A Mixed-Methods Evaluation of Child Health Services in Rural Australia: Access, Quality, and System Coordination

Intervention / Exposure Description: No intervention will be administered. Comparisons will be made observationally across rural regions with differing levels of remoteness (Modified Monash Model 3–7), socioeconomic status, and service provision. Analyses will examine variations in child health service accessibility, utilisation, and quality between these subgroups. What is involved for participants: - Caregivers: Will be invited to complete an online questionnaire about their experiences accessing child health services. The questionnaire will take approximately 15–20 minutes to complete. - Clinicians and service providers: Will be invited to complete an online questionnaire about service capacity, referral pathways, barriers, and coordination. This will take approximately 15 minutes. - Stakeholder interviews: A subset of caregivers, clinicians, and service managers will be invited to participate in a 30–45 minute semi-structured interview conducted online or by telephone. - There are no physical assessments and no clinical interventions. The study will observe: - Patterns of service utilisation (e.g. primary care visits, developmental assessments, allied health referrals, immunisations, emergency presentations). - Caregiver-reported experiences of access, quality, cultural appropriateness, and barriers to care. - Clinician-reported workforce challenges, referral processes, and system-level constraints. - Differences in accessibility based on geography (remoteness), socioeconomic status, and population characteristics. Frequency and duration of observation: - Surveys: completed once during the data collection period (single cross-sectional). - Interviews: conducted once per participant during the study period. - No ongoing follow-up or repeated measures. - Total participation time per participant ranges from 15–45 minutes, depending on involvement. Retrospective data collection: This study includes retrospective analysis of de-identified historical data. - Source: Administrative health datasets provided by state health departments, Primary Health Networks (PHNs), and publicly available hospital and primary care datasets. - Time period: Data from the preceding 3–5 years (exact years dependent on dataset availability). - These data include service utilisation counts, immunisation uptake, hospital presentations, developmental assessments, and provider distribution.