Steegers Eric A P, Struijs Jeroen N, Uijtdewilligen Angela J M, Roseboom Tessa J
Professor of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, the Netherlands.
National Institute for Public Health and the Environment, Bilthoven, the Netherlands, and Professor of Population Health Economics, Leiden University Medical Center Health Campus The Hague, The Hague, the Netherlands.
Health Policy. 2025 Feb;152:105219. doi: 10.1016/j.healthpol.2024.105219. Epub 2024 Dec 4.
The foundations of human wellbeing are laid in early life during the preconception stage and the 1,000-days of life from conception to the child's second birthday. This period is therefore receiving scrutiny as a concept for guiding pregnancy-care innovation and public health policy. The Dutch government took responsibility to invest in this. In September 2018, the Dutch Ministry of Health, Welfare, and Sport launched the Solid Start action programme. Coordinated nationally, the programme is implemented locally through coalitions in all 342 Dutch municipalities involving collaboration between medical and social-care professionals, policymakers, parents and organisations. The programme has generated a nationwide movement in which medical and social-care professionals now develop forms of structural collaboration that support (future) parents by offering evidence-based interventions that simultaneously enhance early healthy human development and prevent unwanted pregnancies. Although monitoring of the programme does not currently make it possible to address the causal effects of the programme itself, lessons can be distilled which have contributed to the successful implementation of this nationwide programme. These lessons include 1) having and maintaining an unambiguous narrative, 2) creating a lasting sense of urgency among stakeholders, and 3) ensuring that the programme is multi-sectoral.
人类福祉的基础在生命早期的孕前阶段以及从受孕到孩子两岁生日的1000天里奠定。因此，这一时期正作为指导孕期护理创新和公共卫生政策的一个概念受到审视。荷兰政府负责对此进行投资。2018年9月，荷兰卫生、福利和体育部启动了“坚实开端”行动计划。该计划在全国范围内进行协调，通过荷兰所有342个市镇的联盟在当地实施，涉及医疗和社会护理专业人员、政策制定者、家长及组织之间的合作。该计划引发了一场全国性运动，在这场运动中，医疗和社会护理专业人员如今开展结构性合作形式，通过提供基于证据的干预措施来支持（未来的）父母，这些干预措施既能促进早期人类健康发展，又能预防意外怀孕。尽管目前对该计划的监测无法确定该计划本身的因果效应，但可以总结出一些经验教训，这些经验教训有助于该全国性计划的成功实施。这些经验教训包括：1）拥有并保持明确的叙事；2）在利益相关者中营造持久的紧迫感；3）确保该计划具有多部门性质。
