Prevention of Teenage Pregnancy Policy in the UK

IntroductionThis essay will discuss the current policies in place to forbid jejune pregnancy in the United Kingdom. Firstly, it will introduce the key i worry of adolescent pregnancy and discuss it against the context of the problems it creates. The current puerile pregnancy policy will thence be presented and critiqued. Fin wholey, a number of recommendations and conclusion will be drawn.Definition and BackgroundAccording to the orb health face (WHO), teenage pregnancy is defined as pregnancy in a charwoman aged 10 19, whilst Unicef (2008) define it as conception occurring in a woman aged 13 19 (Unicef, 2008). On the basis of this definition, Unicef calculated that the teenage pregnancy rate in the UK is the highest in westerly Europe (Unicef, 2001), and aside from a slight decrement in the birth rate to teenage m differents during the 1970s it has remained relatively constant since 1969 (DoH, 2003). In 1999, the Labour G everyplacenments Social Exclusion Unit (SEU) pres ented its bill to parliament acknowledging the ground and seriousness of the problem, particularly with reference to damage to the mothers academic and locomote progression, and the health of the child.The National adolescent maternity schemaThe SEU implored the G overnment to commit to reducing teenage conceptions by 50% by 2010, and to treat the social excommunication of young mothers. To meet the starting time aim, the SEU championed improved informal nurture, some(prenominal) inside and step forwardside civilise and better gate to contraceptives. To achieve the guerilla, it recommended the useation of multi-agency disposal programmes intentional to interpret support in housing, education and raising.To implement the recommendations of the typography, the Government set up the adolescent pregnancy Unit (TPU), which was located in the part of wellness, but required topical anaesthetic governance (LA) to produce their ingest strategies to reduce teenage c onception by 50% by 2010, with an interim target of 15% by 2004. The majority of prevention strategies foc utilise on four key areas the use of mass media to increase sentiency of versed health, invoke and relationship education (SRE) in schools and community settings, easily available operate and discipline on sexual health and better-quality support for young parents to drop social exclusion (DCFS 2009). In 2000, the Department for Children, Schools and Family (DCSF) issued directives to all schools to find that SRE in schools aimed to enable young people to refer responsible and tumesce-informed choices rough their sexual lives and desist from risky behaviours which influence unintended pregnancy (DCSF 2009c). LA gave their strong backing to ensure inclusion of complete SRE programmes into personal and social education lessons in all schools (DfES 2006).The methods of administering SRE differed across LAs. For example, the services of sexual health specialists were stret ched outside clinical environment to encom pass schools and community settings. Programmes outside of the school environment were use to expose teenagers to the realities of parenting and the advantages of sensible sexual choices, and included Choose your Life, Body Tool Kit, Teens and Tots, and the Virtual Doll Plan. The vary needs of culturally diverse communities were measured, and programmes were tailored to meet them. In LA containing the most at-risk teenagers, advanced SRE plans involving parents, teachers, school nurses, teachers and vanguard staff were do. Southwark LA for example, sought to improve the information of young people on former(a)ish gestations, direct them to making reliable choices and in turn decrease the rate of teenage pregnancies ((NHS Southwark 2007 Fullerton et al 1997).The actions interpreted were in line with the goals and purposes of the agenda studies have demonstrated that teenagers value a forum to discuss sex and relationship issues, and muc h(prenominal) forums are beneficial as they decrease the chances of earlier sexual contact (Allen et al. 2007 Fullerton et al. 1997). Nevertheless, local differences occurred that hampered with the distribution of SRE in the schools in some areas. Not all schools embraced SRE in their teaching syllabus, some of the teachers were indefinite of the degree to teach and were either uncomfortable or awkward about young peoples sexual matters. Some schools had a syllabus that excluded social or