Stay informed with the latest updates on coronavirus (COVID-19). Find out more >>
CCCH art

Restacking the Odds

  • Restacking the Odds (RSTO) is a project that aims to ensure that children and families can access a combination of high-quality, evidence-informed services where and when they need them.

    Participation in quality early childhood services helps to set children on the right path to fulfill their potential. But when services are underused, unavailable or vary in quality, they can’t fully meet the needs of children or families.By focusing on the early years and supporting services to better meet the needs of children and families, RSTO helps to create the conditions that enable all children to thrive.

    RSTO infographic


    *select the image to view or download the graphic

    What is RSTO?

    RSTO focuses on how to work differently to improve outcomes for children, families and communities. It aims to develop the skills and knowledge of RSTO partners for collecting, understanding and using evidence-based data to enable them to answer key questions including:

    • Quantity: Are sufficient services available?
    • Quality: Are we delivering high-quality services?
    • Participation: Who is accessing our services?

    While there is no single simple solution to the complex challenges that some children and families experience, by focusing on service participation, quality and quantity, RSTO can amplify the impact of services and help optimise the benefits for children and families.

    Building blocks for change

    RSTO focuses on five services available in most communities. Together, they help to boost children’s health development and wellbeing:

    1. antenatal care
    2. sustained nurse home visiting
    3. early childhood education and care
    4. targeted parenting programs
    5. the early years of school

    Through RSTO, service providers and communities will be better placed to:

    • respond to the needs of children and families in their community, especially those experiencing vulnerability and disadvantage
    • provide more effective and efficient services (and avoid wasting time, money and effort on approaches that fail to deliver results)
    • learn and share with others striving to improve children’s outcomes
    • capture evidence for insights, innovation and advocacy.

    Project stages

    The RSTO project involves three main phases:

    1. Building the evidence

    The project’s first phase completed research to develop and apply evidence-based lead indicators for the effective delivery of the five fundamental strategies. These indicators define how the strategies should be delivered across three dimensions: quality, quantity and participation.Working across seven communities these indicators were assembled to understand how the fundamental services were being delivered and accessed and whether the indicator data was of practical value.

    2. Prototyping

    This phase builds on the progress and lessons from the first phase. It aims to better understand the key barriers and enablers to collecting, analysing and using evidence-based data amongst service providers and communities and to co-design feasible prototype solutions to embed the routine use of the Restacking lead indicators in key settings. It will also focus on translation and advocacy to help build broad-based interest in the framework and its adoption.

    View media release

    3. Scaling

    This phase will focus on moving from prototypes in key settings to full scale adoption needed to accelerate system level change and make a real difference to children experiencing disadvantage across Australia. The work will expand into new communities across Australia and include a rigorous evaluation.

    Publications and resources

    RSTO publications and resources aim to help you learn about the quality, quantity and participation indicators that are most impactful on children’s development and support you to put them into action. These indicators will help identify gaps and priorities in Australian communities.

    Research spotlight

    Barriers, facilitators, and strategies to improve participation in ECEC

    The study aimed to help communities and policy makers better understand why families, particularly those experiencing disadvantage, are disengaged with certain services, as well as identify potential solutions or strategies to increase participation in early childhood education.

    Access the research summary

    Barriers, facilitators, and strategies to improve participation in parenting programs

    RSTO investigated the barriers and facilitators to participating in community interventions. This study used a mixed methods research design with information collected via online surveys and interviews.

    Access the research summary

    Academic papers

    Communication summaries

    The communication summaries give an overview of system indicators. You can use the indicators to ‘test’ whether your organisation’s practices align with the sort of best practice likely to lead to better outcomes for children. You can also use the indicators to start developing a monitoring system for your organisation’s performance.

    Technical reports

    The technical reports supplement the communication summaries by way of providing a detailed account of the reviewed literature that informed the development of best practice indicators for antenatal care, early childhood education and care, and parenting programs. The technical reports for sustained nurse home visiting and the early years of school will be available in due course, in the meantime if you are interested please contact Dr Carly Molloy

    Partner with us

    We welcome the opportunity to work with and learn from those who share our goal so together we can accelerate efforts to reduce inequity and maximise the opportunity of the early years. To partner with us, or find out more about RSTO, get in touch with Olivia Hilton, General Manager:

    Our team

    • Olivia Hilton: General Manager
    • Dr Carly Molloy: Research and Data Lead
    • Karen Villanueva: Research Officer
    • Caitlin MacMillan: Research Associate
    • Kellie Horton: Engagement Lead
    • Rosie Hodson: Advocacy Lead
    • Neal Morrell: Research Assistant 

    Our Steering Committee

    • Prof Sharon Goldfeld: Director, Centre for Community Child Health and Theme Director, Population Health, The Royal Children’s Hospital Melbourne and Murdoch Children’s Research Institute
    • Chris Harrop: Senior Partner, Bain & Company
    • Nick Perini: Director, Consulting, SVA

    Restacking the Odds or RSTO is a collaboration between the Murdoch Children’s Research Institute ,Bain & Company and Social Ventures Australia . RSTO would like to acknowledge our project partners Paul Ramsay Foundation and Seer Data for their support of the project.


Murdoch Childrens Research Institute

The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.