About the Well Child/Tamariki Ora Quality Programme

Well Child Schedule

The Well Child/Tamariki Ora (WCTO) programme aims to support and promote the healthy development of children and their families/whānau from birth to five years. It is a universal programme, designed on the principle of providing services for all, with additional services available according to need.

The current New Zealand WCTO schedule(external link) includes four contacts during the postnatal period provided by lead maternity carers (LMCs), a six-week check by general practice, and a further eight contacts from four to six weeks through to five years provided by WCTO providers (Ministry of Health 2010c, 2010d). Additional contacts (which may begin antenatally) are provided on the basis of assessed need. It also includes oral health, immunisations, new-born metabolic screening, new-born hearing screening along with a before school check.

Aims and standards of the quality improvement framework

Expectations of the WCTO QI Framework:
Aim 1: Improved safety and quality experience for the child, family/whanau and community.

All children and families/whanau have access to primary care, WCTO services, including B4SC and early childhood education

Guiding Principles

  • Families/whānau can access WCTO services easily.
  • Families/whānau feel respected by WCTO providers, and services build on a family/whānau’s strengths, needs and choices (family/whānau-centred approach).
  • Families/whānau have effective relationships with WCTO providers.
  • WCTO services are culturally appropriate, respectful and responsive to diversity.
  • Families/whānau receive WCTO services that are safe and effective.
  • Families/whānau who need extra support receive it promptly.
Aim 2: Improved health and equity for all populations

WCTO Providers use evidence based interventions and education to promote child and family/whanau health and well-being

Guiding Principles

  • Systems support universal access to WCTO services.
  • WCTO services focus on prevention and early intervention at every opportunity and actively facilitate referrals to other services as needed.
  • Clinical governance and review is implemented at a local and national level.
  • WCTO providers actively work to improve engagement with WCTO and other services by all populations.
Aim 3: Best value for health system resource

WCTO services are delivered at the right time

WCTO providers deliver services according to best practice (inappropriate variation is reduced)

Guiding Principles

  • WCTO services are timely, appropriate, safe and efficient, and are evidence-informed.
  • The WCTO workforce is competent, skilled and supported.
  • The WCTO workforce works collaboratively across service and provider boundaries to address the wider determinants of health.
  • WCTO providers regularly monitor quality and coverage data, to drive improvement and reduce inappropriate variation.


Midland initial indicators/measures

  • New-borns are enrolled with a General Practice by 49 days
  • Immunisations are up to date by 8 months
  • New-borns are enrolled with a WCTO service by 49 days
  • Infants receive all WCTO core contacts in their first year
  • Infants are breastfed at 3 months
  • Children are enrolled with oral health services by 12 months
  • Children receive their core oral health checks
  • Children are caries free at 5 years old
  • Four year olds have a before school check (B4SC)

Whole system approach

Quality indicators do not stand alone: they are part of a whole-system approach to quality improvement that includes:

  • standards (the WCTO Quality Improvement Framework)
  • monitoring (Midland performance data dashboard)
  • support for collaboration and planning quality improvement priorities (DHB-led local WCTO quality improvement programmes and Midland WCTO Quality Improvement Manager)
  • support for learning and sharing best practice (Well Child Innovation Hub)

Project team

Project management

The Ministry of Health has provided funding for one full time project manager for a 2 year period to work in each region to help manage and encourage innovation in the sector. The project manager reports quarterly to the Ministry of Health on quality progress for the Midland region.

Kathryn Fromont

Kathryn Fromont - Midland Project Manager
RM, R Comp N, PG Dip Management Studies

Regional governance

Regional governance for the project is carried out by the Midland WCTO Project Board, which consists of the Midland Well Child Portfolio Managers.

Core roles:

  • Ensure the project delivers on the required benefits for their DHB
  • Provide clear leadership and direction to the project
  • Ensure strategic alignment of existing and new projects with the WCTO quality activities.


Ruth Rhodes Senior Portfolio Manager Waikato District Health Board
Julie Wilson Executive Director Strategy and Funding Waikato District Health Board
Karina Elkington Portfolio Manager Waikato District Health Board
Zanta Jones Portfolio Manager Taranaki District Health Board
Tim Slow Portfolio Manager Bay of Plenty District Health Board
Connie Hui Portfolio Manager Bay of Plenty District Health Board
Sharon Pihema Portfolio Manager Tairawhiti District Health Board
Pip King Portfolio Manager Lakes District Health Board

Local steering groups

Each district has formed a local group of expert child health stakeholders to develop and lead quality work/initiatives within their area of expertise.

