Initiatives have been introduced to try to improve the Southern District Health Board's substandard statistics in offering stop-smoking advice to expectant mothers.
The board has regularly missed the national health target of 90% of women who are pregnant receiving help to quit smoking, according to documents released to the Otago Daily Times under the Official Information Act.
The most recent report showed 71.4% of women were given brief advice and support to quit smoking, a decrease of 8.9% from the previous quarter.
Only 53.8% of pregnant Maori smokers were given any advice to stop smoking.
The board has previously questioned the accuracy of the statistic and the validity of any inference drawn from it. In an earlier report it noted "Our 17/18 Q1 result was the worst ever for the total population and second worst ever for the Maori population ... this is completely out of line with previous results and again brings the reporting of this target into question."
However, its most recent response to the Ministry of Health accepted the poor results and promised to address them.
"Little increase in the numbers of women who were offered or accepted support to quit is noted and this is again disappointing," the board said.
Programmes introduced to tackle the problem included reintroducing a weekly Stop Smoking Services clinic at Dunedin Hospital's maternity clinic (mirroring a similar programme at Southland Hospital), and a more targeted approach to help midwives with many clients who smoke.
"The SDHB has mapped the domiciles of women who are identified as smoking at birth and are working with the midwives who practise predominantly in these areas and with these particular caseloads of women in an attempt to increase information sharing and referrals," the board said.
The ministry said the targeted approach was a good initiative and it looked forward to seeing what impact it had.
A separate report circulated at a Smokefree Steering Group meeting earlier this year suggested where those efforts would be of most use.
Southland had far more smoking mothers-to-be (67) than Dunedin (43). In Dunedin, some midwives were not looking after any smokers at all, while in Southland, all lead maternity carers reported looking after smokers.
"The highest number of smoking women cared for was 10 by one midwife, with five others caring for between five and seven women who smoked at the time of birth."
Smoking rates for pregnant women in Gore and Oamaru were also of concern.
"It is not surprising that there is a greater prevalence of smoking in women from Oamaru and the Gore areas, as this would reflect areas of greater deprivation and higher Maori populations," the report said.
It recommended working more closely with midwives in Invercargill, Gore and Oamaru to see how better results could be achieved.
