More Cash For Contraception, UK

Main Category: Sexual Health / STDs
Article Date: 27 Feb 2009 - 5:00 PDT

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£20.5m package to promote contraception Call for action to areas with high teenage pregnancy rates

An extra £20.5 million will help young people get better access to contraception and support for teenagers and raise the awareness of the risks of unprotected sex, Public Health Minister Dawn Primarolo and Young People's Minister Beverley Hughes announced today.

The cash supports the teenage pregnancy strategy that is focused on encouraging young people to delay early sex and to practice safe sex as and when they do become sexually active.

The new package of support and investment to promote the use of contraception includes:

- £7 million for a new 'contraceptive choices' media campaign to raise awareness of the different options - including Long Acting Reversible Contraceptives (LARCs) - available to young people, to prevent teenage conceptions;

- £10 million for local health services to ensure contraception is available in the right places at the right time;

- £1 million to support further education colleges develop and expand on-site contraception and sexual health services to help address the fact that 80 per cent of under-18 conceptions are among 16-17 year olds.

- A further £2.5m will help develop a Healthy College programme and help all services meet the Department of Health's 'You're Welcome' standards for young people friendly services.

Figures released by the Office of National Statistics today show that the increase in teenage pregnancy rates in the first three quarters of 2007 is due to a rise in unplanned conceptions ending in abortion, and not an increase in teenage mothers giving birth. However, the under 18 conception rate for the final quarter of 2007 is 2per cent lower than the same quarter in 2006 - suggesting that the drive to reduce teenage conceptions is continuing in the right direction.

Where there have been rises, and given these have resulted in abortions not births, this suggests that young people are not accessing effective contraception and may be engaging in more risky behaviour - pointing to the need for better advice and information about sex and relationships both from their parents and in schools.

Young people say they would prefer advice from parents and that is why the Government has invested in support for parents to help them talk more openly to their children. The Government has already announced its intention to make Sex and Relationships Education compulsory as part of Personal Social Health Education, and all schools will be provided with new SRE guidance this September.

Evidence shows that where the Government's teenage pregnancy strategy is implemented rigorously, significant reductions in teenage pregnancy rates have been achieved, such as in Oldham where rates have dropped by 29 per cent. The Government wants this success replicated across the country and is today calling on all local areas to redouble their efforts to drive a robust approach to reducing teenage pregnancy rates.

Despite the rise in national figures in the last year the long-term trend is still downward and overall there has been a 10.7 per cent reduction in under-18 conceptions and a 23.3 per cent decline in teenage births since the start of the Government's strategy in 1998. In 2006 the rates dropped to their lowest level in 20 years. Tackling teenage pregnancy requires sustained action by local authorities, the NHS parents, schools, and young people themselves.

Children and Young People's Minister, Beverley Hughes said: "Today's teenage pregnancy statistics are disappointing, although the reduction in the last quarter of 2007 over 2006 gives me cautious optimism that the drive to reduce teenage pregnancy conceptions is still on track. There is no doubt that rates have come down where local areas have implemented the strategy properly, even in deprived areas.

"The evidence suggests that more teenagers may have been engaging in risky behaviour and not using contraception, resulting in an increase in conceptions leading to abortion. Our strategy is to encourage teenagers to delay early sexual activity, but to use contraception when they do become sexually active.

"We have already announced our intention to make sex and relationship education (SRE) compulsory and we will be providing new SRE guidance to schools this September. This is in addition to more support for parents to help them talk more openly to their children about sex and relationships. And for the minority of families where parents are failing in their responsibilities we will continue our programmes of intensive family support which we know works in getting parents to do better by their children.

"Reducing teenage pregnancy requires everyone to play their part - parents, health, local authorities and schools. Where progress has slowed, efforts must be redoubled and we will be focusing our challenge on those areas with high and increasing rates."

Health Minister Dawn Primarolo said:

"Young people need good advice and easy access to contraception when they become sexually active. To help, we are improving access to contraception by providing an extra £20.5 million funding this year.

"We are supporting the NHS to offer women of all ages the full range of contraceptive choices, including long acting, reversible, methods such as implants and injections which are virtually 100 per cent effective. And we're giving local health services more money to come up with innovative ways of making sure young women use their contraceptives properly, such as text message reminders." Further Education Minister Sion Simon said:

"The Further Education sector has an important contribution to make in tackling sexual health issues. Colleges are ideally placed to offer support and advice to young people, and this extra investment will allow them to develop and expand on-site contraception and sexual health services. "Providing health advice services on-site avoids FE students having to take time off from their studies, helps them to deal quickly with health concerns that might be impacting negatively on their learning and can help avoid them dropping out of learning altogether."

The Government has issued clear guidance on effective strategies, which all areas must follow with a concerted and consistent approach. Ministers will be meeting with senior officials from Local Authorities and Primary Care Trusts in areas with high rates as well as receiving six monthly reports on the actions they are taking to strengthen their strategies. The Government has also taken action since 2007 to strengthen delivery of the strategy, which is not reflected in the statistics out today.

