Efua Dorkenoo,OBETeenage Pregnancy and Healthy

Schools ProgrammeChildren and Learners Directorate

Government Office East of England

Teenage PregnancyPutting Hertfordshire in Context

Teenage Pregnancy Strategy (1999): the goals

Halve the under 18 conception rate by 2010 – a renewed Public Service Agreement (14) – Increasing the number of children and young people on the path to success - with NEETS, Positive Activities, Substance Misuse and New Entrants to Criminal Justice System

Improve outcomes for teenage parents and their children, with a goal of 60% of 16-19 mothers in education, employment or training (NEET) by 2010

10 year strategies in each top tier Local Authority with local 2010 reduction target – adding up to 50% national reduction

Teenage pregnancy an LAA priority in 106/150 areas

Progress to date (England): 1998-2007

The 2007 data provide the latest position on progress towards the 2010 reduction targets.

The provisional 2007 under-18 conception rate for England is 41.7 per 1000 girls aged 15-17

Represents an overall decline of 10.7% since 1998

Reduction needs to accelerate rapidly …..…the 2007 national data shows an increase in under-18 conception rate when compared with 2006 data

Ref: ONS/TPU

England TP Trends 98-07 and Trajectory

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Un

de

r 1

8 c

on

cep

tion

ra

te p

er

10

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fem

ale

s a

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d 1

5-1

7

Projection of trend

Trajectory required to meet target

Summary: Under-18 conception rate (2007)East of England

The East of England overall has one of the lowest rates nationally and a reasonable decline, there is still much to do.

Rates are however still declining overall from baseline (although slowly), where the national trend is of increasing rates.

Change in under-18 conception rate by Region 1998-2007 (ONS Feb. 09)

Region 2007 rates Trend % change 98-07

England 47.1 increase 10.7

NE 52.9 increase 6.4

NW 47.1 Increase 6.5

Y&H 47.9 Increase 10.3

EM 40.9 Increase 17.3

WM 47.7 Increase 8.2

London 46.2 Increase 10.7

SE 33.3 Static 13.3

SW 36.5 increase 8.7

EoE 33.4 Static 12.7

Summary: Under-18 conception rate (2007) Hertfordshire

TP rates on very slight upward trajectory currently.

Repeat abortions high. Hertfordshire need to look at the repeat

abortion rates and improve contraception provided post-termination.

Under-18 conception rates 1998-2007 in Hertfordshire

U18 conception rates for 2007

26.5

U18 conception rates for 2006

26.2

Number 560

Decline 98-07 17.9%

06 RAG Amber-Red

Target 45%

Repeatabortions 07

E&N 15.2%, W 13.0%

Key performance improvement questions for U18 conception rate

Are local termination services providing the full range of contraception, in line with the NHS operating framework and NICE guidance?

Is there a post-natal care pathway in place for young mothers to ensure they receive effective contraception prior to discharge plus follow-up, in line with SHA maternity guidance?

Is the PCT using the extra money allocated to its baseline, to improve access for young people to contraception, appropriately?

Are local contraceptive services young people friendly (venue, timing, staff) and appropriately located?

Are plans in place to build capacity in the school nursing service to support delivery of statutory PSHE Education in schools?

Teenage Pregnancy: everybody’s business!

Teenage Pregnancy

Poor and inconsistent contraceptive use among young people

Young people lack skills and confidence to make and carry through positive choices

Parents and professionals lack confidence to discuss sex and relationship issues with young people

Lack of confidence in mainstream health services

Fear of parents/carers finding out Lack of easy

access to contraception

Disengagement from school / poor attendance

Behavioural problems

Low aspirations

Parental influence

Cultural influence

Peer influence

Emotionalwell-being

Social deprivation

Looked after children / young people leaving care

Teenagemother

Mental health problems

Sexual abuse in childhood

Low self-esteem

Lack of confidence in resisting pressure to have sex

Alcohol/substance misuse

More likely to have sex early

Poor knowledge and skills among young people in relation to sex, relationships and sexual health risks

Low knowledge levels among boys and young men

Ethnicity

Poor educational attainment

Less likely to use contraception

Teenage Pregnancy

Poor and inconsistent contraceptive use among young people

Young people lack skills and confidence to make and carry through positive choices

Parents and professionals lack confidence to discuss sex and relationship issues with young people

Lack of confidence in mainstream health services

Fear of parents/carers finding out Lack of easy

access to contraception

Disengagement from school / poor attendance

Behavioural problems

Low aspirations

Parental influence

Cultural influence

Peer influence

Emotionalwell-being

Social deprivation

Looked after children / young people leaving care

Teenagemother

Mental health problems

Sexual abuse in childhood

Low self-esteem

Lack of confidence in resisting pressure to have sex

Alcohol/substance misuse

More likely to have sex early

Poor knowledge and skills among young people in relation to sex, relationships and sexual health risks

Low knowledge levels among boys and young men

Ethnicity

Poor educational attainment

Less likely to use contraception

Teenage pregnancy: A complex issue associated with a large range of risk factors…

Supporting parentsTo discuss sex &

relationships

Building aspirationsand self esteem

Strong use of local data

Targeted SRE work with young people

at risk

Strong youth servicethings to do, places to go

Workforce training on SRE

Strong messagesto young people

and partner agencies

Young people friendlyContraceptive services

SRE in schoolsand out of school

settings

TP ChampionsStrategic leadership

More information:

Teenage Pregnancy Next Steps: Guidance for Local Authorities and PCTs on effective delivery of local strategies (July 2006)

Teenage Pregnancy: Accelerating the Strategy to 2010 (September 2006)

Teenage Parents Next Steps: Guidance for Local Authorities and PCTs (July 2007)

www.everychildmatters.gov.uk/teenagepregnancy