Universal child health and wellbeing services play a critical role in promoting health, wellbeing, development, and safety in early childhood; however, measurable outcomes that demonstrate service impact remain limited. Although child mortality has declined globally, significant inequalities persist, and current child health service evaluation approaches rely largely on participation or activity-based indicators rather than child health and wellbeing outcomes. In Australia, national datasets highlight gaps including limited capacity to track children across systems and the absence of linked, outcome focused data.
The Victorian Maternal and Child Health (MCH) service aims to “promote and optimise health, wellbeing, safety, development and learning outcomes for children (0-6 years) and families”. Yet its effectiveness is primarily assessed through participation rates and population level indicators that depend on non-linked datasets. While extensive, these data do not provide outcome driven reporting and are not represented within national child health datasets. Our global systematic review found no existing consistent or comprehensive outcome set for universal well child health and wellbeing services.
This Core Outcome Set (COS) aims to address these gaps by identifying measurable child health and wellbeing outcomes for children from birth to school age within universal well child services. Informed by a Mixed Methods Systematic Review of the global literature (2010–2026), findings identified fragmented outcome measurement and indicators, typically focused on single issues (e.g., obesity), rather than holistic well child health and wellbeing outcomes and indicators across individual, service, and system levels.
Consistent with the findings from our systematic review, the existing COS landscape includes several outcome sets that relate to specific subsets of relevance to our work. One COS currently in development focuses on Aboriginal and Torres Strait Islander maternal and child health programs (1). This will be important to consider, as it represents a key population subset within our scope; however, its remit is broader, spanning pregnancy, birth and the first five years, whereas our COS is centred specifically on the child, birth to school age.
There are also single issue COS addressing childhood obesity (2,3), which offer relevant insights but remain condition specific. Importantly, no COS could be identified that articulate an overarching set of measurable child health and wellbeing outcomes for children from birth to school age within universal well child services.
To our knowledge, this represents the first COS developed for well child health and wellbeing universal services for children from birth to school age. The COS aims to strengthen outcome driven evaluation, support service improvement, and enhance accountability and investment in universal child health programs.
1. https://www.comet-initiative.org/Studies/Details/3882
2. https://www.comet-initiative.org/Studies/Details/2448
3. https://comet-initiative.org/Studies/Details/1679
Professor Leesa Hooker – Principal Investigator (1,2)
Professor Kristina Edvardsson – Co-investigator (1)
Doctor Catina Adams – Co-investigator (1)
Ms Helen Maree Lees – Student Investigator (1)
1 Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
2 Violet Vines Marshman Centre for Rural Health Research and the Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria. Australia
Disease Category: Child health
Disease Name: Child health, Wellbeing
Age Range: 0 - 5
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Governmental agencies
- Policy makers
- Researchers
- Service providers
- COS for clinical trials or clinical research
- COS for practice
- Focus group(s)
- Interview
- Nominal group technique (NGT)
- Other
- Systematic review
The systematic review informed an exploratory Participatory Action Research (PAR) approach undertaken across two rounds with key Victorian MCH service stakeholders. Round 1 (2025) explored the relevance of identified outcomes, assessed gaps, and examined whether outcomes were influenceable by MCH and measurable in practice. Round 2 (2026) used a Modified Nominal Group Technique (NGT) through idea generation, clarification, prioritisation and ranking outcomes, ensuring equitable participation and consensus.
The combined findings from all focus groups will inform the final COS, comprising 12–15 core outcomes and associated “on track” indicators.