Supermarket top-up of Healthy Start vouchers increases fruit and vegetable purchases in low-income households - These analyses demonstrated that 0.9 more portions of fruit and vegetables (FV) per day per household were purchased during the scheme compared to the 2019 baseline (p = 0.0017). The percentage of FV weight within total baskets also increased by 1.6 percentage points (p = 0.0242), although the proportional spend on FV did not change. During the scheme period, FV purchased was higher by 0.4 percentage points (p = 0.0012) and 1.6 percentage points (p = 0.0062) according to spend and weight, respectively, in top-up redeeming baskets compared to non-top-up redeeming baskets with at least one FV item and was associated with 5.5 more HSV ‘Suggested’ FV portions (p < 0.0001). The median weight of FV purchased increased from 41.83 kg in 2019 to 54.14 kg in 2021 (p = 0.0017). However, top-up vouchers were only redeemed on 9.1% of occasions where FV were purchased. In summary, this study provides novel data showing that safeguarding funds exclusively for FV can help to increase access to FV in low-income households.

The Healthy Start scheme in England “is a lifeline for families but many are missing out”: a rapid qualitative analysis - A novel finding from this study is that raising awareness about HS alone is unlikely to result automatically or universally in higher uptake rate. Recommendations include: continuing to provide this scheme that is universally valued; the need for many families to be provided with a helping hand to successfully complete the application; reframing of the scheme as a child’s right to food and development to ensure inclusivity; improved leadership, coordination and accountability at both national and local levels.

Healthy Start Vouchers Study: The Views and Experiences of Parents, Professionals and Small Retailers in England - Uptake of the Healthy Start scheme amongst eligible families was generally high (in our research sites an estimated 72- 86% of eligible families were signed up). Data provided by DH showed that estimated take-up rates tended to be lower in less-deprived PCTs; the five least deprived PCTs had take-up in the range of 72-77%, while the more deprived were in the range 78-86%.

Getting a healthy start: The effectiveness of targeted benefits for improving dietary choices - We show that the policy has increased spending on fruit and vegetables and has been more effective than an equivalent-value cash benefit. We also show that the policy improved the nutrient composition of households' shopping baskets, with no offsetting changes in spending on other foodstuffs.

The UK Healthy Start scheme: What happened? What next? - The eligibility for and uptake of Healthy Start, and Government spending on the scheme, rapidly declined in the five years from 2013 to 2018. Healthy Start provides an opportunity for retailers who provide locally grown and sourced food.  

Effect of the introduction of ‘Healthy Start’ on dietary behaviour during and after pregnancy: early results from the ‘before and after’ Sheffield study - In phase 1, 176 WFS subjects (ninety pregnant and eighty-six postpartum) were recruited and in phase 2, there were 160 HS subjects (ninety-six pregnant and sixty-four postpartum). The results suggested that pregnant and postpartum HS women significantly increased their daily intakes of energy, Fe, Ca, folate and vitamin C compared with the WFS women. Observed differences remained significant after controlling for potential confounding effects of known factors, i.e. education and age. HS women were more likely to meet the recommended nutrient intakes for Fe, folate, Ca and vitamin C. HS women ate significantly more mean portions of fruit and vegetables per d (P = 0·004 and P = 0·023) respectively. None of the HS recipients was receiving HS vitamin supplements. The present study showed that pregnant and postpartum HS women increased their food consumption, and a higher proportion of them than the earlier WFS scheme met the recommended intakes for Ca, folate, Fe and vitamin C.

Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England - Women reported that Healthy Start vouchers increased the quantity and range of fruit and vegetables they used and improved the quality of family diets, and established good habits for the future. Barriers to registration included complex eligibility criteria, inappropriate targeting of information about the programme by health practitioners and a general low level of awareness among families. Access to the programme was particularly challenging for women who did not speak English, had low literacy levels, were in low paid work or had fluctuating incomes. The potential impact was undermined by the rising price of food relative to voucher value. Access to registered retailers was problematic in rural areas, and there was low registration among smaller shops and market stalls, especially those serving culturally diverse communities.