An equitable early childhood education and care (ECEC) system in Australia relies on the availability of quality services that meet the needs of all children and families. However, availability can be limited in thin markets, such as those in unserved and underserved areas in regional and remote areas. This report sets out the findings of a literature review on approaches to improve access to quality children's education and care services, including ECEC and outside school hours care (OSHC), in regional and remote thin markets. It identifies 8 delivery approaches to improve access that have a promising or emerging research evidence base and asserts that these need to be tailored to each community, with local buy-in and government support.