It was in South Auckland that school-based sore throat clinics were first trialled in New Zealand.
More than a decade later, the region, with the highest rheumatic fever burden in the country and about 500 young people on the register, is being funded to roll out clinics again. Following a pilot last year, the South Auckland clinic model includes a public health nurse per 400 children to address wider health issues.
The initial 1998-2001 randomised-controlled trial of sore throat clinics was lead by Professor Diana Lennon of the University of Auckland and involved about 24,000 children attending 53 historically high risk schools for rheumatic fever. Pupils at the 26 control schools received usual GP care and pupils at the 27 sore throat clinic schools received school-based education and throat-swabbing by community health workers, with public health nurse follow-up for positive swabs.
The major research project, funded by the Health Research Council, Heart Foundation, and Ministry of Health, led to a 28 per cent reduction in rheumatic fever.
Lizzie Farrell, clinical nurse manager for Kidz First public health nurse team at Counties Manukau District Health Board, was part of the project and experienced the frustration of it taking another decade of lobbying, and the efforts of the MÄori Party, for funding to be found again for sore throat clinics in South Auckland.
“As a public health nurse, you feel a sense of despair when you see young people whose potential is blighted by an easily prevented disease.”
Farrell teamed up with Lennon again last year for a research project piloting a public health nurse-led, school-based primary health care programme at
Wiri Central Primary School that, along with daily health worker throat swabbing, included nurses assessing skin infections and working with the wider family.
This has led to a different model of sore throat clinic being offered in South Auckland.
The National Hauora Coalition won the Ministry of Health contract to fund throat swabbing three days a week in 18 schools in Counties Manukau DHB, with the first clinic launched in late July at Rongomai School.
Counties Manukau has stepped in to fund further child health services, so the sore throat swabbing can be offered five days a week and for one public health nurse per 400 children to offer wider child health services to pupils and their siblings.
Farrell says the model is not totally school-based, with the school to be the hub for working with the school’s wider community, including issues like healthy housing.