151 Implementation and experiences of the Solid Start program APPENDIX 2. Description of national and local Solid Start monitor by the National Institute for Public Health and the Environment The Ministry of Health, Welfare and Sport (Dutch abbreviation: VWS) commissioned the National Institute for Public Health and the Environment (Dutch abbreviation: RIVM) to monitor the implementation of the Solid Start program, launched in September 2018. The RIVM began monitoring the program at the national level in 2019 and launched a support program for municipalities called the “Learning Local Monitor Solid Start” in 2021. National Solid Start monitor The national monitor includes both a quantitative and a qualitative component. In a Delphi study conducted in 2019, experts from policy, practice, and research developed a set of 15 quantitative indicators (1). The indicators reflect both processes (e.g. percentage of municipalities with a local Solid Start coalition) and outcomes (e.g. percentage of children born prematurely or with a low birth weight). Annual factsheets (2-4) report the figures for each indicator to monitor the program’s progress and developments/trends in health outcomes. The RIVM uses several data sources to quantify the indicators, including: 1. Data from the nationwide population-based data-infrastructure DIAPER (acronym for Data-InfrAstructure for ParEnts and ChildRen). DIAPER integrates routinely collected observational data from three Dutch nationwide data sources (Perined, Vektis and Statistics Netherlands) at individual level. Perined is the national pregnancy, birth and neonatal data registry, based on data supplied by midwives, obstetricians and paediatricians. Vektis offers data on healthcare utilization and spending by collecting claims data under the Dutch Healthcare Insurance Act. Statistics Netherlands collects, disseminates and facilitates access to data on societal themes, including health, welfare, income, education and labour 2. Inquiries to national organizations involved in the implementation of interventions and youth healthcare organizations, as there is no national youth healthcare data registry in the Netherlands 3. Questionnaires among municipalities The qualitative component involves interviews and focus group discussions with stakeholders that provide further insight into the factors that facilitate or hinder the implementation of the program (4). The Ministry of Health uses the results of the monitor in combination with other data sources and expert opinions to determine whether goals are being achieved and to timely adjust policies. To underpin the key-messages within the factsheets and to provide a scientific base for our work for Solid Start, in-depth scientific research and analyses are conducted. This manuscript serves as an example. 5
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