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Too many children are born into circumstances that do not provide them with a reasonable opportunity to make a good start in life. 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 and 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.
Restacking the Odds (RSTO) aims to transform the capacity of service providers and communities to collect and use data on service availability, quality and participation. 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 strategies (i.e., ensuring they are all applied for a given individual), there will be a cumulative effect - amplifying the impact and sustaining the benefit. The RSTO team analysed data from the Longitudinal Study of Australian Children to show that ‘stacking’ early interventions has a positive effect on child development outcomes. Access the
evidence on 'stacking'.
View more project information
Today, too many early childhood services are delivered with low fidelity and variable quality, and too many children and families miss out – often because decisions on service design, delivery and improvement are based on a limited understanding of what works to improve children’s health and developmental outcomes.
To address this, 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.
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Phase two of RSTO is a prototyping phase that builds on the progress and lessons from the first phase. It aims to embed the use of the Restacking lead indicators at the scale 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 process. This work is supported by a major, multi-year philanthropic grant.
Restacking 2.0 will:
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Our publications aim to help you learn about quality factors that are most impactful on children’s development, who should be participating and what quantity and what infrastructure/workforce is required to deliver these services and programs effectively.
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).
How can I use this information?
These indicators will help identify gaps and priorities in Australian communities. We will test preliminary indicators in 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.
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.
The technical reports supplement the communicat
ion 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
RSTO provides participating communities with a report containing a service environment summary and findings specific to their community. These are presented and distributed to the communities and relevant stakeholders. Below is an example of what a community could expect.
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.
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.
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
Our collective aspiration is to create a new approach to tackling intergenerational disadvantage in Australia that delivers ground-breaking results.
Get in touch for more information:
The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.