100 CHAPTER 4 considerations between all experts. However, since the results of each of the meetings were highly comparable, we expect little influence on the results. Future research and practice Recently, the first indicators were quantified and presented to all municipalities in the Netherlands at www.regiobeeld.nl/kansrijkestart. In the future, we will further refine the website with additional indicators and new functionalities (among which maps with geospatial variation). In quantifying the indicators, we use nationwide observational data sources with routinely collected data, which are linked on individual level. In the last decade, the opportunities of linking observational data sources has increased at an enormous pace, which enhances the usefulness and applicability of the developed indicator set (43). The indicator set has yet to be used and evaluated in practice, as we can only determine the feasibility through empirical testing. A previous systematic review concluded that not many published indicators for maternal and neonatal health are empirically tested for validity and feasibility (25). Starting in 2022, we will evaluate and refine the indicator set in close collaboration with the participants of the monitoring support program (Appendix 1) in order to stimulate the uptake and adoption in daily practice. During this process, we expect to also discover which indicators are most often used and how, also for indicators that are similar across two or three phases (e.g. debts before pregnancy, during pregnancy and after birth). Using the indicator set should not be a one-time action, because the strength of using indicators for monitoring in municipalities is the comparison with previous comparable figures (26). In the future, the indicator set will be refined because of new developments, changing demographics, new evidence and increased dataavailability. In reflecting on the use of the indicator set, it is also important that we pay attention to questions about obtaining and presenting the data. In the coming years, the topics on the development agenda will be prioritized and addressed in collaboration with national parties and local professionals. Central in this process is the formulation and operationalization of indicators and the expected increase of data-availability. Next to the indicator set and development agenda, the choice set with extra, non-prioritized indicators is also publicly shared (including where to find the data) for local coalitions to use. Relevancy We consider our study scientifically relevant as it increases our understanding of relevant indicators for Solid Start and of using a systematic approach in developing indicators for monitoring a cross-sectoral program. In addition, it is relevant for society, as we can directly benefit from the study results by using the indicator set in practice. In the Netherlands, the indicator set can be used by local coalitions in collaboration with local stakeholders to describe their population, to identify gaps in current processes, to make or adapt policies, to prioritize interventions, to monitor developments and to stress the importance of investing in the first thousand days. In this monitoring process, combining quantitative data with
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