A mixed-methods evaluation of child health services in rural Australia: Access, quality and coordination
Alan SilburnBackground:
Children living in rural and remote regions of Australia experience disproportionate rates of preventable illness, delayed diagnosis and reduced access to essential health services. Contributing factors include geographic isolation, workforce shortages, socioeconomic disadvantage, fragmented service provision and inconsistent integration across primary, community and specialist care. Evidence evaluating service accessibility, quality and coordination at a system level remains limited, impeding targeted policy and planning.
Aim:
This proposed study aims to evaluate the accessibility, usage, quality and coordination of child health services across selected rural communities in Australia, providing actionable insights for service planning and equity enhancement.
Methods:
The study will use a convergent parallel mixed-methods design that integrates multiple data sources. Components will include: (i) secondary analysis of de-identified administrative data on primary care attendances, developmental assessments, immunisation coverage, hospital presentations and allied health referrals; (ii) online surveys of parents/caregivers ( n =200) and health providers ( n =80), assessing perceptions of access, quality, cultural appropriateness and co-ordination; (iii) semi-structured interviews with purposively sampled stakeholders ( n =20–30), exploring barriers, enablers and workforce capacity; and (iv) geospatial analysis mapping service locations, travel times and coverage. Quantitative and qualitative data will be analysed separately and then integrated to identify system-level bottlenecks, disparities and opportunities for improvement.
Expected results:
The study will characterise patterns of service access, usage and quality, and identify disparities by age, sex, indigenous status, remoteness and socioeconomic factors. It will elucidate workforce constraints, referral inefficiencies, coordination gaps and unmet needs, while geospatial mapping will provide objective evidence of accessibility inequities. Integration of these data will generate a comprehensive understanding of structural, geographic and experiential determinants of child health service performance.
Significance:
Findings will inform evidence-based policy and programmatic interventions to improve equity, efficiency and culturally safe service delivery in rural Australia. The study will support primary health networks, state health departments and community organisations in prioritising interventions, optimising workforce distribution, enhancing service coordination and leveraging telehealth, contributing to sustainable, scalable strategies for reducing rural child health disparities.