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Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.

This chapter discusses how to involve children and young people in decisions and encourage them to express their needs and participate in the decision-making process to develop a quality intervention. By describing the different aspects of projects involving a participatory approach, it shows how giving voice to children and young people unlocked new perspectives regarding the Hungarian child protection system. Participation of children in research is limited in Hungary, partly due to the challenging legislation and authorisation process. This chapter shows how research to develop child-friendly digital tools can contribute to collecting children's views on their needs related to child protection support, and how the process of listening to children can improve parenting and caregiving responses to the needs of younger and older children living with their families or in the child protection system. The chapter analyses the effect of digital applications on children's and young people's capacity to advance towards autonomy, including applications and a video campaign with short video clips created by young people. These projects gave an opportunity for children and youth in the public care system to describe their lives and wishes for the future. The analysis found: (a) for a functional child protection system and to promote development for children and young people, children's voices need to be amplified; (b) by expressing their voices, children become more autonomous; (c) children's voices contribute to decreasing social prejudices against children and young people in public care; and (d) listening to children and youth who age out of care can help professionals working in the child protection system better understand their beneficiaries.