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Teenage Pregnancy

Teenage Pregnancy. Adrian.Kelly@elc.nhs.uk. Context. Government strategy launched in 1998 to halve the rate of conceptions of under 18s by 2010. Data for the final quarter of 2010 is published at the end of February 2012 concluding the 10 yr strategy.

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Teenage Pregnancy

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  1. TeenagePregnancy Adrian.Kelly@elc.nhs.uk

  2. Context • Government strategy launched in 1998 to halve the rate of conceptions of under 18s by 2010. • Data for the final quarter of 2010 is published at the end of February 2012 concluding the 10 yr strategy. • Three different values up for discussion today: • Conception rates (per thousand females aged 15-17 or 13-15) • % change (in the rate per thousand) and • absolute numbers of conceptions.

  3. Performance Headlines • The best on reduction in U16s of any region • 20.3% reduction in London’s U18 rate (down from 51.1 to 40.7 per thousand) • 4977 conceptions to under 18s in 2009 down from 6042 in 1998

  4. Conception rates in under 16s

  5. Quarterly rates: London v England

  6. Quarterly rates: Outer v Inner

  7. % change in rates 1998-2009

  8. Significance of U18 rates in 2009

  9. Redbridge and Bromley

  10. Some are bigger hitters… The number of conceptions in a borough relates to their impact on the regional rate: • Better performing areas with high numbers: • Croydon, Lewisham, Southwark, Lambeth, Ealing and Hackney • Poorer performing areas with high numbers: • Bromley, Greenwich, Waltham Forest, Bexley, Barking & Dagenham and Redbridge

  11. Redbridge’s unlucky baseline…

  12. Or rapidly changing needs? • Changes in the ethnic composition of the child population over the last decade in London boroughs are likely to have had a bearing on performance. • Greatest demographic change seen in Barking and Dagenham which also had an unlucky baseline. • The number of children from ethnic minority background has increased by more than 20% in: • Redbridge, Enfield, Croydon & Merton. • Research by Chris Hamnett Professor of Geography at Kings

  13. What works? • Draft NICE guidance on contraception for socially disadvantaged young people reviewed the evidence base for effectiveness:

  14. Promoting condom use Strong evidence from five studies to support interventions that combine discussion and demonstration of condoms to increase adolescent condom use and engagement with clinical services. It is the only intervention with a strong evidence base that London is working collaboratively on.

  15. Has moved out of the pilot phase, undergone rapid expansion and is now “sector-led” • 18 boroughs now active with 652 registration points • 25,000 clients registered with 150K condoms issued this year • 50,000 free condoms donated by Durex to boroughs • Harmonisation of policies & procedures is well advanced • Organisational turbulence, local financial pressure and the lack of regional resources for coordination pose a risk to this intervention.

  16. 25k YP registered

  17. Concluding remarks • Acceleration in performance helped by late improvement across outer London. Especially good decline seen in U16 conception rate. • Additional support would be well targeted at: • Bromley, Greenwich, Waltham Forest, Bexley, B&D and Redbridge • Come Correct - more support from London’s institutions will help to realise its full potential and improve value for money. • Maintaining and increasing PCT/LA coverage • Consistency of upper age limit • Engagement of CASH and Pharmacy

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