First 1,000 Days

The first 1,000 days of a child’s life lay the foundations for their entire future. The clock starts at conception and runs to the child’s 2nd birthday.

Te Hiringa Hauora | Health Promotion Agency takes a life-course approach to health promotion. That means focusing on a healthy start to life and targeting a person’s needs at critical points across their lifetime to keep them well, rather than just responding when they are already sick.

For the First 1,000 Days programme, that means focusing on quality of life for mothers and babies, so they get equitable outcomes from generation to generation.

The programme also embraces the wider whānau because whānau and child wellbeing are interdependent.

Key Messages

The first 1,000 days of a child’s life lay the foundations for their entire future. The clock starts at conception and runs to the child’s 2nd birthday.
Robust evidence shows it is critical to invest in the first 1,000 days, so that every child gets the strongest start to life. We must act early. Even earlier than we think.
The time before conception is important. It is a period to secure the wellbeing of future parents, so that if a pregnancy does happen, the first 1,000 days have the best chance of being positive for both the parents and the child.
Becoming a parent can be a hopeful time for change. It can also ramp up a parent’s stress, anxiety or old trauma. Children’s wellbeing depends on adults’ wellbeing.
Mātauranga Māori has much to offer. Long-held indigenous knowledge shows us a lot about how early life experiences affect pēpi. Western science is now including this understanding in its own approach.

What does Te Hiringa Hauora do? 

Understanding what matters most to people helps us to design a better system. One of the biggest things Te Hiringa Hauora does is listen to, and learn from, others.

Te Hiringa Hauora values different ways of doing things and ways of interpreting the world. This helps to build a health and wellbeing system that focuses on equity, as well as quality of life, for mothers and babies from generation to generation.

Communities know exactly what they need. They have the innovation and leadership to find the solutions, they may just need the support to deliver them.

Te Hiringa Hauora partners with communities (see Community partnerships and innovation section below) to support local solutions to their own wellbeing challenges. These may cover maternal mental wellbeing, equitable access to contraception, culturally relevant antenatal education, policy advice or resources for whānau and the child wellbeing sector.

To support the transformation of the New Zealand health system, Te Hiringa Hauora advocates and shares quality research, advice, evaluations and insights. The aim is to influence the health sector and a new direction that will lead to hapū māmā (pregnant women), pēpi, tamariki and whānau thriving long term.

Te Hiringa Hauora also supports the Ministry of Health with its National Immunisation Programme, and works with our Youth in Transition programme to support New Zealand’s future parents.

Find out more in our First 1,000 Days programme summary:

More about the programme

Community partnerships and innovation

Ngā Wānanga o Hine Kōpū (Te Tai Tokerau | Northland)

Ngā Wānanga o Hine Kōpū is a free kaupapa Māori labour, birth and parenting programme. It delivers Māori antenatal knowledge – which draws on mātauranga Māori – to wāhine hapū and their whānau.

Te Hiringa Hauora is supporting an evaluation of this programme. It will provide evidence to support whānau-led, hauora Māori and Māori-centric approaches across the health sector. Digital stories of māmā and whānau who have participated in the wānanga will also showcase how profoundly it has shaped their parenthood journey.

Hakeke Productions – Raro Timu, Raro Take (South Island | Te Wai Pounamu)

Te Hiringa Hauora is supporting Hakeke Productions on a project to revitalise customary birthing practices in Te Wai Pounamu.

The work will provide greater engagement and encouragement of wāhine Māori and whānau in maternity care. It aims to deepen professional midwifery knowledge and build greater confidence to deliver safe cultural practices.

Pēpi Penapena – Ngākau Aroha Parenting (Nationwide)

Pēpi Penapena works to ensure pēpi and tamariki Māori are happy and loved, so they can grow into the rangatira of tomorrow.

Ngākau Aroha Parenting shares parenting practices of tūpuna Māori with whanau and kaimahi in the health, social welfare and education sectors. Te Hiringa Hauora is supporting Pēpi Penapena with its marketing strategy and the design and development of core resources.

Moana Research Maternal and Infant Wellbeing (Tāmaki Makaurau | Auckland)

Moana Research’s team of researchers and clinicians provide evidence-based resources and support to Pacific parents and aiga.

Te Hiringa Hauora is supporting them to develop videos and resources, provide information and aid talanoa about infant care and attachment, maternal mental wellbeing and help-seeking, and safe sleep, all from a Pacific worldview.

National Hauora Coalition – Hapū Māmā Kōrerorero (Nationwide)

The Hapū Māmā Kōrerorero project will co-design resource and messaging to encourage access to primary care supports during pregnancy. It will inform a wider project, Generation 2040, a pro-equity approach where primary care providers are incentivised to use the Best Start Kōwae assessment modules with hapū māmā Māori or pēpi Māori. Its objective is to improve access to quality care and reduce inequities.

