Alison Hadley Teenage Pregnancy Unit Teenage Pregnancy and Young People’s Sexual Health Maintaining progress in the new system

«Building on progress «Using the evidence base «Maintaining priority in the new system «Involving young people

Building on progress «25% reduction in under 18 conception rate «35% reduction in conceptions leading to birth «Lowest rate since 1969 – over 40 years «Continuing decline in first three quarters of 2011 « Concerted and sustained effort makes a difference but...

But progress needs maintaining and some LAs lag behind Tower Hamlets Hackney Oldham Swindon Milton Keynes

Remembering the evidence base §Vast majority of teenage pregnancies are unplanned §Provision of high quality SRE (Kirby 2007) and improved use of contraception (Santelli 2008) are areas where strongest empirical evidence exists on impact on teenage pregnancy rates §No evidence that alternative approaches (e.g abstinence-only/benefit conditionality) are effective

Strategic leadership & accountability SRE in schools and colleges Young people friendly contraceptive & SH services Clear and consistent messages to young people, parents and pracittioners Workforce training on SRE SRE & access to contraception in youth services Targeted SRE and contraception/SH support for young people at risk Strong use of data for commissioning & Local performance management Dedicated support for teenage parents – including SRE and contraception Supporting parents to discuss sex & relationships..and how to translate evidence into practice A whole system approach: clear actions for different agencies

Why teenage pregnancy still matters §11% of all young people who are not in education, employment or training (NEET) are teenage mothers or pregnant teenagers §20% more likely to have no qualifications at age 30 §22% more likely to be living in poverty at 30, and much less likely to be employed or living with a partner §3 times the rate of post-natal depression §higher risk of poor mental health for 3 years after the birth §Children of teenage mothers have a 63% increased risk of child poverty and are more likely to have childhood accidents and behavioural problems §The infant mortality rate for babies born to teenage mothers is 60% higher §3 times more likely to smoke throughout their pregnancy, and 50% less likely to breastfeed, with negative health consequences for the child §The majority of teen pregnancies are unplanned and over half end in abortion

Maintaining the priority in the new system Public Health Outcomes Framework ▪Under 18 conception rate ▪Chlamydia diagnosis (15-24) ▪ Sexual violence Related indicators ▪Children in poverty ▪Child development at years ▪Rates of adolescents not in education, employment or training (NEET) ▪Proportion of people in long term unemployment ▪Infant mortality rate ▪Incidence of low birth weight of term babies ▪Maternal smoking prevalence (including during pregnancy) ▪Breastfeeding initiation and prevalence at 6-8 weeks ▪Hospital admissions caused by unintentional and deliberate injuries to under 5s ▪Child Poverty Act: under 18 conception rate a national and local measure of progress

Joint Strategic Needs Assessment: getting it right Know your local data: ▪Trends in the LA under 18 and under 16 rate over the last ten years ▪ Most recent picture from 2011 Q1, Q2 and Q3 data ▪Comparison with national and regional rate – and statistical neighbours ▪ Proportion of conceptions ending in abortion or maternity ▪ Repeat abortions ▪ High rate wards: low-average rates at LA level can hide high rate wards e.g. Essex has a LA rate of 29.2 v national rate of 35.4 but has 15 wards with rates >58.

Making the JSNA real: walking in the footsteps of young people and mapping data against schools and services young people use (Illustrative slide from Leeds) Under-18 conception rates (02-04) & secondary schools in Leeds

Involving young people Key messages from young people in Positive for Youth ▪make seeking health advice normal, not a last resort ▪tackle the stigma about asking for sexual health advice ▪integrate information and advice into wider youth services ▪make services friendly and welcoming ▪publicise services widely Use existing youth fora and Local HealthWatch to involve young people in JSNA

…and finally, making every contact count ▪Making the system work to full capacity ▪Joining up the dots for all relevant services and frontline practitioners so young people are supported by the whole system ▪‘Engagement days’ for all practitioners to make teenage pregnancy and young people’s sexual health everyone’s business

Links to data and further information Reviewing progress on conception data (including trends on maternity and abortion) enagepregnancy/a /under-18-and-under-16-conception-statistics Connecting to other relevant data Chimat Teenage Pregnancy Snapshot Reports: including other relevant LA data e.g. on NEET, secondary school exclusions, alcohol related hospital admissions, infant mortality. New Child Health Profiles: Links to relevant guidance: enagepregnancy