emotional topics, which play an important situation (Chambers, 2002). Some areas included mixed sex classes these were less successful as some teenagers, particularly females, matte up inhibited (Stephenson et al. 2004). Additionally, some parents refused to support the policy and withdrew their children from SRE classes (Lanek, 2005). In reaction to these difficulties, the health & Social Care test Sub-Committee (2004) made further recommendations, emphasising the responsibility of schools ( particularly faith schools) to include SRE in the curriculum.Post 2010, the policy aims and objectives were to build on the existing system, and enable young people to receive the knowledge, advice and support they need from parents, teachers and other specialist to deal with the pressure to have sex, enjoy positive and caring relationships and have good sexual health.Policy fictitious characterBirkland (1984) and Lowi et al. (1964) have argued that knowing the type of policy one is dealing with will enable one to ring what may arise after the policy has been utilize. However, Wilson (1973) has criticized categorising policies, as some are in like manner complex to be so simply defined. This is a criticism that rotter be fiarly levelled at the policy under discussion, which is both(prenominal) preventive and self-regulatory. It aims to reduce and prevent pregancies to bridging health and education inequality gaps that teenage mothers face, reducing child poorness and reducin g the cost of teenage pregnancy on public funds. It is both diffusive and pragmatic distributive in that it permits benefit to a particular free radical (Birkland, 1984), and pragmatic in that it was designed to be applicatory and pop offable (Maclure, 2009).The Political ContextAccording to Leichter (1979) contextual factors that can affect policy production can be political, social, economic, cultural, national and international, with some factors becoming major contributors to the policy. fetching the example of international factors, Levine (2003) states that interdependency of nations with the equivalent social problem can affect the policy of the adopting nation takes to solve their problem. In the UK, international influences such as the European Union, WHO and countries facing the same high teenage pregnancy rate have all disturbed UK policy on the same issue (Baggott, 2007). As a member state of European Union, the regulation of our national law by the Union takes p riority in informing and sharpening our policies (Mclean, 2006).Politically in Britain, the teenage mother has come to symbolise social filiation. This began with the Conservative government in the 1990s, who first politicised the exclusive mother by describing her as typifying the prevalent moral standards (particularly amongst the lower social classes) that threatened society (Macvarish, XX). spare-time activity the election of the Labour party in 1997, this political perception was altered in line with the invigorated Labour vision a more than optimistic national mood teamed with traditional Labour views on social equality. Under this perspective, issues such as poverty and unemployment were viewed as symptoms of social exclusion whereby individuals were unfairly excluded from combat-ready fully in society. Such communities were to be viewed sympathetically instead of being blamed, and it was within this context that the outline evolved reducing teenage pregnancy was one w ay of making the excluded included (Macvarish XX).Against this backdrop of poitical ideology, the UK has a egalitarian system of government whereby decisions and policies are made based on the influence of the stakeholders. The teenage pregnancy scheme had pluralist influences including the director of public health, consultants in public health, the director of social services, specialist midwifes and parents of teenagers. These contributions were multi-level nationally, regionally and locally. At a national level, financial support and endorsement was provided by senior ministers, guidance and monitoring was provided at a regional level, and participation by young people and their parents provided the local input.Policy implementationImplementation is the help of turning policy into practice (Buse, 2005). The implementation of the teenage pregnancy policy was two mannikin the first launched in 1999 and depended on better sex education both in and out of schools, and improved access to contraception. The