Objective: To identify reasons why eligible families are not accessing free 'Healthy Start' vitamin supplementation (providing vitamins A, C and D) in England.
Design: Qualitative study using in-depth interviews.
Setting: 13 primary care trusts in England.
Participants: Purposive sample of 15 Healthy Start coordinators, 50 frontline health and children's professionals and 107 parents.
Results: Vitamin take-up was low across all research sites, reported as below 10% of eligible beneficiaries for free vitamins. Reasons identified by both parents and professionals included (1) poor accessibility of vitamins, (2) low promotion of the scheme by health professionals, (3) a lack of awareness among eligible families, and (4) low motivation among mothers to take vitamins for themselves during pregnancy or for children under 4 years old.
Conclusions: Low uptake rates can be explained by poor accessibility of vitamins and lack of awareness and motivation to take vitamin supplements among eligible families. Universal provision (at least for pregnant women) and better training for health professionals are identified as potential solutions worthy of further research and evaluation.
Keywords: Epidemiology; General Paediatrics; Health services research; Nursing; Qualitative research.