Healthy start vouchers how much

If you are pregnant or have a child under four years old you may be eligible to get Healthy Start vouchers to help buy some basic foods. Healthy Start helps you give your family the very best start in life. The means-tested scheme provides vouchers to buy some basic foods and vouchers to swap for vitamins. Access the application form online. You will be required to:. Women who are at least 10 week pregnant or families with children under four years old will qualify if they are getting:.

Healthy Start currently supports approximately , women and children in over , families in the UK [ 29 ]. There is little evidence of the impact of food subsidy programmes on health outcomes for mothers and children. A small-scale, before and after study [ 31 , 32 ] found that women receiving Healthy Start food vouchers ate significantly more fruit and vegetables per day than those on the previous milk-based Welfare Food scheme.

As well as impact, important dimensions of evaluating complex programmatic public health interventions such as food subsidy programmes include description of processes, contextual factors and qualitative data that might explain intervention effects [ 39 ].

Such evidence to inform the design and operation of food subsidy programmes is lacking, particularly from the perspectives of beneficiaries and health practitioners. Small-scale qualitative studies of WIC found that participants valued the inclusion of fresh fruit and vegetables and anticipated that this would increase intake [ 40 ]. For young single mothers, food vouchers were the only means by which they could afford to include fruit and vegetables in their diets [ 41 ]; and women highly valued the provision of free infant formula because it was an expensive product [ 42 ].

From interviews with beneficiaries, those authors concluded that there was a need for clearer information about the programme and about eligibility criteria; to reinforce healthy eating messages, health professionals should link with local services and encourage beneficiaries to take part in relevant practical, experiential activities locally; to ensure access and choice of retailers, additional information about registered retailers should be provided; and retail staff should be trained to minimise the potential embarrassment or stigma of using Healthy Start vouchers.

We aimed to evaluate the Healthy Start programme in England from the perspectives of beneficiaries, potential beneficiaries and health practitioners and to focus on whether food vouchers can contribute to reducing nutritional inequalities for women and young children.

We addressed two key questions:. Do Healthy Start food vouchers have the potential to improve nutrition for low-income women and young children? The study comprised four key stages:. Focus group discussions with health practitioners involved in operationalising Healthy Start in their local areas. A national online consultation with health and social care practitioners, service managers, commissioners, and user and advocacy groups.

Qualitative participatory workshops with low-income women from diverse backgrounds who were eligible or borderline eligible for Healthy Start, irrespective of whether they were registered for the programme. Additional focus group discussions and telephone interviews were conducted to include the views of women who did not speak English and those from Traveller communities. Cross-sectoral workshops with stakeholders including practitioners, service managers and commissioners, policy makers and advocacy groups.

Here we report findings from the first three stages relevant to the aims of this paper. The recommendations culminating from the cross-sectoral workshops, which were specific to England, will be reported elsewhere. User involvement, congruent with the principles of INVOLVE [ 46 ], was achieved through a key informant user panel comprising six women who were or had been registered for Healthy Start and who contributed their views on the design, conduct and interpretation of the findings throughout the study.

Informed written consent was obtained from all study participants taking part in focus group discussions and interviews. The qualitative work with practitioners and women was conducted in two regions of England; Yorkshire and the Humber, and London, selected because of their large and diverse populations.

Localities within these regions were selected to provide opportunities to access different population groups and urban and rural contexts. The online consultation was circulated across stakeholder groups in England. Six focus groups discussions, lasting minutes and attended by between six and eleven practitioners were held during March and April ; three in Yorkshire and the Humber two in rural areas and one in a city and three in London all in inner city localities.

Recruitment was facilitated by local Healthy Start leads. Each group was attended by two members of the research team, one to facilitate the discussion and the other to take detailed notes.

The discussion guide covered all aspects of Healthy Start including perceived advantages and disadvantages of the programme, how eligible families are identified, experiences of the application process and awareness of how vouchers are used in the local area. Audio-recordings of the focus groups were used to add key information and illustrative quotes to the field notes.

