'Choices' helps reduce health inequalities.

What began as a vision of one determined woman 14 years ago has surely been realised today. Choices/Kahungunu Health Services in Hawke's Bay has grown enormously since it began as an independent midwifery practice in 1995 (see profile Koi Tiaki Nursing New Zealand, July 2007, p12-13).

Under the guidance of founder and chief executive Jean Te Huia, Choices is now not only a midwifery service but a health service provider led by a team of registered nurses and health workers. The organisation offers a wide range of services via nurse-led clinics and community nursing. These services include Tamariki Ora, school-based nursing, diabetes and asthma services, B4 school checks and sexual health, to name a few.

Choices has three clinics in the Hawke's Bay area, in Hastings, Flaxmere and Waipukurau. There are 20 staff and seven nurses, three of whom are also registered midwives. It has recently relocated the Hastings' clinic and office to a larger, more central location and was officially opened last month. The move has certainty ted to some exciting new beginnings.

The new location has a fully equipped indoor sports court and gym, allowing Choices to run indoor netball, dodgeball, handball and indoor cricket games. We now have somewhere to hold sports events with other hauora as part of networking within the Hawke's Bay community. The gym also caters for those participating in the Healthy Lifestyles programme.

This programme, funded by the Hawke's Bay Primary Health Organisation, is a new service that gives clients, especially Maori, the opportunity to improve their physical heath and well-being. Working alongside the healthy lifestyles coach Heather Skipworth, and her fully trained and competent gym staff, clients are supervised through all aspects of the programme, including full health assessments, nutrition advice and individual fitness regimens tailored to their needs. Some activities include excursions to walk/run the Te Mata Peak track, Kahuranaki Hikoi and circuit training. On completing the programme, clients are presented with certificates at a graduation ceremony, held at the gym.

Being part of the Choices/Kahungunu Health Services has helped me grow both personally and professionaly. I began my health career in 1995 as a Plunket kaiawhina in Putaruru, the south Waikato township where I grew up. Working with Plunket for eight years gave me a wonderful insight into many aspects of the health system.

In 2003, when our family relocated to Hawke's Bay, I got a different perspective while working as a caregiver. I then realised that nursing was the pathway for me and so I completed a bachelor of nursing at the Eastern Institute of Technology in 2006. I started my nursing career doing the new graduate programme in the Hawke's Bay Regional Hospital's orthopaedics ward for approximately seven months. However, shift work proved very difficult to manage with my young children to care for. Thankfully, I was given the opportunity to work with Choices as the co-ordinator for the Tamariki Ora contract.

Furthering my nursing knowledge

Working at Choices for nearly two years now has provided me with many opportunities to further my nursing knowledge and experience. I have not only learned about Tamariki Ora services but have also been fortunate to deliver all nursing services including immunisations, nurse-led clinics, practice nursing, school-based nursing, smoking cessation, asthma, cervical screening and mobile nursing clinics. Earlier this year, I completed a postgraduate certificate in primary healthcare--Well Child health. With the suport of Jean Te Huia, I was also one of four nurses from the Hawke's Bay region to attend a "train the trainers" course in Wellington for B4 school checks. This allowed me to be part of the team to introduce this new Ministry of Health initiative to the local region. I am now one of three supervisors with Choices, overseeing our community nursing contracts.

Last year I took on the role of proxy for Te Runanga O Aotearoa, representing Hawke's Bay. This is a very exciting role and I am finding it both challenging and rewarding. Being part of Te Runanga has empowered me to promote the wonderful opportunities available and provides a chance to meet other Maori nurses.

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Being part of the Choices team continues to be an ever-growing, ever changing and positive experience. The Healthy Lifestyles programme continues to be a great success and a wonderful health promoting incentive for the community. Our nursing services cater to a wide range of clients, particularly those belonging to the high-needs sectors of our region.

Working for Choices has made me realise and appreciate the uniqueness and diversity of our organisation and the services we provide. Choices/Kahungunu Health Services continues to strive for the best, working with other local providers towards a shared goal of reducing health inequalities in Hawke's Bay.

Report by Te Runanga Hawke's Bay proxy Tracey Morgan in Ngati Raukawa raua ko Tainui