Improving Child Health Through Early Years Settings in the UK: Qualitative study of Parents’, Practitioners’ and Policymakers’ Perspectives

Abstract Background Early years settings (EYS) provide an important place for health improvement, reaching most young children. However, health policy and practice in EYS are less developed than in schools. We explored stakeholder perspectives on opportunities, priorities and challenges for improving child health through EYS. Methods We conducted a qualitative study using online and in-person interviews and focus groups with parents, early years practitioners, and local and national policymakers across England, Scotland, Wales and Northern Ireland. Fifty-four participants took part: 19 parents, 13 practitioners, 10 local policymakers and 12 national policymakers. Data were analysed using thematic analysis. Results EYS are trusted and accessible environments with the potential to improve health, identify health concerns and reduce inequalities. Priorities for health improvement included mental health and wellbeing, food security, food quality, speech and language development, outdoor play and physical activity, and vaccination delivery. Substantial challenges were identified, including workforce, resources, access to health services, fragmented data, and the diversity of EYS provision. Policymakers perceived EYS as receiving less policy attention than schools. Conclusions EYS represent a powerful but underused setting for improving child health and reducing health inequalities. Realising their potential requires strategic national policies and resourcing, with better integration with health services and a stronger evidence-base.