For the minority of families needing additional support, we have a range of parenting programmes designed to identify problems early and provide intensive help. These include the Family Nurse Partnerships for young mothers and Family Intervention Projects being expanded to all areas this year. From April this year, all areas will have at least two parenting experts to work with families and children experiencing serious problems.

In their guidance on Long Acting Reversible Contraceptives (LARC), NICE estimated that if 7 per cent of women switched from the pill to LARC methods (doubling current usage to 15 per cent) the NHS could save around £100 million each year through reducing unplanned pregnancies by 73,000.

Notes

1. England's under-18 conception rate is 41.7 per 1000 and has fallen by 10.7 per cent since 1998. The under-16 rate is 8.3 per 1000 and has fallen by 6.4 per cent over the same period.

2. Statistics published today by the Office of National Statistics show that in 2007 the under-18 conception rate rose by 2.6 per cent, accounted for by an increase in those having abortions. Despite the rise in national figures in 2007 the long-term trend is still downward.

3. The NHS offers women of all ages the full range of contraceptive choices, including long acting, reversible, methods such as implants and injections which are virtually 100 per cent effective. 4. In 2001 the Government published the National Strategy for Sexual Health and HIV which aims to prevent the spread of STIs and HIVe, improve care and treatment and reduce unintended pregnancies. See here.

5. The Teenage Pregnancy Strategy is based on the best international evidence. All areas have been provided with clear guidance on the key factors for effective local strategies. It is the responsibility of senior leaders in each Local Authority and Primary Care Trusts to implement this in their area.

6. The success of the Teenage Pregnancy strategy relies on all local areas applying it effectively. Where they do, rates come down - for example Calderdale has reduced its rate by 30 per cent and Oldham has reduced its rate by 29 per cent.

South West: Gloucestershire: -25.1 per cent
South East: Milton Keynes: -23.6 per cent
London: Newham: -24.9 per cent
East: Southend: -26.1 per cent
East Mids: Nottinghamshire: -24.0 per cent
West Mids: Telford & Wrekin: -23.9 per cent
Yorks & Humber: Calderdale: -29.9 per cent
North West: Oldham: -29.4 per cent
North East: Darlington: -13.7 per cent

7. A recent study from the US attributed 86 per cent of the decline in teenage pregnancy rates to improved contraception use.

8. Reducing the under-18 conception rate by 50 per cent by 2010 is one of the five National Indicators against which progress on PSA 14 "young people on the path to success" is measured, as part of a broader strategy to improve sexual health (joint DH/DCSF target). See http://www.condomessentialwear.co.uk and http://www.RUThinking.co.uk

9. Sexual health is identified as a priority area in the 2008/9 and 2009/10 NHS Operating Framework. The High Quality Care for All: NHS Next Stage Review Final Report has identified sexual health as one of six priority areas for PCTs to commission comprehensive wellbeing and prevention services to meet the needs of their local population. See here.

10. Under the Abortion Act 1967 women in Great Britain have access to safe, legal abortions. We are working hard to ensure that women have access to abortion services as soon as possible as evidence shows the risk of complications increases the later the gestation. Data for 2007 shows that progress is being made to increase early access: 68per cent of NHS funded abortions took place at under ten weeks, compared with 51per cent in 2001. In a bid to prevent repeat abortions, practitioners are now required to discuss future contraceptive options at the point of abortion.

- The 10 key factors of successful teenage pregnancy strategies

- 1. Advice and information for parents on talking to their children openly about relationships and sexual health.

- 2. A high priority given to sex and relationships (SRE) within PSHE in schools, with support from the local authority to develop comprehensive programmes of sex and relationships education (SRE) in all schools.

- 3. The availability of a well publicised young people-centred contraceptive and sexual health advice service, with targeted outreach work.

- 4. Strong senior champions in the LA and PCT who are accountable for delivery of the local strategy - with active engagement of Health, Education, Social Services, Targeted Youth Support and IYSS - and the voluntary sector.

- 5. Clear messages to young people on resisting peer pressure to have early sex and using contraception when they do become sexually active.

- 6. A strong focus on targeted interventions with young people at greatest risk of teenage pregnancy, in particular with Looked After Children and care leavers.

- 7. The availability (and consistent take-up) of SRE training for professionals in partner organisations (such as Connexions Personal Advisers, TYS Lead Professionals, Youth Workers and Social Workers) working with the most vulnerable young people.

- 8. Good use of local data to ensure strategies are targeted in high rate neighbourhoods and on young people most at risk of early pregnancy.

- 9. Support for vulnerable young people to raise self-esteem and tackle low aspirations.

- 10. A well resourced Youth Service, providing things to do and places to go for young people, with a clear focus on addressing key social issues affecting young people, such as sexual health and substance misuse.

Department of health, UK

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