A web-based questionnaire was developed from the study aims and objectives, the findings of the practitioner focus groups, the views of collaborators and stakeholders and the key informant user panel. The statements were drawn from those findings of the practitioner focus groups which had high consensus. Additional free text questions asked about barriers, strategies for improvements and examples of good practice.

The consultation was open for six weeks during July and August An a priori sampling matrix guided purposive sampling to achieve maximum diversity of participants eligible for Healthy Start including women from specific groups such as teenagers, minority ethnic groups and those from urban and rural areas of high socio-economic disadvantage.

Somali, Sylheti, Urdu and Polish speaking women were recruited to focus groups and women from Traveller communities participated in telephone interviews. We included women at all stages from pregnancy until their children were four years old, from any of the following categories:. Although we expected that most participants would be women, men who were in any of the above categories or who wished to accompany their partners were welcomed. Venues were chosen that were familiar to women, easily accessible and in which women would feel comfortable.

Wherever possible, women were drawn from pre-existing groups, as it was felt that knowing at least one other person would be less intimidating than being among strangers. Participatory workshops use a combination of activities aimed at facilitating participation and the sharing of opinions and perspectives in an environment free from hierarchy and officialdom [ 47 ]. We chose this method to gain the trust of women from low-income and vulnerable groups, including those with little or no formal education.

The workshops were facilitated by Food Matters, an NGO working on food policy issues with expertise in food access and participation, and were also attended by a researcher.

Women were given an information sheet by recruitment facilitators a week before each workshop. The workshops, which lasted about two and a half hours, addressed a sequence of questions including; the purpose of Healthy Start and whether it achieved its aims, what recipients receive as part of Healthy Start and its impact on shopping, eating and health.

In two workshops, only one woman arrived on the scheduled day. In these workshops the facilitator used a modified version of the workshop activities to carry out an informal interview. In March , three focus group discussions were held to enable inclusion of women who did not speak English, as they would have found it difficult to participate fully in the English-language workshops.

A researcher facilitated the focus groups with the aid of interpreters. The information sheet and consent form were translated by a professional translation service and checked for meaning by the interpreters. The topic guide was based on the same topics used for the participatory workshops. Each focus group was audio-recorded and key points extracted. Specialist health visitors working with Traveller communities in a city in Yorkshire found it difficult to recruit women from those communities to a participatory workshop.

However three women were willing to share their experiences of the Healthy Start programme in one-to-one telephone interviews. The telephone interviews, lasting 30 minutes and addressing the same key topics as the workshops and focus groups took place in April The researcher took notes of key points from the interviews. The framework method [ 48 ] was used to analyse the research material. A framework of nine themes, as listed below, was derived from the different aspects of the programme and the aims of the study and agreed by the research team.

All qualitative research material was coded deductively according to the nine themes. The lead researcher AM was involved in coding data from all stages of the study with co-analysis and discussion of interpretation with different members of the research team for the different stages of the study.

The data from the different methods and groups of participants were triangulated to enhance rigour and to identify commonalities and differences. All the research team discussed the interpretation of differences between the multiple sources of data.

Analysis of quantitative data from the online consultation comprised descriptive statistics. As shown in Table 1 , 49 practitioners, representing a range of disciplines and roles in respect of Healthy Start and who worked with vulnerable groups, participated in focus groups. The questionnaire was completed by respondents representing a wide range of roles and from all English regions Table 2.

Altogether, women and four men took part in this phase of the study. Table 3 shows the characteristics of the participants who completed the demographic questionnaire. Only 12 women were aged 20 years or under. To answer our research question concerning the potential contribution of food vouchers to reducing nutritional inequalities for women and young children, we present relevant findings under two major themes.

The first is accessibility of Healthy Start which subsumes the framework -themes of eligibility, awareness of the programme, and the application process.

The second is the framework theme using food vouchers, which includes the sub-themes of influence of Healthy Start vouchers on food choices and accessing retail outlets. Direct quotes from participants are shown in italics. There was consensus across participants that the eligibility criteria were clear for families who were in receipt of qualifying welfare benefits. Half of respondents to the online consultation thought that the criteria were about right while a third thought more women should be eligible.

