Once you have a child your life will never be the same again. Parenting is challenging, and you learn parenting only by doing, but that doesn’t mean parents are on their own.
When presenting the second phase of the Solid Start Action Programme (Actieprogramma Kansrijke Start) to the Dutch parliament in 2022, Maarten van Ooijen, Secretary of State (Ministry of Health), emphasised:
The ambitious Solid Start Action Programme was launched by the Dutch government in 2018 [1]. It is based on the conviction that every child deserves the best possible start in life, and that parents are crucial to support this start. Our strategy for the programme is based on supporting professionals who support families – including healthcare professionals, professionals from the social domain and those who work for municipal government services – to interact more effectively with each other, and with the informal networks on which families rely.
Ministry of Health, Welfare and Sport (2018) Kansrijke Start. Available at: https://www.kansrijkestartnl.nl (accessed November 2023).
In 2022, the programme entered its second phase. It aims to put a local Solid Start approach and interventions on a structural basis in every municipality, so new and future parents in vulnerable situations receive the help, care and support they need in a timely manner. This ambition follows from the 2021 coalition agreement, which commits the Dutch government to the broader societal agenda of achieving a healthy generation in 2040 [2].
De Gezonde Generatie (2023) Een gezonde omgeving voor onze kinderen. Available at: https://www.gezondegeneratie.nl (accessed November 2023).
Children build on the foundation of their first 1,000 days for the rest of their lives. A good start leads to a better chance of healthy outcomes – and a good start depends on support for parents. As our 2022–2025 strategy tagline puts it, “Sterke ouders, gezonde kinderen!” (“Strong parents, healthy children!”).
Why services must be joined up
A wide range of issues can put parents under stress that compromises their ability to care for their young children. Perhaps they are worried about money or an insecure housing situation. Perhaps they have physical or mental health issues, or face struggles with substance abuse or violence.
Services exist to tackle each of these issues, but they do not always link up with each other or ask questions that go beyond their domains. A healthcare provider, for example, might never know if a patient is facing eviction. A debt counsellor might not find out that a man they are working with is about to become a father.
By taking an integrated approach, municipalities can better identify when parents need support and connect them with the service providers that can help most effectively. Since we began the Solid Start programme, we have seen how powerful the results can be. Here is testimony from a midwife in Delft:
The earlier we can support parents, the better it is for their children. Ideally, that means starting support before a child is even conceived.
Overcoming barriers to an integrate approach
The two main pillars of the second phase of the Solid Start programme are supporting municipalities to learn from each other on two primary pathways:
- Ensuring proper care for new and future parents through sustainable regional and local agreements, and arranging the preconditions for cooperation between medical and social services.
- Optimising support for parents from professionals and informal networks by strengthening professionalism, cooperation, and the informal social networks of new and future parents.
Our experience in the first phase of the programme, since 2018, has helped us identify the main barriers and bottlenecks to achieving an integrated approach that includes the following:
Training
As illustrated by the midwife from Delft, professionals who have trained to focus on one domain may need additional guidance on how to start conversations about other relevant issues and suggest appropriate sources of further support.
Agreements
New agreements may need to be put in place, both among municipal service providers and with other local organisations on which families rely, in areas such as data exchange, access to interventions and coordination between services.
Finance
Taking a longer-term perspective, supporting parents to give their children a better start can be expected to pay for itself many times over. But in the short term, integrating services can incur additional expense for municipalities. The Solid Start programme is now anchored in national policies through the Healthy and Active Life Accord (Gezond en actief leven akkoord, GALA), with a sustainable funding arrangement through the Specific Allowance (SPUK), and Integral Care Agreement (Integraal Zorgakkoord, IZA). Through the SPUK arrangements, all 342 municipalities in the Netherlands receive funding in order to benefit the building of local Solid Start coalitions.
Regulations
We strive to facilitate and anchor agreements between different stakeholders such as municipalities and health insurance providers in (national) policy (GALA, see above).
Solid Start 2022-2025: A Good Start for every child! [3]
Ministry of Health, Welfare and Sport (2023) Kansrijke Start April 2023, Zesde voortgangsrapportage [6th Report]. The Hague: Ministry of Health, Welfare and Sport, Available at: https://goab.eu/media/rwannjmn/zesde-voortgangsrapportagekansrijke-start-1.pdf (accessed November 2023).
