Home visitation was a response to the dreadful outcomes for children found among very poor families. Intensive programs of pre-natal and post-natal support extending to the school years emerged from the 1960s onwards. Many have been rigorously evaluated.

Six US programs have survived a series of evaluations and been widely implemented, although they are only for poor children and only reach about one in ten new borns. They are: Early Head Starts; Healthy Families America; HIPPY (Home Instruction for Parents of Preschool Youngsters); Nurse Family Partnership; Parents as Teachers; and the Parent Child Home Program. All have had to compete for resources in an often hostile policy environment. This has led to a series of sophisticated quality control mechanisms, and strong service delivery organisations.

In England, the absence of rigorous evaluation of the universal health visitor service has led to many questions about its efficacy. The potential to enhance the service for vulnerable families has been seized by a small number of programs. The Oxfordshire Home Visiting Study, for example, is an experimental trial involving mothers found to be in need of extra support. at the "booking-in" visit .