However, both women and practitioners said that the eligibility criteria relating to qualifying tax credits were confusing and that the household income threshold for families receiving tax credits was too low and discriminated against those in low paid work. Comments included:. When I was working I was worse off. I get vouchers and other support. London workshop participant. So people on a low income have to cut back everything Sylheti-speaking focus group participant. The system Healthy Start is not successful because I have five kids.

My husband is self-employed-sometimes he has loads of work and sometimes we have to scrimp and sometimes he has no work. I want to be able to access the vouchers when my husband has no work Yorkshire and Humber workshop participant, rural. This was especially confusing for women under 18 years old because Healthy Start is a universal benefit for this group during pregnancy but is means-tested after birth and following their 18 th birthday.

I get working and child tax credits. I did get the vouchers when I was pregnant but after the baby was born they said the scheme was not available anymore. Many practitioners were concerned that those with uncertain immigration status e. A key factor in whether eligible women register for Healthy Start and receive food vouchers is their awareness of the programme. Only a quarter of respondents to the online consultation thought that the women they saw were already aware of their eligibility for Healthy Start, highlighting the importance of practitioners giving women Healthy Start information.

However, not all women were told about Healthy Start by their midwife or health visitor and a few women had not found out about Healthy Start until their child was over two years old.

Women did not appear to be aware of the scheme from other sources such as leaflets on benefits and tax credits or through government helplines when applying for benefits and tax credits. This was particularly evident among women who did not speak English. Practitioners corroborated the difficulty of publicising Health Start to women who do not speak English and those with poor literacy, because of the lack of information in languages other than English or in non-written formats.

Consequently some busy health practitioners, usually community midwives and health visitors public health nurses , targeted information to those they judged to be eligible.

However, many participants were concerned that eligible families were missed because incorrect assumptions were made about their economic circumstances or because their circumstances changed - just over half of consultation respondents agreed that they could easily identify women who were eligible, and some were reticent about asking women about their financial circumstances.

In addition, while most practitioners suggested their responsibility was to provide information about the programme, a minority viewed their role as gatekeepers of eligibility, expressing concern that some women may abuse the system. Many practitioners recommended that all women should be informed about Healthy Start and that awareness among the general population should be raised. Biggest issue we are having is to differentiate between those not working [from those who are working] — all health professionals feel the same, nurses, doctors etc.

According to the reports of women and practitioners, the barriers to registering for Healthy Start described in the previous sections were exacerbated by a cumbersome application process. Women who did not speak English or with poor literacy described problems with completing the application forms. One Urdu-speaking participant brought a letter from the Healthy Start issuing department to the focus group because she could not understand it.

Several women described applying once and being refused and applying a second time and being accepted and they did not understand the reasons for this. Some women assumed that if they did not hear from the issuing department it meant that they were ineligible whereas others had followed up their claims successfully. I got the information and filled in the forms but I never got a reply back. Urdu-speaking focus group participant. In the week the vouchers come we can eat vegetables telephone interviewee from Traveller community.

The majority of women reported that the vouchers enabled them to buy better quality and a greater variety of fruit and vegetables. One woman from a Traveller community described how, when she no longer received vouchers, she could not experiment with different types of fruit because she could not afford waste. Many women said they would buy similar amounts of milk, fruit and vegetables even if they did not get the vouchers; however the vouchers helped them to manage better financially.

Others reported that they bought less fruit and vegetables once the vouchers ceased. The vouchers were also said to provide a reminder of the need to eat a healthy diet, and to help establish good habits for the future.

Get your kids used to it and demand it of you London workshop participant. Several young mothers said that Healthy Start provided them with resources for food to which they would not otherwise have access.

After your baby is born, you will only continue to qualify for Healthy Start if you get the qualifying benefits or tax credits. To make sure you continue to receive Healthy Start vouchers once your baby is born, you should:.

WTC run-on is what you receive in the 4 weeks immediately after you have stopped working for 16 hours or more per week. Without this, your payments may stop and you will need to reapply. Contents How do I apply for Healthy Start vouchers? How can I apply?