The First 1000 Days: A South Island Report

The First 1000 Days Report was published in September 2018 and developed by Community and Public Health (Canterbury DHB) with the South Island Public Health Partnership as part of the Partnership’s contribution to the Hauora Alliance*. The report includes a handy summary document, comprehensive report and appendices (links below).

The report sets out to provide information to inform inter-sectoral planning, action and monitoring to enable the best start in life for every child in the South Island. Highlighted are the opportunities for inter-sectoral action by addressing gaps in leadership, accountability and monitoring; improving access to or engagement with existing services; improving co-ordination and integration of existing services, and addressing gaps and inequalities.

Using the Te Pae Mahutonga Framework, the report outlines the existing services available for whānau over the First 1000 days and provides key actions to improve outcomes for every South Island Child.

* Hauora Alliance is a cross-sector partnership working to address South Island hauora from a population perspective. Hauora Alliance is hosted by and includes members of the South Island Public Health Partnership, alongside members from community and local and central government organisations.

First 1000 Days Report
First 1000 Days Summary
First 1000 Days Appendices

Improving Health Through Transport Planning


27 Aug 2018
UK public health specialist Lucy Saunders presents on the Healthy Streets initiative in Christchurch earlier this month.

Making streets more inviting and public transport more accessible is part of an approach that could be adopted across the South Island to improve health and social connection.

UK public health specialist Lucy Saunders, who is the driving force behind the ‘Healthy Streets’ initiative, visited Christchurch earlier this month to engage with planners, local government, social services and others from across the region. Supported by the South Island Alliance, Environment Canterbury, and the Canterbury/West Coast branch of the Transportation Group to visit the city during her stay in New Zealand, Lucy spoke about Healthy Streets at a workshop, governance breakfast, and a public hui. Lucy was also the keynote speaker at this year’s ‘2 Walk and Cycle’ conference in Palmerston North.

Rather than the traditional approach of tackling physical inactivity by putting the responsibility on the individual and encouraging them to do more sport or be active, Healthy Streets focuses on incidental exercise, where people are supported by their environment. “It’s about little and often exercise throughout the day that you don’t have to pay for or even think about,” Lucy says. “Some of the healthiest communities in the world where people are the most active is not because they are highly motivated to exercise or are really sporty, it’s because it’s a necessity of their daily life that they do a little bit of exercise throughout the day.”

Lucy currently leads on the integration of transport and public health in London, supporting Transport for London, boroughs and advocacy organisations. Her approach has revolutionised street planning in the UK. Roading that promotes safe walking or cycling over short car journeys will get people thinking, and changing their routines, she says.

“We need to make our streets inclusive to everyone. It’s about looking at the spaces between buildings and asking – is this meeting our basic, fundamental needs? Do I feel safe? Is the air clean? If I need to stop, is there shelter and somewhere to rest? Many streets don’t meet these criteria, which all make it safer and easier for people to include healthy activity into their daily lives by cycling and walking, or at least walking to the bus stop.”

Len Fleet of Environment Canterbury, Lucy Saunders of Healthy Streets, Jane Murray of Nelson Marlborough Health and Tom Scott of Southern DHB, discuss how the initiative could be used in cities and towns across the South Island.

Jane Murray, Health in All Policies Advisor for Nelson Marlborough Health, attended all three events and says it was inspiring to hear an expert in the field talk so passionately about creating healthy streets. “Lucy made it easy to understand her concepts, not only the content of her Healthy Streets programme, but the different ways she adapts her presentations to a range of audiences.” Jane says she can see Lucy’s concepts being brought into submission work and collaborative project work locally. “Since returning to Nelson, other transport engineers in the district also saw Lucy speak in Palmerston North and are interested in carrying on conversations about it here.”

Tom Scott, Team Leader of Healthy Environments for Public Health South at Southern DHB, attended two of Lucy’s events and says he found her work, ”very insightful”. “The learnings will be imparted to our staff, in the hope we can engage even more effectively with our transport stakeholders. Moving the conversation away from promoting active transport to strategies for disincentivising motorised transport was a key learning for me.”