Learning from community during the pandemic (Nationwide)

Psychosocial responses to the 2020/2021 COVID-19 lockdowns created opportunities for community partnerships to not only support women through the pandemic but also to explore:

  • what it takes to work effectively with change-makers in communities
  • the power of mātauranga Māori to support maternal wellbeing.

The Innovation Unit, a group of social innovation and community-led development experts, produced a report which clearly identifies how to make the most of learning from the experience.

This report will influence the work of Te Hiringa Hauora, especially in relation to the First 1,000 Days strategy and be shared with others to maximise its impact.

For example Te Pā Harakeke o Papatūānuku aimed to make people more aware of maternal mental wellbeing during the 2020 COVID-19 lockdown. The video discusses homebirth, post-natal depression, wahakura and connections with whenua, whakapapa and whānau. The project was a collaboration between whānau, Whānau Āwhina Plunket, Hāpai Te Hauora and Te Hiringa Hauora.

Resources and tools

Many innovative community resources, tools and initiatives play an important part in advocating for and driving change across the health system and the practice of those working in the sector. Others are designed to support whānau and communities to strengthen their own wellbeing. They include:

  • Manaaki Tamariki – Kia au tō moe, a toolkit on safe and healthy sleep for babies and young children to support health professionals who work with Māori and Pasifika parents and caregivers.
  • Alcohol.org.nz. which provides information to wāhine hapū and those who support them about alcohol free pregnancies.
  • Mana Pasifika, which builds on the success of the 2020 campaign which told stories of hope and resilience, we are continuing to work on this kaupapa.
  • He Kai Kei āku Ringa, a partnership with Toi Tāngata to develop resources around every day kai.
  • HealthEd (healthed.govt.nz), New Zealand’s largest collection of prevention-focused public health information resources. It is available for health professionals and the public to access free of charge.

Pre pregnancy

The time before conception is important. It is a period to secure the wellbeing of future parents, so that if a pregnancy does happen, the first 1,000 days have the best chance of being positive for both the parents and the child.

In the past, we largely focused on preventing fetal alcohol spectrum disorder (FASD), and alcohol-free pregnancies. While these kaupapa are still important, the way we approach them has changed.

We are shifting from messages aimed at individuals to supporting whole communities to develop solutions to reduce alcohol harm and improve maternal wellbeing. Alcohol.org.nz will still provide up-to-date evidence and online learning opportunities about preventing FASD.

We are expanding our work to include a focus on equitable access to contraception. These are some of the projects happening in this area:

  • hui on reproductive health promotion and access to contraception
  • contraception projects – investing in kaupapa as identified by Māori and Pasifika leaders
  • ‘Whare Tangata and Contraception’ an online wānanga series with Māori Māmā about their experiences of contraception (produced by ‘Kia Ora Māmā’ a private online community of 5000+ and Arataua Media).  

Maternal mental wellbeing

Becoming a parent can be a hopeful time for change. It can also ramp up a parent’s stress, anxiety or bring up old trauma. Children’s wellbeing depends on adults’ wellbeing.

Mental wellbeing for all New Zealanders is a high priority for Te Hiringa Hauora. It informs all priority areas and maternal mental health is a particular area of focus for the First 1,000 Days programme.

Three partnership projects will build our kete of resources and influence to support maternal wellbeing.

  1. Pasifika projects: for example supporting Perinatal Anxiety and Depression Aotearoa (PADA) to improve availability of resources and information for Pasifika parents and aiga.
  1. Māori maternal wellbeing hui: supporting PADA to host a perinatal mental wellbeing hui which will focus on restoring traditional knowledge in a modern world.
  1. Mana Pasifika, to build on the success of the 2020 campaign which tells stories of hope and resilience, we will continue to work on this kaupapa.

Immunisation

Te Hiringa Hauora works with the Ministry of Health's immunisation team to provide communications and marketing support for its National Immunisation Programme.

Throughout the year - and in response - to disease outbreaks, we promote immunisations for babies, children, adolescents and adults including pregnant women.

The gap between immunisation rates of Māori, Pasifika and other ethnicities has widened in recent years. We are working on targeted efforts to support Māori and Pasifika confidence in, and access to, immunisation.

Te Hiringa Hauora is working with Māori researchers to better understand Māori communities’ experiences of childhood immunisation and identify what discourages, or encourages, families to immunise their children. The research will be used to develop tools to support the Ministry and the wider sector, in their work for and with Māori families who are making decisions about childhood immunisations.