Transcript Document
Teenage pregnancy and promoting prevention Alison Hadley, Director, Teenage Pregnancy Knowledge Exchange, University of Bedfordshire A quick update on progress Some important new research Some reflections from supporting local areas England progress: 1998-2011 34% reduction in under 18 conception rate Lowest rate since 1969 2012 quarterly data shows continuing downward trend Variation in local progress 1998-2011 30 20 Percentage change in rate 10 0 -10 -20 -30 -40 England -50 -60 -70 Top-tier local authorities Doncaster Milton Keynes Bracknell Camden 4 Why the work needs to continue Nationally, rates remain higher than similar Western European countries – only two thirds towards original goal Progress needs sustaining in the 47% of LAs showing good reductions and accelerating in LAs with smaller reductions The vast majority of pregnancies remain unplanned with at least 50% ending in abortion Disproportionately poor outcomes for young parents and their children Public Health Outcomes Framework ▪ Under 18 conception rate ▪ Chlamydia diagnosis (15-24) Related indicators ▪ Children in poverty (63% higher risk) ▪ Rates of adolescents not in education, employment or training (NEET)(11% of all female NEETs are pregnant or teenage mothers) ▪ Proportion of people in long term unemployment(22% higher rates of poverty for teenage mothers x2 rate of unemployment for young fathers ▪ Infant mortality rate (60% higher risk) ▪ Incidence of low birth weight of term babies (25% higher risk) ▪ Maternal smoking prevalence (including during pregnancy) (x3 smoking rate) ▪ Breastfeeding initiation and prevalence at 6-8 weeks (1/3 lower rate) ▪ Hospital admissions caused by unintentional and deliberate injuries to under 5s (higher rates of A&E attendance for falls/swallowing substances) ▪ Sexual violence (38% of all rapes recorded by police in 2010-11 were committed against children under 16) Some important new research Sticking to the evidence • Provision of high quality, comprehensive sex and relationships education linked to improved use of contraception are areas where strongest empirical evidence exists on impact on teenage pregnancy rates • New evidence from NATSAL 3 that school based SRE is protective against unplanned pregnancy Proportionate universalism: new analysis of young people at risk The strongest associated risk factors for pregnancy before 18* - Free school meals eligibility - Persistent school absence in Year 9 - Slower than expected progress between Key Stage 2 and 3 (11-14 years) *Teenage Pregnancy in England. DfE/IFS research report 2013 The critical importance of universal prevention The majority of girls who conceive under 18 do not have specific risk factors “A teenage pregnancy prevention strategy that seeks to reduce conception rates by a substantial margin cannot concentrate on high risk groups alone.” *Teenage Pregnancy in England. DfE/IFS research report 2013 A ‘whole systems’ approach: endorsed by the Sexual Health Framework SRE in schools and colleges Supporting parents to discuss sex & relationships Dedicated support for teenage parents – including contraception and sexual health Young people friendly contraceptive & SH services Clear and consistent messages to young people, parents and practitioners Strategic leadership & accountability Strong use of data for commissioning & Local performance management Workforce training on SRE Targeted SRE and contraception/SH support for young people at risk SRE & access to contraception in youth services Some reflections from supporting local areas Contraception and condoms • Knowledge and access to all methods – definition of LARC? • Condoms – falling through the gap between contraception and STI screening? • The importance of C-card schemes – and including boys/young men in prevention strategies • Service publicity - is it systematic? Pregnancy options pathways • Is abortion a realistic option in all areas? • Are teenage parents included in the prevention pathway for contraception, condoms and chlamydia? Workforce training: making every contact count Incorporate the prevention role of the wider non-health workforce into commissioning (Sexual Health Framework) Identifying the new assets in the system – which services and practitioners are young people in touch with? Building an open and honest culture: a national and local challenge Some overarching messages for young people and communities Open and honest conversations about relationships and sexual health help young people make well informed choices Asking for advice about contraception, sexual health or parenting support is the right and responsible thing to do No wrong door – all services and practitioners will try and help For more information: Teenage Pregnancy Knowledge Exchange www.beds.ac.uk/knowledgeexchange [email protected]