Poverty predisposes childbearing women and children to poor nutritional and health outcomes, and to related health behaviours such as smoking. A range of adverse health, developmental and education outcomes may result, with short and long term consequences for maternal, infant, child and ultimately, adult health. Food support programmes for low income pregnant and postnatal women, babies and children are intended to improve nutrition and reduce these adverse outcomes. In England, the longstanding Welfare Food Scheme (WFS) has been replaced by Healthy Start, a revised programme intended to address several of the problems of the WFS. The incoming Healthy Start scheme has several elements, the main one of which is food vouchers for fruit and vegetables, or formula milk for bottle fed babies. The evidence base for food support programmes is weak, but suggests that they are unlikely to have an impact on headline indicators such as low birth weight; other benefits, such as increase in mean birth weight and maternal weight, and an improvement in maternal diet, may result.
The aim of this project was to advise DH on approaches to monitoring and evaluation of longer-term health and social outcomes of the Healthy Start scheme, including establishment of baseline data. The work will include: scoping outcomes of interest that are plausible, measurable and feasible; identifying sources of existing relevant data; examining whether analysis of these data is possible at the level of women/children eligible for Healthy Start; establishing baseline data from existing datasets; critiquing existing relevant data collection tools; and finally, identifying options for evaluation.