second phase came 10 years later in 2008 and relied upon different government programs designed to see teenage mothers with returning to education or training, gaining employment or providing support with other social factors such as housing.The implementation of teenage pregnancy policy was also top-down. The purpose of the policy was to reduce and prevent teenagers from becoming early(a) parents through support and increasing implementation of preventative guidance by the government and to combat social exclusion of teenage mothers. The policy can be seen to be self-regulatory because it was behavioral and aimed to provide the individual with the skills to make informed decisons regarding their sexual health (Bartle & Vass, 1998).There are additional factors that help to drive the implementation of policy actors in policy, and experts in the agenda. Actors generally are individuals with power that can be excercised through influencing policy. They may be lobby or pressure groups and can include politicians, civil servants, and members of an interest group (Buse, 2005).The inter-group communication of experts in the agenda setting was clear from the outset. The National guidance allowed the local areas to enlarge the scope of the policy using guidance. The involvement of local actors and the use of information from the local areas helped to motivate local action. Taking advantage of local knowledge or information facilitates matching policy to the specific needs of the teenagers. psychoanalysis of policy successStrategy implementation related successFollowing the publication of the policy, the earliest the strategy could begin to be implemented was early 2000, but this was highly dependent on the employment of local teenage pregnancy co-ordinators. By the tierce quarter of 2000, 75% of these posts were staffed, rising to virtually 100% in 2001 (TPSE, 2005). With regards the communication strategy, the percentage of local areas that used media campaigns to reinforce the messages of the national campaign grew steadily from 2% in 2000 to 40% in 2001 (TPSE, 2005). The number of areas with at least one sexual health service dedicated to young people increased systematically from 68% in 2000 to 84% in 2001, while support for young parents with emphasis on reintegration into work and training rose to 70% according to TPSE (2005). Over the course of the strategy, 10,000 teachers, support staff and nurses were trained to generate Personal, Social and wellness Education in schools (TPAIG, 2010).Prevention related successThe original ambition of the teenage pregnancy strategy was to achieve a 15% reduction in under-18 conception by 2004 and 50% reduction by 2010, accompanied by a downward trend in the under-16 conception rate (TPSE 2005). The first phase of the strategy came to an end after a period of ten years without achieving its entire target. In the early part of tits implementation, the policy appeare d to have moderate success. By 2002, the conception rate for under-18s had fallen by 9%, reversing the upward trend seen prior to the strategy implementation, and contrary to the relatively static evaluate observed over the past 30 years (TPSE, 2005). Success varied across the UK, but a steeper decline in conception rates in socio-economically deprived areas suggested that it had targeted the most at-risk areas. For example, Hackney council reported a decrease in the rates of repeated abortion from 49% to 27% in under-18s, and they report that the majority of under-16s report non having sex out-of-pocket to understanding of abstinence. How successful the policy had been depended greatly on how robustly it was implemented across various local areas. In general, there was a reduction in areas that have carried out proper implementation, with some areas able to report a 45% decline, while other areas performed poorly due to poor implementation, with no reduction, or in some cases, a n increase (TPAIG, 2010).However, the follow-up report Teenage motherliness Strategy Beyond 2010 found that the overall conception rate had fallen by 13.3% since 1998, falling well short of the projected 50% reduction. However the DoH add that births to under-18s had fallen by 25% over this period (DoH, 2010).They also point to the increase in access to sexual health services, information and advice as an additional indicator of success. The new phase goes beyond the original 10-year target, adding more content added to the