A new University of Otago study is calling for fundamental changes to New Zealand’s health system after finding that systemic barriers are preventing many pēpi from being enrolled in primary healthcare early enough to receive timely immunisations.
The research, led by Dr Amber Young, Senior Lecturer in the School of Pharmacy and Pharmacology at the University of Otago, highlights how gaps in the healthcare system are disproportionately affecting Māori and Pacific infants, contributing to lower enrolment rates with primary care providers and delayed childhood vaccinations.
Speaking to Radio Waatea, Dr Young said improving immunisation rates requires more than encouraging parents to vaccinate. She says the health system itself must make it easier for whānau to access services from the very beginning of a child’s life.
The study found that many of the barriers occur well before a child is due for their first vaccination.
Delays in enrolling newborns with a general practice, inconsistent information-sharing between maternity and primary care services, workforce shortages and difficulties navigating the health system can all contribute to missed or delayed immunisations.
Researchers say these challenges are often greatest for Māori and Pacific whānau, who continue to experience longstanding inequities in access to healthcare.
Early Enrolment Matters
Enrolment with a primary healthcare provider shortly after birth is a critical step in ensuring pēpi receive routine health checks, developmental assessments and vaccinations according to the National Immunisation Schedule.
When enrolment is delayed, opportunities to build relationships with healthcare providers and deliver preventative care can also be delayed.
The study suggests that strengthening links between maternity services, hospitals, Well Child/Tamariki Ora providers and general practice could significantly improve continuity of care during a child’s earliest months.
Researchers argue that system-wide coordination, rather than expecting whānau to navigate multiple services independently, is essential to improving outcomes.
Māori Continue to Face Greater Barriers
Although childhood immunisation rates have improved in some areas, inequities remain.
Māori infants continue to experience lower on-time vaccination rates than many other population groups, despite strong evidence that immunisation protects against serious infectious diseases and reduces hospital admissions.
Health experts say these differences are not the result of lower levels of care for tamariki, but are driven by structural barriers including access to primary care, transport, workforce shortages, poverty, housing instability and the ongoing effects of institutional inequity.
Researchers say addressing those barriers is central to achieving equitable health outcomes.
Prevention Starts Before Illness
The study reinforces the importance of viewing immunisation as part of a broader system of preventative healthcare.
Early engagement with health services allows healthcare professionals to provide breastfeeding support, monitor child development, offer health education and identify issues before they become more serious.
Dr Young says improving enrolment processes could deliver benefits extending well beyond immunisation rates by strengthening the relationship between whānau and primary healthcare providers throughout a child’s early years.
A System Designed Around Whānau
The researchers argue that future improvements will require a more coordinated and whānau-centred approach.
This includes simplifying enrolment processes, improving information-sharing between health services, ensuring families are connected with primary care before or immediately after birth, and supporting Māori-led health providers to deliver culturally responsive care.
For Māori, healthcare is increasingly recognised as being most effective when services are built around whānau, recognising that the wellbeing of pēpi is closely connected to the health and wellbeing of parents, caregivers and wider family networks.
Health advocates say investing in early childhood healthcare is one of the most effective ways to improve lifelong health outcomes and reduce inequities across generations.
As Aotearoa continues working to improve childhood immunisation coverage, the University of Otago research suggests the solution lies not only in encouraging vaccination but in building a health system that ensures every pēpi has an equal opportunity to access care from the very beginning.
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