Core roles:

  • Providing expertise on initiatives for the quality plan;
  • Providing clinical input for targets related to clinical outcomes;
  • Leading/carrying out tasks to meet the objectives of the quality plan;
  • Motivating and supporting staff to achieve targets;
  • Reviewing the reports to ensure that the measures are reaching their targets;
  • Acting upon identified areas for improvement; and
  • Assessing the effectiveness of the plan and its implementation as well as making changes as required.

Waikato steering group membership


Dr David Graham

Clinical Unit Leader for Child Health, Community & General Paediatrician Waikato District Health Board
Shirley Hopping Manager South Waikato Rural Maternity Birth Facilities Waikato District Health Board
Karina Elkington Well Child Portfolio Manager Waikato District Health Board
Rachel Cassie LMC Hamilton
Diane Rawiri Clinical Nurse consultant Plunket
Janet Leonard Tamariki Ora Nurse Te Korowai Hauowai o Hauraki
Denise Kingi General Manager Te Kohao Health
Jill Dibble   Waikato District Health Board
Diane Pevreal Manager Community Oral Health Waikato District Health Board
Wanetta Sayer WCTO Nurse Raukura Hauora o Tainui
May Thomas WCTO Nurse South Waikato Pacific Island
Donna Leger Health Manager Raukawa Charitable Trust
Sandra Mentjox WCTO Nurse Raukawa Charitable Trust
Koratika Kabwea/Rachel Fata WCTO Nurse K’aute Pasifika
Phallyn Rangitaawa Registered Nurse/Outreach Immunisation Ngati Maniapoto Marae Pact Trust
Bronwen Warren Child Health Service Manager Midlands Health Network PHO
Karen McKellar Team Leader Hauraki PHO
Ditre Tamatea Director Te Puna Oranga

Tairawhiti steering group membership

Julia Brooking Registered Nurse Ngati Porou Hauora
Janine Brown Immunisation Coordinator Tairawhiti District Health Board
Kim Cameron B4SC Public Health Nurse Tairawhiti District Health Board
Aporina Chapman Health Promotion Advisor Tairawhiti District Health Board
Justine Crawford Project Manager Te Ora Hou
Nicki Dever Clinical Care Manager WCY Tairawhiti District Health Board
Sandi French Clinical Nurse Manager – Well Child Tairawhiti District Health Board
Melaine Harema Social Worker Tairawhiti District Health Board
Megan Holmes Clinical Leader Plunket
Janneen Kinney Tamariki Ora Nurse Turanga Health
Tausilia Leftufuga Registered Nurse – Tamariki Ora Turanga Health
Hinemoa McLelland Rural Health Nurse Ngati Porou Hauora
Nicki Mathieson Health Promotion Advisor Tairawhiti District Health Board
Arish Naresh Team leader Dental Tairawhiti District Health Board
Sharon Pihema Portfolio Manager Tairawhiti District Health Board
Paula Renouf Nurse Practioner Ngati Porou Hauora
Shona Samuels YMCA Coordinator YMCA
Tui Takarangi Health Promotion Advisor Tairawhiti District Health Board
Kuini Tichborne Kaiawhina Ngati Porou Hauora
Mike West Data Analyst Tairawhiti District Health Board
Kiri Wray Registered Nurse Turanga Health

Taranaki steering group membership

Jacqui Herrett Child Health Project Lead Taranaki DHB
Kathryn Fromont Midland WCTO Quality Manager Midland DHB’s
Zanta Jones Portfolio Manager – Planning and Funding Taranaki DHB
Marnie Reinfelds Child Youth and Family facilitator Midlands Health Network PHO
Jody Hardy LMC LMC
Bernadette Winks LMC and TDHB Midwife Taranaki DHB
Cheryl Sole Neo Nats Nurse Taranaki DHB
Cass Gray or Gina Plunket Plunket
Gaylene Gary Tui Ora Tui ora
Joanne Larsen Ngaiti Ruanui Ngaiti Ruanui
Amber Erueti IT project Manager Taranaki DHB
Ngamata Skipper Maori Health Taranaki DHB
Robyn Maxwell Screening Unit Taranaki DHB
Cressida Gates- Thompson TDHB comms Taranaki DHB

Bay of Plenty and Lakes to be confirmed.