policy, following an additive process according to TPSE (2005). Incrementalpolicy according to Lindblom (1993) is a major achievement that is attained as a turn out of small steps taken which guarded against policy disaster. However, the new phase exists within a humor of austerity. The current downtrend of conception rates in the under-18 age group will be difficult to adduce against a backdrop of disinvestment, which has already led to widespread closure o f specialist sexual health services for under-18s.Gaps in the policyIn applying teenage pregnancy policy to the present situation, it can be said that the policy did not really look inward into the situation that the country was facing. It looked at the success rate of other countries without tailor their measures to curb the problems specific to Britain. The policy is a social policy and as such it focussed on the social aspect of the problem without looking at the health issues that come with teenage pregnancy. Addiitonally, the time underframe given to meet its target of a 50% was too short. Teenage pregancy is inextricably linked to both poverty, a social issue too wide to tackle in one decade. It is also potently related to culture, and specifically the need to foster a culture of openess regarding sexual behaviour and health. This again is too complex to challenge in 10 years.RecommendationsIn the first instance, the coalition Government must address the shortcomings curren tly seen in sexual relation education (SRE). The former Government elected to not make SRE part of the compulsory curriculum, and as a result provision of SRE across the country is patchy. The Government should pass legislation ensure good practice such as SRE becomes compulsory. Additionally, refinements to existing SRE need to be made. In particular this should include devising ethnic and faith-based SRE programmes, which will better address the diversity of beliefs held in a modern multi-cultural Britain. Also, the deliberation of same-sex SRE classes should be completed and implemented (Fullerton et al 2001). More use should be made of robust team-working within communities, health sectors and schools in encouraging SRE, and the creative use and further training of more peer-educators to deliver the strategy within schools should be considered.Secondly, an approach which combines measures to prevent teenage conception and support teenage mothers must be in tandem to wider measu res to address poverty and social exclusion. The loss of the Education nutrition Allowance and the closure of many Sure Start centres disproportionately disadvantage the socio-economically deprived, and widen the gap in attainment between the rich and poor.Thirdly, the coalition government must be invested in making reductions to teenage pregnancy rates a priority. Ring-fencing of funds for specialist sexual health services and training in SRE must be guaranteed in order to not lose the small, but significant reductions in teenage pregnancy rates seen to date. Relatedly, strategies to address teenage pregnancy should be integrated into all future policies.Finally, the patchy nature of strategy deliverance across local authorities must be addressed. Areas that neglect to implement the strategy effectively should be identified, and supported according. Sharing of good practice across local authorities should be made routine.ConclusionsIn conclusion, this essay has outlined the teenag e pregnancy strategy devised in 1998, its primer and political context. It went on to discuss the outcomes of the first ten-year phase. At this point, it is still too early to say whether the second phase will meet its overall target, especially in the current economic climate, although the strategy pore attention on the problem and provided materials to help local, regional and national implementation of the strategy. As Britain remains a culturally diverse country, addressing this with regards teenage sexual health should remain a priority. In particular, adequate training of all personnel that will help and support teenagers in and out of school, increasing parental involvement in sex and contraception, and ring fencing specialist sexual health services should all be seen as important and complimentary factors in continuing to address pregnancy in UK teenagers.ReferencesAllen, E., Bonell, C., Strange, V., Copas, A., Stephenson, J.,Johnson, A.M. & Oakley, A., (2007). Does the UK governments teenage pregnancy strategy deal