Child and Maternal Health Continuity of Care Protocol Program - Phase 2 Testing and Co-Design
South Australian Department for Health and Wellbeing (DHW)
Who funded the project
Karabena Consulting was engaged to evaluate the co-design process underpinning South Australia’s Child and Maternal Continuity of Care Protocols (CCP) Program. The project aimed to strengthen how Aboriginal voices inform the design of culturally safe, coordinated care for Aboriginal children aged 0–4 years and mothers of Aboriginal babies.
Using an Indigenous-led, participatory approach, the evaluation focused on how co-design was implemented across the program, including the effectiveness of engagement, governance, and resource use. Karabena worked closely with Aboriginal stakeholders, SA Health, and sector partners to document learnings and support continuous improvement.
The evaluation provided insights to improve the current co-design process and inform future efforts across the health system. Key deliverables included an Evaluation Plan, Program Logic, and Final Report, contributing to the development of a long-term co-design framework for Aboriginal health initiatives in South Australia.
Summary
The primary aim of this project was to evaluate the co-design process undertaken as part of the Testing and Co-Design Phase of South Australia’s Child and Maternal Continuity of Care Protocols (CCP) Program. The evaluation sought to:
Assess how Aboriginal and Torres Strait Islander voices were embedded in the design of culturally safe, coordinated models of care;
Identify strengths, challenges, and opportunities for improvement within the co-design process;
Inform ongoing co-design activities within the CCP Program and support the development of a broader, systems-level co-design framework for Aboriginal health initiatives in South Australia.
By privileging Aboriginal knowledge systems and perspectives, the project aimed to strengthen future approaches to service design, ensuring alignment with Closing the Gap commitments and long-term improvements in maternal and child health outcomes.
Project Aims
To achieve the project’s aims, Karabena employed the following methodologies:
Aboriginal and Torres Strait Ilsander woman -led, participatory evaluation
The evaluation was led by Karabena Consulting using methods that centre Aboriginal and Torres Strait Islander knowledge, leadership, and decision-making.Desktop review of co-design practice
Analysed national and international examples of co-design with Aboriginal and Torres Strait Islander communities, and for Indigenous peoples internationally, including academic and grey literature, and identified better practice and common pitfalls.Stakeholder engagement
Engaged with CCP testing networks, Aboriginal leaders across government, Aboriginal Community Controlled Organisations (ACCOs), and co-design working groups.Culturally grounded governance and ethics
Established appropriate governance structures and obtained ethics approvals to ensure the process was safe, respectful, and aligned with community expectations.Collaborative development of evaluation tools
Co-designed an Evaluation Plan and Program Logic in partnership with stakeholders to guide the process and clarify intended outcomes.Continuous improvement and feedback loops
Provided regular verbal and written reports to SA Health and Aboriginal Health to support learning and adaptation throughout the project.
Methodologies
Outputs
Key Deliverables included:
Evaluation Plan
A Co design Data Dictionary
Program Logic
Monthly verbal progress updates
Quarterly written reports
Final Evaluation Report
It is anticipated that Karabena’s findings will contribute to ongoing developments to the CCP Program, including:
Short-term outcomes
Improved understanding of co-design in Aboriginal health contexts
The evaluation identified what worked well and where improvements are needed in the CCP Program’s co-design process, helping clarify how Aboriginal voices were engaged and supported.Practical guidance for program implementation
Provided real-time feedback and recommendations to SA Health and partners, supporting more responsive and culturally grounded program delivery.Strengthened stakeholder relationships
Built trust and collaboration across CCP testing networks, ACCOs, and government stakeholders through respectful and inclusive engagement.
Medium-term outcomes
Enhanced co-design practice across the CCP Program
Findings from the evaluation informed ongoing co-design activities, strengthening governance, resourcing, and the cultural safety of the program.Tools to guide future evaluations
The co-designed Evaluation Plan and Program Logic provide a clear, transferable framework for evaluating similar initiatives in the future.
Long-term outcomes
Contribution to a broader co-design framework
The evaluation supports the development of a whole-of-system approach to co-design in Child and Maternal health, aligned with Closing the Gap commitments.
Improved continuity of care for Aboriginal families
By strengthening how services are designed and delivered, the project contributes to long-term improvements in culturally safe, coordinated care for Aboriginal children and mothers.
Project Outcomes
Aboriginal Health
Co-Design
Continuity of Care
Child and Maternal Health
Cultural Safety
Closing the Gap
Indigenous-led Evaluation
Community Engagement
Health System Reform
South Australia Health