Experiment and innovate to best support and heal during the first 1000 days.

The project of the first 1000 days puts experimentation in the first place to design the most suitable devices to meet the needs of the child and his (future) parents.

The project of the first 1000 days starts from the need to always (re) start from the needs of the child and his (future) parents.

This implies an approach that strictly associates professionals and parents in the design of any action or device, as for the mobile application or the Booklet of our first 1000 days for example.

This also justifies the encouragement to involve parents, for example in the development of settlement projects in kindergartens and other childcare facilities, in application of the National Charter for the reception of children.

Finally, this militates for experimentation: to co-build from well-supported needs, to test, refine or correct, then to decide on a possible sustainability.

The first 1000 days project puts experimentation first.

Since the first 1000-day education on April 1, 2021, the project has included three major experiments:

  1. The bag of the first 1000 days, a French baby box tested on a large scale in 2022;
  2. Groups of parents, who lived by 8 CAF as part of the “birth course” with the CPAM;
  3. The Referent for perinatal care (RéPAP), experienced by 4 territories.

The evaluation of these experiments will allow in the future to shed light on possible decisions regarding sustainability and financing.

Several so-called “Article 51” experiments within the first 1,000 days are closely monitored.

System decomposition and overall support being at the heart of the project for the first 1000 days, Article 51 experiments are good tools.

Introduced by the Social Security Financing Act for 2018, “Article 51” is a device that allows experimenting with new healthcare organizations based on new ways of financing. And that’s when these new organizations help improve patient journeys, healthcare system efficiency, access to care or the relevance of healthcare product prescribing.

This is a real opportunity to experiment with new approaches as this device allows for derogations from many common law financing rules, applicable in the city as well as in hospitals or medical-social institutions.

Several ongoing experiments fall within the first 1000 days. Their results will inform future decisions.

BASE – Need for Attachment and Health of the Child. Object? Accompany future parents and young parents to adapt to the essential psychoaffective needs of the child, in the prenatal / perinatal period (0-3 years) and during early childhood (3-6 years), implementing universal and multidisciplinary preventive care pathways. Where ? Deployed in New Aquitaine. Who ? Federation of Parenting Practitioners. When ? 4 years of experimentation; end of the experiment in March 2026.

- COPA – Parent Coaching. Object? Prepare access to postnatal support by child care assistants, complementary and coordinated with existing systems. The objectives pursued are to improve the satisfaction of pregnant women, their state of health as well as that of the newborn and the efficiency of care. Where ? Territory of the GHT Cœur Grand Est (Grand-Est). Who ? Cœur Grand Est hospital group. When ? 3 years of experimentation; end of the experiment in January 2024.

- RéPAP – Perinatal Care Referent. Object? Offer to all pregnant women and, in particular to the most vulnerable, personalized and graduated support from a referent of the perinatal path, from pregnancy to three months of the child, in complementarity and in coordination with existing systems and professional figures (city / hospital / SME). Where ? Distributed in Guyana, in the Drôme (Auvergne-Rhône-Alpes), in the Pays Loire Touraine (Center-Val-de-Loire) and in the territory of the CPTS Center Essonne (Île-de-France). Who ? Led by the Directorate General of Health. When ? 1.5 years of experiment; end of the experiment in July 2023.

- TLS gestational diabetesObject? Improve the management of gestational diabetes through telemonitoring. Where ? Two experiments, one in Brittany and the other in 14 departments (distributed in 8 regions: Auvergne-Rhône-Alpes, Center-Val-de-Loire, Grand-Est, Hauts-de-France, Ile-de-France, Occitania , Pays de la Loire, PACA). Who ? the university hospitals of Brest and Rennes in Brittany and the MDHC company in the other 8 regions. When ? Experiments of 18 months (Brittany) and 3 years (8 other regions); end of the experiment in July 2022.

- Pégase – Standardized health protocol for children who benefited from a child protection measure (ASE) before the age of 5. Object? Strengthen and structure the health monitoring of young children who benefit from a child protection measure up to the age of 7 by establishing a health protocol that covers the physical and psychological health and development of the child. Where ? 15 nurseries in 8 regions: Chambéry and La Tronche in Auvergne-Rhône-Alpes; Chantepie in Brittany; Charleville-Mézières, Epinal, Mulhouse and Strasbourg in the Grand-Est; Dainville in Upper France; Poitiers in New Aquitaine; Nîmes and Perpignan in Occitania; La Roche-sur-Yon, Avrillé and Saint-Sébastien-sur-Loire in the Pays de la Loire; Marseille in PACA). Who ? Dr Rousseau of the University Hospital of Angers, medical coordinator of the PEGASE program. When ? 5 years of experimentation; end of the experiment in August 2024.

- Cocoon. Early and coordinated care pathway for vulnerable infants. Object? Arrange for ultra-early identification, from birth or prenatal period if necessary, of vulnerable infants at high risk of developing an additional disability or disability. Where ? Provence-Alpes-Côte d’Azur; New Aquitaine; Occitania. Who ? The project is supported by three perinatal networks: Occitanie Perinatal Network (RPO), Périnat Nouvelle Aquitaine Network and Mediterranean Perinatal Network. When ? Waiting for authorization

Find all the information on the “Article 51” experiments. on the website of the Ministry of Solidarity and Health.

In Corsica, the Community and the Regional Health Agency are working on the early identification of vulnerabilities under the DITP call for challenges.

Launched in September 2021 by the Interministerial Directorate for Public Transformation, the call aims to promote ways of planning public services with users and agents, in order to take better account of their needs and expectations in a context of digital transformation.

Among the 27 winners is the project carried out by the Community of Corsica and the Regional Health Agency of Corsica.

“Identifying vulnerabilities in the context of the child’s first 1000 days in Corsica” aims to create a tool to help identify vulnerability in the first 1,000 days of the child for community agents, early childhood and family partners.

The Community will rely on workshops, field dives or even a mapping of key players to co-build the tool.

In concrete terms, the tool to be implemented should allow each professional to provide relevant and usable observations with the aim of improving support and pathways for families in vulnerable situations from pregnancy onwards.

What are the expected benefits for agents and users? Early identification of situations of vulnerability of families with children under the age of 6 and therefore establishment of adequate and multi-professional support.

The project also makes it possible to organize a partnership and cohesion up to now informal between the various territorial actors, be they institutional, associative or liberal.

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