Programme of Action for the Government’s Child and Youth Wellbeing Strategy (the Strategy). This Strategy identifies that maternity and child health services hold the responsibility to ensure children have the best possible health, starting before birth.

The MAP has five workstreams, with associated work programmes, outputs, outcomes and measures.

  1. Strengthening maternity service commissioning and accountability
  2. Improving equity, quality and safety of maternity services
  3. Building a sustainable maternity workforce
  4. Delivering whānau-centred maternity care
  5. Linking whānau health and social supports

The Government and the Ministry of Health acknowledge the special position of Māori as tangata whenua of Aotearoa New Zealand and the MAP strives to reflect the principles of Te Tiriti o Waitangi throughout its design and delivery.


Maternity Action Plan initiatives - updated 28 September 2021

Maternity Initiative Timeframe Anticipated Outcome

Expansion of Maternity Quality and Safety Programmes

(under contract)

2020-2024

Improvement of quality care and consumer satisfaction

Reduction of maternal and infant adverse events, particularly with Māori, Pacific and Indian women

Robust learning and feedback from adverse events

Support for maternity sector professionals to enable provision of safe and quality maternity care for all women and babies

Te Ara ō Hine

(under contract)

April 2020-2024

Reduced attrition of Pacific and Māori undergraduate students

Increased Māori and Pacific midwifery workforce providing culturally-safe midwifery care

Improved outcomes for Māori and Pacific women and whānau

Midwifery Clinical Coaches

(under contract)

2021-2024

Improved safety culture within maternity units in DHBs

Greater workforce retention

Reduction in maternal and neonatal adverse events

Supporting Midwifery Return to Practice programme

(under contract)

2021-2024

Supporting midwives to return to clinical practice through removing financial barriers

Increased number of midwives working clinically.

Improved maternal and infant outcomes

Reduced attrition in better supported midwifery workforce

Support for the Notice 2021 Project (Primary Maternity Services Notice)

Health Information Standards Organisation Maternity Care Summary Standard

Support for implementation of perinatal spine

(all under contract)

2021-2023

Enables implementation of new Notice and enables allocation of Budget 2020 funding of care for women with complex needs and care provided to women in rural locations

Standardisation of maternity data allows clinicians real time access to women’s pregnancy details wherever they present in New Zealand, ensuring the provision of clinically appropriate care

Refresh of Ministry of Health Pregnancy and Parenting Information webpage with equity focus

(under contract)

2020-2021

Provision of culturally appropriate consumer-facing information for Māori and Pacific populations

Increasing access to culturally appropriate parenting information

Review and refresh of Maternity Clinical Guidance

(under contract)

2020-2022

Improve provision of equity and evidence-based care leading to improved maternal and infant outcomes for Māori, Pacific and Indian women and babies

Undertaking triennial consumer survey (including bereaved parents)

(under contract)

2021-2022

To inform future planning/ system change for service integration models

To inform development of bereaved parents’ pathway

Reconvening the Maternity Ultrasound Advisory Group

2021-2022

Receive findings from the Maternity Ultrasound Advisory Group to inform future investment options.

Promotion and support of Rautaki Whakamana Whāngote, Aotearoa’s Breastfeeding Strategy

 

2021-2022

To protect, promote and support breastfeeding in New Zealand Aotearoa through acting as a resource for communities, policy makers, researchers and other stakeholder organisations.

 

 

Future initiatives under refocused Maternity Action Plan

Timeframe

Anticipated Outcomes

Maternal mental health initiatives

  • Maternal Mental Health Stocktake
  • Other to follow

2021-2023

Improve provision of equity and evidence-based care for women and whānau with mental health needs leading to improved maternal and infant outcomes for Māori, Pacific and Indian women and babies

Development of bereavement pathway for parents

2022-2023

Bereaved parents are supported and have access to consistent and appropriate support services

Maternity ultrasound

2022-2023 To ensure that pregnant women have equitable access to high quality, clinically appropriate maternity ultrasound services
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