118 CHAPTER 5 in other countries (24-26) reported on facilitators and challenges with interprofessional and interorganizational collaboration during pregnancy and childbirth. Some of the reported challenges were competition, suboptimal communication, power imbalances and fragmented structures, while facilitators included trust, feeling valued, formalized procedures and insight into each other’s knowledge and competences (19-22, 24-26). Other studies that reported on integrated youth (health)care (27-29) found similar facilitators and challenges and also mentioned the need for further collaboration. Collaboration in maternity care is often described as complex and not self-evident, as healthcare providers historically have worked relatively autonomous with separated organizational structures, education programs, protocols, cultures and practices (8, 22, 30). More integrated care requires changes at different interrelated levels (micro, meso and macro), as outlined by Valentijn and colleagues (31). Although these previous studies have furthered our understanding on collaboration, to date, there is limited knowledge into the development of cross-sectoral collaboration between the medical and social sector during the complete trajectory of the first thousand days as only few studies have devoted attention to this topic as a whole (7, 8). This knowledge is particularly relevant as we do not know if collaboration between sectors presents different challenges compared to collaboration within a sector, due to for example the larger differences in cultures and structures. Moreover, limited qualitative research has been conducted to comprehensively examine client experiences within the Dutch context (32), despite enhanced client experiences being one of the ultimate goals of cross-sectoral collaboration and integration. Existing studies primarily include either the perspectives of healthcare professionals and policymakers, or adopt a more quantitative approach (33, 34). The overall exploration of the implementation of Solid Start can be enriched if the viewpoints of those who provide, organize, examine ánd receive care are considered. Additionally, monitoring and reflecting on the development towards crosssectoral collaboration during the implementation of a national policy program is important to support learning for future practice and policy developments in this direction. Therefore, in this study, we aimed to describe the implementation of the Dutch Solid Start program during 2019, 2020 and 2021. We formulated the following two research questions: 1) To what extent is the Solid Start program implemented within municipalities? 2) What are the experiences of stakeholders with the implementation of the Solid Start program and cross-sectoral collaboration?
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