The origins of Kootuitui ki Papakura are rooted in the commitment of the Middlemore Foundation for Health Innovation to improving the health and well being of children and their families. In the past, working with Counties Manukau Health (CMH) they raised funds for and supported the building of a dedicated children’s hospital in South Auckland; Kidz First Children’s Hospital and Community Health.

In 2012, the Children's Commissioner released a report on Child Poverty that reinforced the impetus for developing a joined up approach. Discussions of how to get children out of poverty focused on those elements of their lives that would have the greatest long term impact through providing equality of opportunity, namely:

- being healthy

- good housing

- improved educational outcomes

At the same time, the declining health of children in South Auckland was of considerable concern to both CMH and the Middlemore Foundation. Working in partnership they established an innovative programme called Mana-ā-Riki. The programme, which was to be based in schools, included 3 strands: Education, Health and Homes.

Papakura was identified by CMH as an area for such a programme as it had high health needs, had a clearly defined population and was not included in the existing Mana Kidz programme.

The Manaiakalani Education Programme had started making measurable gains for children in Glen Innes and through association with the Chair of MET, the Middlemore Foundation visited Manaiakalani schools. The insights gained provided further inspiration to include the Manaiakalani Education programme as the Education Strand of the Mana-ā-Riki programme. Improving educational outcomes for children was recognised as an investment; giving children the opportunity to reach their full potential.

The Middlemore Foundation held forums with schools, Marae and community groups to share the vision and concept, and gauge interest in uptake. Schools were asked to opt in to the whole programme with all three strands. At the start six schools opted in to be part of the cluster.

The Middlemore Foundation named the programme Mana-ā-riki: the mana of the child, achieved through investing in many small (riki) changes to make a powerful (mana) impact. The aim was to raise funds for the pilot of the programme for three years (2016- 2018) in Papakura.

The pilot was launched in Papakura in Feb 2016 with the name ‘Kootuitui ki Papakura’, the weaving together of the strands. A school based health service was established first in all 6 schools followed by the sequential roll out of the chromebooks through the Manaiakalani Outreach education programme. The healthy homes strand together in collaboration with local whaanau and community representatives and was rolled out in 2017.

The Foundation recognised that in order for the programme to be sustainable after the initial three years, the establishment of a local charitable trust would be necessary. It identified an inaugural Chair and thereafter school and community representatives made themselves available to enable the formation of the Kootuitui ki Papakura Trust in late 2015. The trust structure gives the community ownership of the programme. Establishing it early in the pilot programme allows time for the Trust to develop the skills and independence necessary to assume full responsibility for Kootuitui ki Papakura from 2019.