Abstract

Not all children in the Netherlands are born in good health or get to grow up healthy in a safe, protected environment. Since 2018, municipalities can set up initiatives together with medical and social partners to support parents before, during and after pregnancy. The programme is called Kansrijke Start (Solid Start). It is aimed mainly at people facing difficult circumstances, such as poverty. The National Institute for Public Health and the Environment (RIVM) has been monitoring the establishment of such initiatives and trends in young children's health since 2019. This is the seventh report.

In 2025, the majority of municipalities (92 percent) had established agreements with local providers of medical services such as midwives, postpartum care organisations and child health clinics. Collaboration is important to ensure that problems are identified early, timely referrals are made, and existing or expectant parents receive the support they need. Municipalities are continuing to offer more initiatives, such as the 'Nu Niet Zwanger' (Not Pregnant Now) programme available in 91 percent of municipalities.

Some improvements are still needed. Few municipalities have involved people with practical experience or existing and expectant parents in the development of initiatives. Their contributions are valuable in ensuring that these initiatives are a good match for parents' needs. It is also important to gain a better idea of who is participating in initiatives and how effective these are. That information is not available currently.

Furthermore, there is no improvement in children's health visible so far. Many children are still being born into families living in difficult circumstances. The numbers have even increased slightly since 2024. Premature births and low birth weight occur more frequently in these families. They are also less likely to make use of postpartum care at home. Furthermore, more than 43 percent of expectant parents living in difficult circumstances have mental health issues (in 2017, this was just over 36 percent).

There are more and more overweight two-year-olds (more than 10 percent in 2025 compared to just over 8 percent in 2018). Two-year-olds are more likely to have speech and language delays as well (more than 6 percent in 2025 compared to just over 5 percent in 2018). Attention to health issues before, during and after pregnancy continues to be necessary, both locally and nationally.