Healthy Start vitamins—a missed opportunity: findings of a multimethod study

Alison McFadden (Lead / Corresponding author), Josephine M. Green, Jenny McLeish, Felicia M. McCormick, Victoria Williams, Mary J. Renfrew

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    Abstract

    Objective
    To evaluate and provide a real-life view of the operation of the Healthy Start vitamins scheme.

    Setting
    The study took place in primary care and community settings that served rural, urban and ethnically diverse populations, in two sentinel sites: London, and Yorkshire and the Humber. An online consultation and stakeholder workshops elicited views from across England.

    Participants
    669 health and social care practitioners including health visitors, midwives, public health practitioners, general practitioners, paediatricians and support staff participated in focus group discussions (n=49) and an online consultation (n=620). 56 participants representing health and social care practitioners, policymakers, service commissioners, and voluntary and independent sectors took part in stakeholder workshops.

    Methods
    Three-phase multimethod study comprising focus group discussions, an online consultation and stakeholder workshops. Qualitative data were analysed thematically and quantitative data from the online survey were analysed using descriptive statistics.

    Results
    Study participants were concerned about the low uptake of Healthy Start vitamin supplements and the consequences of this for health outcomes for women and young children. They experienced Healthy Start vitamin distribution as logistically complex, requiring the time, resources and creative thinking of a range of local and regional practitioners from senior strategists to administrative support workers. In the light of this, many participants argued that moving to universal provision of vitamin supplements would be more cost-effective than the current system.

    Conclusions
    There is consistency of views of health practitioners that the current targeted system of providing free vitamin supplements for low-income childbearing women and young children via the Healthy Start programme is not fulfilling its potential to address vitamin deficiencies. There is wide professional and voluntary sector support for moving from the current targeted system to provision of free vitamin supplements for all pregnant and new mothers, and children up to their fifth birthday.
    Original languageEnglish
    Article numbere006917
    Number of pages7
    JournalBMJ Open
    Volume5
    Issue number1
    DOIs
    Publication statusPublished - 8 Jan 2015

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