with the correct risk factorsFindings from a secondary analysis of data from a randomized trial of sex education and their implications for policy. Journal of epidemiology and community health, 61(1), 20-27.BERTHOUD, R. (2001).Teenage births to ethnic minority women. macrocosm Trends, 6(104)12-17.BONELL, C., ALLEN, E., STRANGE, V., COPAS, A., OAKLEY, A., STEPHENSON, J. and JOHNSON, A. (2005). The effect of dislike of school on risk of teenage pregnancy testing of hypotheses using longitudinal data from a randomised trial of sex education. Journal of epidemiology and community health, 59(3), 223-230.BONELL, C.P., STRANGE, V.J., STEPHENSON, J.M., OAKLEY, A.R., COPAS, A.J., FORREST, S.P., JOHNSON, A.M. and BLACK, S. (2003). Effect of social exclusion on the risk of teenage pregnancy development of hypotheses using baseline data from a randomised trial of sex education. Journal of epidemiology and community health, 57(11), 871-876.BOS, R. (2 006). Health impact assessment and health promotion. Bulletin of the domain of a function Health Organization, 84(11), 914-915.BREEZE, C.H. & LOCK, K., (2001). Health impact assessment as part of strategic environment assessment. Copenhagen WHO Regional federal agency for Europe.Buse, K., Mays, N. and Walt, G. (2005) Making health policy. Open University PressOxford English Dictionary. 1989. 2nd ed. Oxford Clarendon Press.CAMERON, M. (2000).A short guide to health impact assessment. capital of the United Kingdom NHS Executive London. http//www.londonshealth.gov.uk/pdf/hiaguide/pdf (accessed 1 February 2010).Chambers, R., Boath, E. & Chambers, S. (2002). little peoples and professionalsviews about ways to reduce teenage pregnancy rates to agree or not agree. Journal of Family Planning and Reproductive Health Care, 28(2)85-90DCSF. (2009). Sex and relationship education (SRE). http//www.dcsf.gov.uk/everychildmatters/policy/health/sre/. (accessed January 30, 2010).DCSF. (2009). About Teenage Pregnancy Strategy http//www.dcsf.gov.uk/everychildmatters/healthandwellbeing/teenagepregnancy/about/strategy/ (accessed January 10, 2010).DCSF. (2009). Teenage universe Statistics for England 1998-2007. http//www.dcsf.gov.uk/everychildmatters/resources-and-practice/IG00200/ (accessed January 17, 2010).DCSF, (2008). Teenage Pregnancy Independent Advisory Group. Annual report 2007-2008. http//www.everychildmatters.gov.uk/health/teenagepregnancy/tpiag (accessed December 27, 2009)DCSF. (2005). Teenage Pregnancy Strategy Evaluation. http//publications.dcsf.gov.uk/eOrderingDownload/RW38.pdf (accessed December 29, 2009).DEPARTMENT OF pedagogics AND SKILLS. (2006). Teenage pregnancy Accelerating the strategy to 2010. London Crown.DEPARTMENT OF EDUCATION AND SKILLS. (2003). Sex and Relationship Education Guidance. DfES 0116/2000, 1-35. in stock(predicate) at http//www.dfes.gov.uk (accessed December 29, 2009).DoH (2010). Teenage Pregnancy Strategy beyond 2010. http// http//dera.io e.ac.uk/11277/1/4287_Teenage%20pregnancy%20strategy_aw8.pdf (accessed July 25th 2012).DoH. (2007). Health impact assessment questions and guidance for impact assessment.http//www.dh.gov.uk/en/Publicationsandstatistics/ statute/Healthassessment/Browsable/DH_075622 (accessed January 17, 2010).Fullerton, D., Dickson, R., Eastwood, A.J. & SHELDON, T.A., 1997. Preventing unintended teenage pregnancies and reducing their adverse effects. Quality in Health Care, 6(2)102-8.HOUSTON, A. (2006). Neighbourhood Renewal investment trust Strategic Gaps Health Inequalities Reducing Teenage Pregnancy in Southwark an evaluation report. UK Houston Enterprises.KEMM, J., PARRY, J. and PALMER, S. (2004). Health impact assessment. Oxford Oxford University Press.Joffe, M. & Mindell, J. (2005). Health impact assessment. Occupational and environmental medicine, 62(12), 907-12, 830-5.Joffe, M. & Mindell, J. (2002). A framework for the depict base to support Health shock Assessment. Journal of epidemiology an d community health, 56(2), 132-138.Lanek, R., (2005). Communities & Outreach Presentation to the Multi-Faith Seminar on Sex & Relationships For Young People in Southwark.LOCK, K. (2000). Health impact assessment. British Medical Journal, 320 1395-1398.Macvarish, J. (2010). Understanding the significance of the teenage mother in contemporary parenting culture. Sociological look into Online 15 (4).Metcalfe, O., Higgins, C. & Lavin, T. (2009). Health conflict Assessment Guidance. Dublin The Institute of Public Health in