In 1999, the Government launched its Teenage Pregnancy Strategy with a target of
halving the 90,000 teenage conceptions in 1998 by 2010, and an interim goal of
a 15 per cent reduction by 2004. The latter was missed and few experts believe
the Government will reach its objective. But the Government and its advisers
insist there has been progress. Since the strategy was set out, the number of
conceptions for under-18s has fallen by 11 per cent, while birth rates have
come down by 20 per cent due to an increase in abortions. But progress is
uneven and between 2004 and 2005 conceptions among women under 16 in fact
nudged up by 0.3 per cent.
The national strategy was based on intensive research carried out in parts of
the country where rates had fallen. It concluded there were five key elements
to reducing teenage conceptions: the importance of a local champion,
inter-agency working, an active youth service, strong sex education in schools,
and services such as clinics in schools.
But some campaigners and academics claim the strategy is built on contraception
rather than a change in behaviour, and is bound to fail. Dr Trevor Stammers, a
lecturer in healthcare ethics at St Mary's University College Twickenham, south
west London, believes setting up clinics in schools where young people have
access to the morning-after pill is undermining the message that sex has
consequences. "The Government cannot see any answer other than contraception,"
he says.
David Paton, a professor of economics at Nottingham University, argues there is
no strong evidence for the effectiveness of school sex education or advocating
the use of contraception. Paton, who has a background in the pro-life movement,
says social class is the big factor in determining a young person's
expectations - the most important influence on conception rates: "The
opportunity cost of having a baby if you're a young woman on a sink estate is
low. But for a middle-class girl the cost is very high: it could mean not going
to university and getting a good job."
Room for improvement
Inspectorate Ofsted has repeatedly voiced concerns about the standard of sex
education in schools. In 2005, it released a report criticising the level of
personal, social and health education (PSHE) as "poor". This year, a separate
Ofsted report said standards at primary schools had risen but secondary schools
were still problematic. In particular, it urged schools to do more to help
parents discuss sex with their children.
Indeed, liberal campaigners, including sexual health charity fpa, argue that
until sex education is compulsory and properly examined, not enough schools
will take it seriously. Some even argue that the UK needs to go down the Dutch
route where the equivalent term for sex education translates as "sexual
forming", with topics ranging from development to reproduction and
relationships.
With half of all teen pregnancies occurring in just 20 per cent of wards, fpa
also believes more targeted intervention could make a difference. "Providing
good contraceptive services, giving sex education status at school and working
with parents are all important," says a spokeswoman for fpa.
One of the charity's projects in North Wales is Jiwsi, a Welsh phonetic take on
the word juicy, which delivers sex and relationships education to vulnerable
young people. For acting project co-ordinator Joe Hinchliffe, the big issue is
raising self-esteem. The group supports young people's right to contraception
and aims to give them the facts so they can make informed choices: "With the
pill we'd always be clear that it's not as good afterwards as before - the
morning-after pill is there for emergencies only."
It is the type of message Barbara Convery, teenage pregnancy co-ordinator at
Gateshead Council, is equally keen to push. Her council is among 15 local
authorities identified by the Government's Teenage Pregnancy Unit as having
brought about the biggest falls in teenage pregnancies.
According to Convery, its work is about providing a broad service that fits
young people's lifestyles, and links into drugs and alcohol education. Its
primary school scheme looks at friendship, changing bodies, emotions and how
you form positive relationships, something she feels is critical, citing the
recent Unicef report An Overview of Child Well-being in Rich Countries: "Only
43 per cent of children felt their peers were supportive. How can you negotiate
condom use with your partner if you don't know how to negotiate friendship?"
Convery uses her £250,000 annual budget to co-ordinate nine projects. There is
a specialist nurse for teenage pregnancy, a worker for looked-after young
people and those close to being put in care. There is also a worker who takes
young men away on trips to the countryside: "Quite a lot of young men feel
disenfranchised from taking any responsibilities."
Varied results
In Bournemouth, the team has overseen a 28.8 per cent cut in pregnancy rates
over the past nine years. The £99,000 project delivers advice on sex, alcohol
and risk-taking in every secondary school. It funds teachers and nurses in
high-rate conception areas to go on sex education training courses. There are
two nurses focusing on offering contraception to girls known to be sexually
active, as well as a male-only worker.
But the example of Leicester shows just how rocky the road can be. Its figures
for 2004 showed an impressive cut in conceptions of 24 per cent since 1998 but
the following year there was a rise, making the underlying reduction a less
impressive 15.9 per cent. Such variation year-to-year is not uncommon. Kirsty
Reid, the city's teenage pregnancy co-ordinator, emphasises that the reasons
for such a blip are often as much about societal trends as specific
interventions, but says it could be linked to belt tightening at the local
primary care trust: "There's no money from the primary care trust to expand or
introduce services - the job is to keep what we've got."
Kensington and Chelsea's Approach
In Kensington and Chelsea, the teenage pregnancy team has presided over a fall
of 32 per cent in conception rates over the past nine years. Its co-ordinator,
Tunde Olayinka, is a man, something he says can work as an advantage: "For too
long sexual health has been taught to females by females."
The key to Kensington and Chelsea's success has been to start young and focus
on relationships, he says. Sex and relationships education (SRE) begins in
primary schools and is pitched at an appropriate level according to the
children's ages: "We put our emphasis on the relationship side rather than the
biology. Children are encouraged to discuss what it is to love and about
romantic relationships. By the time they move to secondary school and get to
the biological side, sex is viewed in terms of relationships."
Abstinence policies don't work, he believes - instead, Kensington and Chelsea
promotes a "leave it until later" approach. Contraception advice plays an
important part but Olayinka warns against putting it at the centre of your
strategy. Many of the borough's schools are run along faith lines, and the
focus on relationships is more important, he believes.
Key projects include getting young people to research teenagers' attitudes to
sex before putting on a play to demonstrate the issues. Another role-play uses
the Trisha show as a model for discussing hypothetical situations such as a
young man trying to pressure his girlfriend to have sex before she's ready.
"We know that youth workers have the creativity to engage hard-to-reach young
people," says Olayinka. "These projects don't cost much money and can be
delivered in many settings."
