Lead indicators to drive Early Childhood Development (ECD) Systems


Sharon Goldfeld1, 2, Nicholas Perini4 Christopher Harrop5, Karen Villanueva1, 3, Hannah Badland3, Carly Molloy1, 2

1 Policy and Equity, Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne Australia, 2 Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia, 3 Centre for Urban Research, RMIT University, Melbourne, Australia, 4 Social Venture Australia, Melbourne, Australia, 5 Bain & Company, Melbourne, Australia

Health and education inequities are preventable. Early childhood (0-8 years) lays the foundation for health and developmental trajectories into adulthood.  These early years are especially influenced by the environments in which children live and grow.   Evidence shows that intervening early can produce positive and sustained effects on child outcomes. A large body of international evidence demonstrates that children who experience disadvantage fall increasingly behind over time.  A contributing factor is that children experiencing adversity are less likely to have access to the environmental conditions that support them to thrive.  Many of these factors are modifiable at the community level. Driving local system change toward equity is both urgent and important. Data-driven, evidence-based system metrics provide communities with access to more precise data to assist them with decision-making and allocation of limited resources.  Lead indicators form the bridge between outcome indicators, such as the Australian Early Development Census, and early childhood development system assets that are more immediately modifiable.  By combining system metrics from two projects we propose a set of lead indicators that provide communities with information to both understand and prioritise effort according to their needs and subsequent co-designed solutions to any performance gaps.  The Kids in Communities Study (KiCS)  investigated community-level factors associated with early childhood development in five community domains – physical, social, service, governance, and socio-economic environments. It developed a set of evidence-based foundational community factors (FCFs) which lay the foundations of a good community for young children. Within the service domain, Restacking the Odds has derived and tested a set of evidence-based lead indicators encompassing quantity, quality and participation across 5 key services platforms (antenatal care, early childhood education, schools, nurse home visiting, and parenting programs).  Together, these lead indicators can help focus efforts to create more equitable and adaptive systems.


Professor Sharon Goldfeld is a paediatrician/public health physician, Director of the Population Health Theme (Murdoch Children’s Research Institute) and Director of the Centre for Community Child Health (Royal Children’s Hospital). She has built a career as a policy-focused public health and paediatric practitioner and researcher. Her research interests are made up of complementary, synergistic and cross-disciplinary streams of work focused on investigating, testing and translating sustainable policy relevant solutions that eliminate inequities for Australia’s children. Sharon has a decade of experience in state government as a senior policymaker in health and education, including principal medical advisor in the Victorian Department of Education and Training. Sharon was recently awarded the inaugural Marles Medal for excellent and original research that led to outstanding achievement in research impact.

Dr Carly Molloy is a Senior Research Officer at the Murdoch Children’s Research Institute (MCRI) and Senior Program Manager for Restacking the Odds (RSTO) a collaboration with Bain & Company and Social Ventures Australia seeking to establish an actionable, evidence-based measurement framework to sharpen funding and service delivery in the early years.  Most of her research has focused on the long-term outcomes of children who were born preterm, including the evaluation of targeted interventions.  Carly has recently focused her research on paediatric public health and her research investigates how evidence-based quality and access indicators can be used to drive change.