Healthy Starts: The state of Australia’s child and family health service system is a report from the Centre for Policy Development that maps the experiences of families accessing the network of health services and supports available from the very beginning of pregnancy, through birth, and across the first 2,000 days of a child’s life.
Research consistently shows that a child’s early years lay the groundwork for their entire life. This is a critical period that shapes lifelong outcomes across a wide range of areas, including educational achievement, career pathways, physical and mental health, and future interactions with social and justice systems.
While parents and families play the central role in a child’s development, governments have a critical responsibility to ensure that our child and family health service system is properly resourced, integrated, and accessible so that every family gets the right support at the right time.
While there are areas where the system is working well, the report highlights a number of gaps and policy barriers preventing families from accessing services and receiving the support they need. Addressing these gaps through policy reform and investment will be vital to building a system children and families can rely on.
This is made even more important in light of the Prime Minister’s commitment to building a universal early education and care system, something that must be underpinned by a cohesive, accessible child and family health system. It is also critical to national reform initiatives like Thriving Kids—where seamless integration between health, education, and care services is essential to delivering early, inclusive developmental support based on a child’s needs rather than a diagnosis alone.
Healthy Starts is a report from the Centre for Policy Development that maps the experiences of families accessing health services across the first 2000 days—from pregnancy to age 5.
Healthy Starts analyses Australia’s current child and family health service system—the network of health services that support families and children from the point of pregnancy recognition through to school entry at age five. These services are essential for assessing and supporting the health, wellbeing, and development of children, parents, and caregivers. They play a vital role in building trust with families, identifying developmental and health needs early, and providing preventative support before challenges escalate.
Common services in this system include general practice, antenatal and postnatal hospital care, midwifery, Child and Family Health services, allied health, and parenting and developmental support programs.
The report identifies three key periods across the early years where family support needs change and families transition between different types of care:
The report maps the services, funding, practitioners, and settings that families interact with across each of these transitions. It highlights the current gaps and policy barriers, building the case for greater investment and the systemic reforms needed to help all families thrive.
In mapping the network of services, funding, and settings across Australia’s child and family health service system, the report identifies key system-wide barriers that prevent children and families from accessing high-quality, connected support. These barriers cut across pregnancy, birth, postnatal care, and early childhood:
The report also finds that services are not consistently inclusive or culturally safe, and are not designed to respond effectively to families’ specific circumstances—such as housing stability, employment conditions, or mental health—meaning that many families do not receive the right support based on their unique needs. Limited data and digital infrastructure, and a lack of national oversight only compounds the disconnection between services, the varied quality across the system and the consistency of service delivery.
Australia is at a pivotal moment in early childhood reform. From increases to paid parental leave entitlements, a commitment to universal early childhood education and care, and national collaboration through Thriving Kids, there is significant momentum around improving how governments support children and young families.
However, while recent reforms have strengthened some parts of the early years system, the child and family health service system has received comparatively less attention. This is despite its essential role in supporting child and family health and wellbeing throughout the perinatal period, ensuring healthy pregnancies, identifying developmental and health needs early, and connecting families to care over time.
Supporting families well means ensuring their needs are met across health and wellbeing, not just education and care. To fix this, we need to shift our child and family health system away from a set of disconnected, inaccessible services to a system that is available to all families, embedded in everyday community settings, and flexible enough to scale in intensity as a family’s needs change. By investing in this foundational health network and improving system integration across the first 2,000 days, we can ensure that risks are identified early, children’s development is supported and families are set up for lifelong success.