Lucy says there are many things different individuals and agencies can do to make changes. “Delivering Healthy Streets is everyone’s responsibility, not just one leader or agency, so it was really encouraging to see Christchurch City Council, health and ECAN working together to keep people out of hospitals and living well in the community.”

Find out more at

Creating Healthier Streets A Special Christchurch Event

31 Jul 2018

Lucy Saunders

The South Island Alliance is pleased to be supporting public health specialist Lucy Saunders’ upcoming visit to Christchurch.

Lucy is a prominent public health consultant visiting from London, where she currently leads on the integration of transport and public health, supporting Transport for London, boroughs and advocacy organisations.

Lucy is the keynote speaker at this year’s ‘Walking and Cycling’ conference in Palmerston North. In Christchurch, she will be engaging with a variety of planners, local government, social services and others from across the region about her Healthy Streets initiative. A workshop, governance breakfast and public hui are all planned from 5-8 August.

Find out more about Lucy at  

Public Health Partnership Update

30 Nov 2017

Read the latest news from the Public Health Partnership for November 2017, here.

Guest Editorial Keith Reid Chair Of The Public Health Partnership

31 Aug 2017


Keith Reid, chair of the South Island Public Health Partnership, and Clinical Leader, Public Health South.

Across the South Island, there is much talk and activity aimed at reducing the burden on our hospital services – providing ‘the right care in the right place at the right time’ or ‘care closer to home’. Comparatively, there is little talk about addressing the root cause of this demand, by making our population healthier. But, there is important activity going on. It’s only by generating health in our people where we live, learn, work and play, that we will tackle the long-term demand on health care services. So, why is there less of a focus on this aspect of demand reduction, than on health care services?

A number of studies demonstrate that the quality of health care services and ease of access to them accounts for only about 10 percent of the overall ‘health’ of a community.  If we examine variance in health status between communities, most of that variance is determined neither by the quality and accessibility of clinical care, nor by the genomic characteristics of the population – each of which accounts for only 10 percent of the variance. Most of the variance in health status is accounted for by factors not under the direct control of the health care sector. About 30 percent is determined by individual behaviour (i.e. physical activity, diet, smoking) and about 40 percent arises from social and economic factors, such as community cohesion, income inequality and meaningful employment. It’s vital that we look outside the health care sector for solutions if we’re serious about health. In public health, we interpret such studies as demonstrating that effective action on health needs to be focused on building healthy communities, which is sometimes seen as denigrating or devaluing the work of clinicians. We are not advocating for an ‘either/or’ approach, but for a ‘both/and’ way of working. Both public health approaches and health care are important in maximising human capital: the first by creating the conditions for people to flourish and the second to mitigate the effects of illness, disease or injury.

Concepts of return on investment are important here. The benefit of ‘public health’ approaches is not always directly attributable at an individual level. There remains the misconception that return on investment from public health initiatives only occurs over several years, decades or generations. However, there is a growing body of evidence that public health interventions not only represent an excellent return on financial investment, but also deliver measurable results over comparably short periods: months to years. That’s why the South Island Public Health Partnership (SIPHP) is working together with partners from other sectors across the South Island to establish a Public Health Alliance.  This is a project the SIPHP began work on last year and has now expanded to include members of other sectors, as we seek to define a common purpose, identify shared priorities and map out new or expanded ways of working. 

Although this initiative began within the ‘health’ sector, the Public Health Alliance is being created jointly by the sectors it contains. Health will be one among many. The expectation is that work undertaken on behalf of the Public Health Alliance might include cross-sector work initiated by health, with a direct payback for health care budgets and work initiated by other sectors where health is both a contributor and a beneficiary of the activities. We hope that in time it will also be an overarching body for work undertaken outside the health care sector, which will nonetheless also provide a very direct benefit through its contributions to well-nourished, well-housed, well-educated, active and engaged communities across the South Island. We look forward to supporting the work of our clinical colleagues through this initiative. But mostly, we look forward to helping the whole population live longer, happier and more fulfilled lives, wherever they work, learn or play.

