Hitting the target without missing the point: New Zealand’s immunisation health target for two year olds

ABSTRACT

The use of health targets as a form of performance measurement has become more prominent internationally as governments have sought to control public expenditure, produce greater efficiency and improve accountability. However, health targets have faced criticism for their potential to produce negative outcomes within a health system. This paper examines how a health target was used as a policy instrument within the New Zealand health system to improve immunisation coverage at two years of age. It explores how the immunisation health target was implemented within four case study sites and discusses the effectiveness of the health target as a policy instrument for improving immunisation coverage and addressing persistent immunisation inequities. Measuring and monitoring performance towards the immunisation health target improved accountability for immunisation coverage within the New Zealand health system and focused attention on improving immunisation coverage in a way that previous policy attempts had failed to do. Health targets may be an effective policy instrument for creating change within specific areas of a health system if their potential for dysfunctional consequences are taken into consideration at the outset.

KEYWORDS:

• Performance measurement
• policy instrument
• targets
• accountability
• health systems

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Esther Willing is a lecturer with Te Kupenga Hauora Māori at the University of Auckland, Auckland, New Zealand. Her research interests include indigenous health, health policy and health services research.

Additional information

Funding

This research was funded by a University of Auckland Doctoral Scholarship.