title: Nurse-led school-based  clinics for rheumatic   fever prevention and skin   infection management:   evaluation of Mana Kidz   programme in Counties   Manukau.
abstract: OBJECTIVE
  To evaluate registered nurse-led school clinics in 61 primary and intermediate schools in Counties Manukau.
  
  
  METHODS
  The evaluation (conducted August–December, 2014) collated evidence concerning service delivery, outcomes, value for money and effectiveness.
  
  
  RESULTS
  97% (23,756/24,497) of eligible children were consented, 11% (20,696/191,423) of throat swabs taken (February 2013–September 2014) were culture positive for Group A Streptococcus (GAS); 20,176 were treated. Mana Kidz teams treated (includes cleaning and covering alone) 17,593 skin infections and actioned 4,178 school health referrals. A pre-programme cross sectional GAS pharyngeal prevalence demonstrated a relative risk 1.8 (1.3–2.3) (95%CI) of being pharyngeal GAS positive in 2013 compared to 2014. Hospitalisations for acute rheumatic fever (ARF) and skin infections for children aged 5–12 years living in Counties Manukau are declining and this appears to be temporally related to the introduction of the Mana Kidz programme. Effective engagement with children, parents/ whānau and improved health literacy was demonstrated, especially knowledge about sore throats, ARF, medication adherence and skin infection. The programme was delivered at $280 per participating child in the 2013/14 financial year.
  
  
  CONCLUSIONS
  Mana Kidz is an effective programme with a substantial contribution to health care for children, aged 5–12 years, identified at increased risk of poor health outcomes.
authors.forename: Philippa
authors.initials: P
authors.lastname: Anderson
authors.forename: Julian
authors.initials: J
authors.lastname: King
authors.forename: Michelle
authors.initials: M
authors.lastname: Moss
authors.forename: Phil
authors.initials: P
authors.lastname: Light
authors.forename: Tracy
authors.initials: T
authors.lastname: McKee
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Farrell
authors.forename: Joanna
authors.initials: J
authors.lastname: Stewart
authors.forename: Diana
authors.initials: D
authors.lastname: Lennon
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D057220:Health Literacy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010612:Pharyngitis / Q000175:diagnosis / Q000382:microbiology; D011320:Primary Health Care; D015397:Program Evaluation; D011637:Public Health Nursing; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012213:Rheumatic Fever / Q000517:prevention & control*; D012572:School Health Services; D012874:Skin Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents