Health visitor

Health visitors are professional individuals engaged in public health work within the domestic setting, predominantly found in countries with state-funded health systems. They are distinct from district nurses, who provide clinical healthcare, domestically. In the UK, since 1945, health visitors are required to be Registered Nurses or Midwives who have undertaken further training to work as part of a primary health care team.

In 1977 there were 10623 health visitors in the UK. In 2015 there were 12292 in England and Wales, an increase from 10,046 in 2000. In 2000 there were 297 children under 5 per health visitor, a figure which rose to 419 in 2011.

They are mainly concerned with helping to ensure that people's domestic behaviour is sanitary, hygienic, and beneficial to the welfare of themselves and their families, particularly to their children. As their name suggests, they fulfil their role in the community, by visiting family homes, to give advice and support to all age groups. They have a key role with regard to safeguarding vulnerable people, as they are often the first experts to enter the homes of individuals at risk of abuse and neglect, especially children.

At the time their profession began, living conditions for the urban poor were often cramped and extremely insanitary, leading to many business owners sending women around to workers' homes to educate their wives about sanitation and nutrition; healthy workers were better for economic output. This was formalised as the Ladies Sanitary Reform Association in 1862 and by 1890 some local councils were paying their salaries. In 1929, they began to be employed by local councils on a statutory basis and since 1974 they have been employed by the National Health Service.

In the early days of statutory health visiting, training in the UK was overseen by the Royal Sanitory Institute, who later evolved into the Royal Society of Public Health. This was later taken over by the government's Ministry of Health, and they are now regulated by the Nursing and Midwifery Council.

The initial focus of health visiting was on families with young children, and all mothers were given a statutory right to a visit from a health visitor in the first week since birth, once postpartum care is handed over from the midwives. Visits would cover topics such as sanitation, feeding, nutrition, care, and support to both infants and parents. Typically there would be regular visits throughout a child's early years, to provide routine child development checks; a check at two years of age is now a major part of the standard provision.

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