Executive summary

This report is part of a broader Nordic collaboration within the Nordic Network about the Child's First 1000 Days — a healthy start in life, on behalf of the Nordic Council of Ministers. It contributes to the network's core mission: strengthening knowledge sharing, supporting the systematic use of evidence-based approaches, and strengthening implementation capacity across Nordic social and healthcare systems to promote children's well-being from pregnancy to two years of age. It is intended for policymakers, civil servants, service developers, clinicians and researchers across the Nordic region who are involved in planning, delivering and/or developing services for families during the first 1000 days of life.

This report summarises the findings of 167 meta-analyses and systematic reviews, an evaluation of psychosocial interventions in Nordic and international evidence portals, and Nordic expert dialogues conducted in 2025. The synthesis was organised using the WHO maternal well-being framework which guides the interpretation of evidence across its six domains and supports a coherent understanding of psychosocial risks, protective factors and effective interventions (Le Lez, 2025). Together, these sources provide an overview of psychosocial well-being during the first 1000 days of life, highlighting the main risks, protective factors and intervention gaps affecting families across the Nordic region. These results can inform the development of services for the first 1000 days of life.

Key findings

Perinatal mental health a major concern

Maternal depression, anxiety, trauma-related symptoms and psychosocial distress are common, and are associated with poorer parental well-being, impaired parent–infant interaction and risks for children’s health and development. Fathers and partners face similar risks as mothers, yet their needs are rarely systematically assessed. Risks to a child’s well-being begin before birth and shape later health and development, making parental mental health a critical (pages 22-45). Nordic expert discussions highlighted the need to further develop and clarify care pathways for families facing mental health challenges, as current gaps in services continue to affect the continuity of care and overall outcomes (page 54).

Risk factors are often related and reinforce each other

Parental mental health issues, loneliness, financial strain, socioeconomic inequalities, negative care experiences and migration-related stress are often related. These cumulative factors increase the likelihood of poor outcomes for both parents and children (pages 22-84).

Substantial inequities within and between groups

Migrant, minority and indigenous families disproportionately experience high levels of psychosocial distress and face barriers to care, including linguistic obstacles and limited access to culturally responsive support and effective interventions. There is limited evidence on the factors related to the psychosocial well-being and experiences of infants, non-birthing parents, Sámi, sexual and gender minorities (LGBTQ+), migrants, parents with disabilities and single parents (pages 79- 83).

Existing interventions do not cover all needs

The review identified over 60 effective interventions internationally and 28 that have been evaluated as effective within Nordic contexts. However, most have focused on maternal depression and universal parenting support, with few addressing trauma, cumulative risks or culturally diverse families. Fragmented care pathways, uneven screening, limited culturally sensitive practices and regional disparities hinder the systematic use of effective methods.

Protective factors are well known but access to interventions uneven

Consistent promotion of good outcomes is achieved through social support, continuity of care, sensitive early interaction, stable income and living conditions, culturally safe care and timely identification of risks. However, access to interventions aimed at supporting these factors varies between regions and population groups.

Policy implications

The findings suggest that while the Nordic countries have strong universal services and extensive expertise, existing systems do not sufficiently reflect the complexity of psychosocial risks or ensure equal access to timely and appropriate support. Effective interventions exist, but their potential is constrained by evidence gaps, inequities and structural barriers.

Next steps

To bring about change and address the identified gaps and barriers, the following measures are proposed:

Nordic level

Develop a shared assessment and implementation model for effective psychosocial interventions to support scalability, quality assurance and consistency across the Nordic region.

The model should support the selection of interventions that are suitable for high-risk groups.
The model should strengthen systematic, cross‑country research on intervention effectiveness, enabling the identification of evidence gaps and ensuring that the needs of minority and high‑risk groups are addressed.

Strengthen knowledge exchange and dissemination of good practices between the Nordic countries.

Develop joint training modules on perinatal mental health and early interaction support.
Establish regular Nordic knowledge-sharing forums to disseminate implementation experiences and good practices across countries.

National level

Strengthen and further develop consistent care pathways and stepped-care models that align with national service structures.

Assess national capacity and readiness by reviewing identified needs and intervention gaps in relation to legislation, service models and available resources.
Support the systematic implementation of interventions found effective in the Nordic context by establishing national frameworks, funding structures and training programmes that enable consistent adoption across service settings.

Ensure equitable access to perinatal support for all families.

Develop culturally sensitive and accessible services for parents with disabilities, sexual and gender minorities and immigrant families and assess equity implications.
Develop national training programmes on perinatal mental health and early interaction support.

Regional level

Support the local implementation of interventions found effective in the Nordic context.

Conduct local context analyses to identify obstacles and enablers and ensure staff training and practical implementation planning to embed interventions to regional service structures.

Strengthen multiprofessional perinatal teams and family-centred care.

Ensure systematic screening of risk factors for all parents, including fathers and non-birthing parents.
Support peer support groups and community‑based models, including father groups and family coaching.
Strengthen attention in services to cultural and linguistic accessibility for migrant, minority and indigenous families.

Overall conclusion

The Nordic countries have a strong foundation for supporting families in the first 1000 days, yet a clear gap remains between available evidence and the equitable delivery of effective interventions. Current approaches do not consistently reach all population groups or identified needs, and further progress requires strengthening multidisciplinary care pathways and stepped care models that ensure timely, proportional and culturally sensitive support across service levels. The WHO maternal well-being framework appears well suited to structuring these needs and the phenomena linked to perinatal mental health.

Collaboration between the Nordic countries can add value in evaluating interventions for rare or high-risk groups, developing culturally adapted care and developing shared implementation models. By pooling evidence and aligning training and implementation frameworks across borders, a shared Nordic approach avoids costly duplication of development work and generates more robust findings than any single country could produce independently. Progress should be coordinated at the Nordic, national and regional levels to develop coherent and equitable perinatal mental health systems, with each level supporting the next. A coordinated Nordic approach can ensure that all families in the Nordic region receive timely, appropriate and equitable support during the first 1000 days of life.