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Restacking the Odds

  • Inequities emerging in early childhood often continue into adulthood, contributing to unequal rates of low educational attainment, poor mental and physical health and low income. In some cases, this experience is part of a persistent cycle of intergenerational disadvantage. Inequities constitute a significant and ongoing social problem and – along with the substantial economic costs – have major implications for public policy. To redress inequities, research tells us that efforts should be delivered during early childhood (pregnancy to eight years of age) to deliver the greatest benefits. 

    About the project

    Restacking the Odds focuses on five key evidence-based interventions/platforms in early childhood: antenatal care; sustained nurse home visiting; early childhood education and care; parenting programs; and the early years of school. These five strategies are only a subset of the possible interventions, but we have selected them carefully. They are notably longitudinal (across early childhood), ecological (targeting child and parent), evidence-based, already available in almost all communities, and able to be targeted to benefit the ‘bottom 25 per cent’. Our premise is that by ‘stacking’ these fundamental interventions (i.e. ensuring they are all applied for a given individual) there will be a cumulative effect - amplifying the impact and sustaining the benefit. For more information see the project information sheet (PDF).


    Our intent is to use a combination of data-driven, evidence-based and expert informed approaches to develop measurable best practice indicators of quality, quantity and participation for each of the five strategies:

    Quality: Are the strategies delivered effectively, relative to evidence-based performance standards? A strategy with ‘quality’ is one for which there is robust evidence showing it delivers the desired outcomes. A large number of research studies have explored aspects of this question (i.e. “what works?”). Therefore, we pay particular attention to the quality dimension in our work and analysis.

    Quantity: Are the strategies available locally in sufficient quantity for the target population? ‘Quantity’ helps us determine the quantum of effort and infrastructure needed to deliver the strategy adequately for a given population.

    Participation: Do the appropriately targeted children and families participate at the right dosage levels? ‘Participation’ shows us what portion of the relevant groups are exposed to the strategy at the level required to generate the desired benefit (e.g. attending the required number of antenatal visits during pregnancy). Participation levels can be calculated whether the strategy is universal (for everyone), or targeted (intended to benefit a certain part of the population).

    These indicators will help identify gaps and priorities in Australian communities. We will test preliminary indicators in 10 communities over the next three years to determine which are pragmatic to collect, resonate with communities, and provide robust measures to stimulate community and government action. 


    Project team

    Restacking the Odds is a collaboration between three organisations, each with relevant and distinctive skills and resources:

    Murdoch Children's Research Institute (MCRI) is an independent medical research institute. MCRI’s research covers the breadth of health and medical research from basic science through to clinical sciences and population health. MCRI is committed to giving all children the opportunity to have a happy and fulfilled life.

    • Prof Sharon Goldfeld – Deputy Director Centre for Community Child Health and Co-group leader Policy, Equity, and Translation, Royal Children’s Hospital and Murdoch Children’s Research Institute
    • Dr Carly Molloy – Research Officer and Project Manager, Murdoch Children’s Research Institute. Carly is the Project Manager for Restacking the Odds, and can be contacted at

    Bain & Company is one of the world’s leading management consulting firms. Bain works with executives and organisations to help them make better decisions, convert those decisions into actions, and deliver sustainable success.

    • Chris Harrop – Partner, and member of Bain’s worldwide Board of Directors.

    Social Ventures Australia (SVA) supports partners across sectors to increase their social impact. SVA helps business, government and philanthropists to be more effective funders and social purpose organisations to be more effective at delivering services

    • Nick Perini – Principal, SVA Consulting.

    Our collective aspiration is to create a new approach to tackling intergenerational disadvantage in Australia that delivers ground-breaking results.


    Restacking the Odds is funded by philanthropic grants.


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.