1. Getting it right for children Dr Justine Cornwall Deputy Children’s Commissioner New Zealand Respiratory Conference Wellington 19 September 2013

2. Office of the Children’s Commissioner Independent Crown entity, with the role to advocate for better outcomes for New Zealand children under the age 18 years Main functions include: –Monitoring CYF delivery –Advocating for children –Promoting UNCROC

3. The priorities More children grow up healthy More children grow up with access to adequate resources More children achieve their education potential More children are safe and free from all forms of abuse and neglect

4. Child Poverty Many children do not have access to the resources they need to thrive. NZ has high levels of child poverty 25% or 270,000 children living in poverty in NZ (was 11% in 1986) Child poverty is costly and affects everyone about 3% of GDP per annum Child poverty can be reduced … but there are no inexpensive simple solutions: we need an evidence-informed, comprehensive, sustained effort Child health

5. So who is growing up in poverty? Children living in poverty and their families are diverse and there is no one typical “poor child”. Family structure Income source Ethnicity Housing tenure Age of children Size of families Geographical area

6. Child Health NZ has poorer child and youth health outcomes compared to many OECD countries We have marked health disparities among Māori and Pacific peoples and among those living in poverty ̶ differences exist within and among DHB NZ children have high levels of infectious disease, injury, maltreatment, social morbidity, and suicide. Child poverty

7. Some children are at greater risk Young children experiencing poverty –as many significant aspects of child development occur in the earliest years and harm in this period has life-long impacts In New Zealand, we need to give specific attention to: –overcoming inequalities for Māori and Pasifika –the particular issues facing children in sole- parent families –children facing severe and persistent poverty Child poverty Child health

8. What do kids say poverty is? “Get sick ‘cause it’s cold – can’t afford heating.” “You can’t afford basic necessities – can’t afford to go to the doctors. Live in shit damp, cold houses.” “If you don’t have much money you can’t afford to get there [to the doctor] – petrol, public transport and then you can’t afford to pay the doctor.” “You may get into debt with paying any medical treatment.”

9. The experiences of childhood are not like footprints in the sand. They are more like footprints in cement – long lasting

10. So what is happening?

12. What’s the problem we’re trying to solve? Unexplained variation between services in delivery & outcomes across DHBs-> potential to improve outcomes by –Identification of “positive deviance” Innovation, leaders, areas with > expected outcomes –Peers supporting peers to improve –Improve equity of outcomes

13. Compass themes 2013: 1.Best start to a healthy life 2. Child development and disability 3. Child, youth and whānau-centred care 4. Leadership and governance 5. Primary care 6. Youth health

14. What else can be done to make a difference in addressing child health and poverty? 1.Get housing sorted 2.Look at ways to deliver health services through schools or community hubs 3.Start early – improve antenatal and early childhood services 4.Work collaboratively – common assessment and referral pathways

16. Our Challenge We know there are a range of fantastic initiatives out there in communities working to address health and poverty related issues. But how do we get the impact we need? How can we harness the range of activity going on so that agencies and services are working side by side to the same goal?

17. Collective Impact: 5 conditions Common agenda Backbone support Shared measurement Mutually reinforcing activities Continuous communications “Collective impact” describes highly structured collaborate efforts to achieve substantial impact on a large scale social problem

18. Thank You