128 CHAPTER 5 Development within municipalities Over the years, the number of municipalities with a plan of action, objectives, ambitions and activities increased (Table 2). By 2021, almost all responding municipalities (85%) were engaged in setting objectives. More than one in four municipalities set objectives aimed at a longer period (children until 4 or 18 years) than the original Solid Start program (up to 2 years), and Solid Start was almost always part of a wider policy framework. In 2021, 64% of the responding municipalities made collaborative agreements about the Solid Start approach at implementation level, managerial/policy-level, or both. Moreover, 80% of the responding municipalities reported having activities on the topic of Solid Start, and twothirds of them started these activities in the timeframe after receiving the Solid Start funds. The quantitative data also showed that several municipalities started with monitoring Solid Start, and many reported having plans to monitor. Municipalities reported that they more often monitored processes than outcomes. Additionally, 68% of the responding municipalities in 2021 conducted a baseline assessment to gain insight into the statistics and facts concerning the first thousand days in their municipality. Three-quarters of the municipalities indicated that COVID-19 influenced Solid Start activities and progress in 2020 and 2021; it mostly caused a delay. Involved stakeholders There was a wide variety of stakeholders involved in Solid Start. Figure 5 shows which parties municipalities mentioned when they were asked who is part of the local coalition or with whom they collaborate. Most often mentioned were midwives, maternity care assistants, youth healthcare, Public Health Services, neighbourhood/social teams and policy makers within other municipal departments on the topics of youth healthcare and public health. In 2021, around one-third of the municipalities collaborated with expertsby-experience or other community-partners (Figure 5). General practitioners (GPs), health insurers and experts-by-experience were most often regarded as missing parties (Table 2).
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