Using data and evidence to drive effective policy and practice for children Best Start Forum Melbourne, November 27, 2007 Professor Frank Oberklaid Director, Centre for Community Child Health Royal Children’s Hospital, Melbourne, Australia

‘By kindergarten, significant preventable inequalities in development have emerged…’ - Hertzman (2006)

The developmental trajectory and life course Outcome Age

Sub-optimal developmental trajectory… Unfulfilled potential and problems in childhood Beginning of pathways to problems later in life Evidence that many problems in adult life have their origins in pathways that begin in childhood Loss of potential of achievement in multiple domains and facets of life

Intervention effects and costs of social-emotional mental health problems over time (Bricker) Time High Low Cost Intervention effectiveness

‘Nothing hard is ever easy’ Don Berwick

The importance of data ‘Data should be at the centre of child health (and policy), not in the periphery of monitoring.’ Child Health Indicators of Life and Development (CHILD) - Report to the European Union 2002

Data collection Reliable Valid Relevant Meaningful Simple to collect Coverage adequate for validity - universal Useful - can be utilised to inform policy or programs

Uses of community data Measuring variables relevant to ECD Evaluating change in variables over time Comparisons with other communities Informing community about ECD Assessment of community support for ECD

Data are useful Community program/services directors Local government planners Government policy makers School principals Community ECD leaders

ECD data help break down service and professional silos ‘…maps invite observers to contemplate a broad understanding of early development that transcends the boundaries of any single policy envelope…education, health,childcare, welfare or justice…’ -Hertzman (2006)

Data help create partnerships Interpreting and acting on the results Asking the question why? Community responses to results Provides best chance of local community ownership and sustainability (Offord)

Reliable data mobilise communities around ECD Raises awareness of ECD Provides surprises Answering the question ‘why’ Breaks down silos Informs service planning Prompts new policies and programs Encourages innovative community responses Supports argument for additional resources

Data can guide community interventions Allows the provision of specific recommendations that can be implemented at population and community-wide level

The Platforms Strategy A research based strategy designed to assist local communities refocus services for children and families, and strengthen the capacity of communities to provide positive outcomes for children

Platforms Service Redevelopment Framework PHASE 1 Raising awareness PHASE 2 Engaging the community PHASE 3 Planning PHASE 4 Implementing PHASE 5 Monitoring and evaluation

PHASE 2: ENGAGING THE COMMUNITY Objectives  Identifying key government and non-government stakeholders  Identifying key policies, programs and initiatives  Profiling community demographics and major community issues  Health/developmental profile of children at school entry Resources CCCH Community Audit Tool: A set of guidelines for conducting a systemic audit of policies, initiatives, funding and key community issues in a particular locality AEDI: An instrument used to assess key domains of a child’s functioning considered important for ‘school readiness’

PHASE 3: PLANNING Objectives  Identifying and building local resources and leadership  Mapping community resources and needs  Setting priorities and developing a detailed action plan Resources CCCH Community Planning Toolkit: Guidelines and resources designed to assist communities in planning and refocusing services to emphasize prevention and early intervention to improve ECD outcomes. This involves linkages and improved coordination between different service types (e.g. child health and child care services) CCCH Outcomes Framework: A guide to planning community-based services and service systems to optimize outcomes for ECD

Community Planning Toolkit A practical and accessible series of resources (manuals and guidelines) that enables communities to address important service delivery issues: Map community assets and resources Establish data collection systems and select indicators Undertake a community needs survey Establish a Community Partnership Group Identify a community links worker Work with culturally and linguistically diverse and hard to reach groups

Domains of the AEDI The EDI measures a child’s development in 5 areas: – physical health and well-being – social competence – emotional maturity – language and cognitive development – communication skills and general knowledge

Abbreviations used: PhysPhysical health and wellbeing SocSocial competence EmoEmotional maturity LangLanguage and cognitive skills ComCommunication and general knowledge Vul 1Vulnerable on one or more domains Vul 2Vulnerable on two or more domains NoTotal number of children surveyed AEDI Profile Summary LOGAN BEAUDESERT, Queensland Prepared by: AEDI National Support Centre, GIS Source: AEDI Communities Data 2007

LOGAN BEAUDESERT Geographic Area, Queensland. 60km South of Brisbane Proportion of children vulnerable on one or more domains

Early childhood community profiles Profiles developed initially for Best Start Sites (25) Produced for all LGAs in Victoria Contain demographic profile of families and children aged 0-8 Show how children in the LGA are faring across a range of early childhood indicators Allows comparison with Rural/Metro/State benchmarks

Demographic Data Couple and one-parent families with children 0 to 8 years in Elsewhere and Victoria

Demographic Data Median income for families with children 0 to 8 years in Elsewhere and Victoria

Demographic Data Parental education for families with children 0 to 8 years in Elsewhere and Victoria

Breastfeeding rates in Elsewhere Elsewhere (C) was ranked 62 out of 78 LGAs on the percentage of infants fully breastfed at 3 months. A rank of 1 was assigned to the LGA with the highest percentage of infants fully breastfed. Elsewhere (C) was ranked 67 out of 78 LGAs on the percentage of infants fully breastfed at 6 months. A rank of 1 was assigned to the LGA with the highest percentage of infants fully breastfed. Based on

Breastfeeding rates in Elsewhere Percentage of children fully breastfed at 3 months and 6 months in Elsewhere

Reading assessment in Elsewhere

Percentage of children meeting benchmarks on reading assessment in Prep, Year 1 and Year 2 in Elsewhere

Demographic data for Elsewhere Percentage of all children aged 0 to 8 in Elsewhere and Victoria who are Aboriginal

Teen births in Elsewhere The rate of births per 1000 females aged 15 to 19 in Elsewhere and Victoria Note: births data pooled for 4 years, single year population denominator

Immunisation rates in Elsewhere Percentage of children months fully immunised in Elsewhere and Victoria,

Child protection substantiations in Elsewhere Rate of child protection substantiations per 1000 children aged 0 to 8 in Elsewhere and Victoria, Note: child protection data pooled for 2 years, single year population denominator

‘Nothing hard is ever easy’ Don Berwick

“The way in which the world is imagined determines at any particular moment what men will do.” - Walter Lippmann, Public Opinion, 1921