IrelandMINDELL, J., BOAZ, A., JOFFE, M., CURTIS, S. and BIRLEY, M., 2004. Enhancing the evidence base for health impact assessment. Journal of epidemiology and community health, 58(7) 546-551.MINDELL, J., HANSELL, A., MORRISON, D., DOUGLAS, M., JOFFE, M. and QUANTIFIABLE HIA DISCUSSION GROUP. (2001). What do we need for robust, valued health impact assessmentJournal of public health medicine, 23(3) 173-178.MINDELL, J. and JOFFE, M. (2003). Health impact assessment in relation to other forms of impact assessment. Journal of public health medicine, 25(2), 107-112.NHS (2007). Southwark Vital Statistics. London, NHSNHS SOUTHWARK. (2009). Southwark Health Profile 2009. http//www.southwarkpct.nhs.uk/documents/5480.pdf. (accessed 28 December 2009)NHS SOUTHWARK, (2007). Southwark Young Peoples Sexual Health &Teenage Pregnancy Needs Assessment & Equity Audit. NHS SouthwarkNHS SOUTHWARK, (2004). Southwark Teenage Pregnancy and Parenthood Action Plan 2003-04. NHS SouthwarkONS (2009). Health Statistics Quarterly. London CrownONS (2004). Southwark Neighborhood Statistics. Key Figures for 2001 censusCensus Area Statistics. http//neighbourhood.statistics.gov.uk/dissemination/LeadKeyFiguresPARRY, J., STEVENS, A. (2001). Prospective health impact assessment pitfalls, problems, and possible ways forward. British Medical Journal. 323(7322)1177-82.PUBLIC HEALTH INSTITUTE SCOTLAND. (2004). Health Impact Assessment a guide for local authorities.ROSS, D.A. (2008). Ap proaches to sex education peer-led or teacher-ledPLoS medicine, 5(11), 229.SCOTT-SAMUEL A. (1988). Health impact assessment theory into practice. Journal of epidemiology and community health, 52,704-705.SCOTT-SAMUEL, A., BIRLEY, M., ARDERN, K., (2001). The Merseyside Guidelines for Health Impact Assessment. Second Edition, May 2001.SEAMARK, C.J. and LINGS, P, (2004). Positive experiences of teenage motherhood a qualitative study. The British journal of general practice the journal of the Royal College of General Practitioners, 54(508), 813-818.Sexual health charity, FPA. (2010) Teenage pregnancy factsheet Online. Available at http//www.fpa.org.uk/professionals/Factsheets/teenagepreggnancy (Accessed on 30 May 2012).STEPHENSON, J.M., STRANGE, V., FORREST, S., OAKLEY, A., COPAS, A., ALLEN, E., BABIKER, A., BLACK, S., ALI, M., MONTEIRO, H., JOHNSON, A.M. and RIPPLE STUDY TEAM, (2004). Pupil-led sex education in England (RIPPLE study) cluster-randomized intervention trial. Lancet, 364(9 431) 338-346Teenage Pregnancy Independent Advisory Group (2010). Teenage Pregnancy Past Successes Future Challenges. Online. Availiable at https//www.education.gov.uk/publications/eOrderingDownload/Past%20successes%20-%20future%20challenges.pdf (Accessed on 25th July 2012).WHITEHEAD, M. and DAHLGREN, G., 1991. What can be done about inequalities in healthLancet, 338(8774), 1059-1063.WIGGINS, M., BONELL, C., SAWTELL, M., AUSTERBERRY, H., BURCHETT, H., ALLEN, E. and STRANGE, V. (2009). Health outcomes of offspring development programme in England prospective matched comparison study. BMJ (Clinical research ed.), 339, b2534. human Health Organization (2004) WHO intervention papers on Adolescence, Online. Available at http//whqlibdoc.who.int/publications/2004/9241591455_eng_pdf (Accessed 30 May 2012).WHO (2002). Technical Briefing Health Impact Assessment A tool to include health on the agenda of other sectors. EUR/RC52/BD/3. Brussels European Centre for Health Policy, realism Heal th Organization Regional Office for Europe.World Health Organization (2001). Health impact assessment. Harmonization, mainstreaming and capacity building. Report of an inter-regional meeting on harmonization and mainstreaming of HIA in the World Health Organization and of a partnership meeting on the institutionalization of HIA capacity building in Africa. Geneva WHO.World Health Organization, 1999. Health impact assessment main concepts and suggested approach. Brussels European Centre for Health Policy, World Health Organization Regional Office for Europe.Unicef. (2008). Planning Teenage pregnancy online. Available at http//www.unicef.org/Malaysia/Teenage pregnancies_overview.pdf young people and FamilyTAYLOR, L., GOWMAN, N., QUIGLEY, R., 2003. Evaluating health impact assessment. Yorkshire, UK NHS Health Development Agency.THOROGOOD, M. & COOMBES, Y., 2000. Evaluating health promotion practice & methods. Oxford Oxford University Press.WHO, 2010. Health Impact Assessment. http//www .who.int/hia/tools/en/ (accessed 30 January 2010)