HistoryThe South Island Public Health Partnership comprises the clinical leaders and managers from the three Public Health Units of the South Island and Maori public health specialist, and the Ministry of Health. The partnership pre-dates the South Island Alliance arrangements, but now works within the South Island Alliance framework.

Public Health Partnerships Alcohol And Tobacco Work Endorsed

16 Dec 2013

The Boards of all five South Island DHBs have endorsed regional position statements on tobacco control and alcohol harm reduction that will now support a South Island coordinated approach on these issues.

Both documents have been developed collaboratively by the three South Island Public Health Units that make up the SI Alliance’s Public Health Partnership (PHP).

Southern DHB-based Chair of the PHP Dr Marion Poore said these statements demonstrated the value of working collaboratively on two significant risk factors for a number of chronic diseases.

“By working in a co-ordinated way the DHBs aim to reduce the harm people currently experience from drinking alcohol in a hazardous way and also aim to minimise the potential for future harm,” she said.

“For example working with police and licensing inspectors to improve the safety around special license events in order to reduce the number of people being seen in emergency departments.”

Alcohol use is a major risk factor for numerous health conditions, injuries and social problems, causing approximately 4% of deaths worldwide and (in 2000) 3.9% of all deaths in New Zealand.  Much acute harm results from intoxication and includes: road traffic injuries and fatalities, burns, falls, drowning, poisoning, foetal alcohol spectrum disorder, assault, self-inflicted injury, suicide and homicide.

Dr Poore explained that the PHP is supporting the Public Health Units to develop an outcomes framework and set of indicators to guide DHBs in their development of and monitoring of their Alcohol Harm Reduction Strategies. A draft of this is due to go out for consultation with key stakeholders early in 2014.

PHP member and GM of Canterbury Public Health Evon Currie said tobacco use is the most important cause of preventable disease, so multiple approaches are key to overall reduction of smoking.

“Having support across the boards enables all DHBs to tackle harm minimisation in a whole-of-system, collaborative way, which will have greater impact on tobacco control.”

Ministry health research shows that tobacco use leads to a higher incidence of cancer, cardiovascular and respiratory disease and lower life expectancy for Maori compared to the rest of the population. In 2009 smoking data in New Zealand showed that one in five (21%) adults aged 15-64 years were current smokers, with 19.2% of adults smoking daily (Ministry of Health 2010), a steadily declining figure (recent census data shows smoking rates have fallen from 2006 to 2013 to 15.1% in adults aged 15+.)

New South Island Alliance Vision Underscores Public Health Work

10 Dec 2013

The South Island Alliance’s Public Health Partnership (PHP), which draws together the three South Island Public Health Units (PHU) to work collaboratively on regional issues, has been buoyed by the recent change to the South Island Alliance vision that puts emphasis on people – inclusive of communities – in contrast to a focus on patients.

PHP Chair Dr Marion Poore said she was delighted with the new Alliance Framework which embraces improving population health as a core aim of health services.

“From our perspective the community we work with is by and large healthy. So it is important that the three SI PHUs continue to work collaboratively to keep our SI population as healthy as possible by creating and protecting healthy environments.”

“The revised vision highlights increased awareness of the importance of the wider environment in which we live and work, recognising that factors outside of the immediate health system impact on our health,” she said.

This point was expressed in the South Island Alliance Programme Office’s (SIAPO) presentation at the recent Alliance workshop. 

“We should be making decisions for our South Island population, not just the individual patient.  This revised framework brings the population health factors into the framework in a more visible way,” said SPaIT chair David Tulloch.

The PHP also aligns well with two of the alliance’s goals of population health and sustainability, working in tandem with the third goal, the experience of care.