(Submission to GONW + Reported to Strategic Partnership Executive 7
December 2006- Item 4 Part 4)
2.11 Teenage Pregnancy
Position RED
We have some way to go to reducing teenage conceptions in Salford. The
latest figures we have are for 2004, which shows 57.0 conceptions per 1000
female population aged 15-17. This represents a reduction of –7.3% between
1998 and 2004. This is smaller than the corresponding reduction of –11% in
England and shows a long way from achieving the 50% reduction target by
2010.
Progress towards targets: The rate is falling, but not as quickly as we would
have liked. The teenage pregnancy rate was 55.8 per 1000 female population
aged 15-17, in 2001-2003, 54.3 in 2000-2002 and 57.4 in 1999-2001.
 Salford has experienced a decrease in under 18 conception rates from
2003to 2004. This represents a 7.3% reduction from baseline (1998).
 Salford’s under 16 conception rate (2004) has increased 4.3% from
baseline (1998).
 Live birth’s to all young women under 18 in 2005 have decreased by
15.6% from baseline and by 53.8% for those aged 15 and under.
However in 2004 and 2005 live births have begun to increase for those
young women aged 16-17.
 Terminations of pregnancy have increased 17.6% from baseline
(1998).
 Sexually Transmitted Infections continue to increase amongst young
people.
Analysis of Performance
The forecast is an accurate reflection of the trend in under 18 conception
rates. Please note that the under 16 conception rate (2004) for Salford has
increased 4.3% from 1998 baseline.
The limited reduction in Teenage Pregnancy rates in Salford is historical.
Progress towards targets: (Source: ONS, 2006)
Under 18
Conception
Data
No of U18
Conceptions
% of conception
leading to
abortion
26.4
Conception
rate/1000 young
women aged 1517
61.5
% increase
(+)/decrease
(-) in rate
since 1998
N/A
1998
(Baseline)
1999
2000
2001
2002
2003
2004
2004
interim
250
252
219
236
216
238
232
214
36.7
40.2
36.4
36.1
40.8
44.0
N/a
62.1
53.5
56.7
52.6
58.2
57.0
52.2
1.0
-12.9
-7.8
-14.4
-5.3
-7.3
-15
- 37 -
target
2010
Target
125
N/a
30.73
-50
Concern over under 16s rate
Under 16
Conception Data
No of U16
Conceptions
Conception rate/1000
young women aged
13-15
1998 (Baseline)
1999
2000
2001
2002
2003
2004
48
44
46
40
37
42
51
11.6
10.5
11.2
9.7
9.1
10.1
12.1
% increase
(+)/decrease (-)
in rate since
1998
N/A
-9.5
-3.4
-16.3
-21.6
-12.9
+4.3
Three year averages more reliable.
Salford under 18 conception rates, with 95% CI 1994-2004
80.0
70.0
u18 conception rate
60.0
50.0
lower confidence limit
40.0
actual rate
upper confidence limit
30.0
20.0
10.0
0.0
19941996
19951997
19961998
19971999
19982000
19992001
20002002
20012003
20022004
Data with confidence intervals
Change in under 18 conception rate 1998-04
% change
Salford MCD
-7.3
North West
-9.4
England
-11.1
Upper limit Lower limit
11.3
-22.8
-6.2
-12.5
-9.8
-12.3
- 38 -
% change
-7.3
-9.4
-11.1
Under 18 conceptions per 1000
2004 conception rate with 95% confidence interval
2004 Upper Lower 2004 Difference from England
limit
limit
rate
rate
rate
Salford MCD 57.0
50.3
64.5
57.0
Significantly higher
North West 45.6
44.5
46.7
45.6 Significantly higher
England 41.5
41.1
41.9
41.5
n/a
70
60
50
40
30
20
10
0
Salford
MCD
North
West
England
Barriers to improving performance – the Deep dive factors, educational
attainment and attendance at school, deprivation and cultures of low
aspiration amongst young people.
Deep dive 2005
Indicators for success for Local Authority conception rate reduction
(Teenage Pregnancy Unit Deep Dive Exercise 2005)
Key issues, which were identified :
1. Active engagement of all of the key mainstream delivery partners who have a
role in reducing teenage pregnancies - Health, education, Social Services and
Youth Support Services – and the voluntary sector;
2. A strong senior champion who was accountable for and took the lead in driving
the local strategy;
3. The existence of a discrete, credible, highly visible, young-people friendly
sexual health/contraceptive advice service, with a focus on health promotion as
well as reactive services
4. Strong delivery of SRE/PSHE by schools
5. Targeted work with at risk groups of young people, in particular Looked After
Children
6. Training on sex and relationship issues within mainstream partner agencies
7. A well resourced Youth Service, with a clear remit to tackle big social issues,
such as young people’s sexual health
- 39 -
Ward based data suggests large areas of Salford have above average rates
of under 18 conception & hotspot wards (above 60/1000 rate of under 18
conception) in the central locality, with 5 of these wards, (1 each in West and
South), is a key area to focus effort.
Hotspot wards
Note: Irwell Riverside is included as Pendleton and Blackfriars were hotspot
wards before re-organisation.
Ward level under 18 conception and deprivation data
2001-2003
120
100
Number of under 18
conceptions 2001-03
Under 18 conception
rate 2001-03
Estimated deprivation
score 2004
80
60
40
20
La
ng
w
o
Li
ttl rth
y
e
H
ul
to
O n
rd
Pe sa
nd l l
B leto
W lack n
al
kd fria
en rs
N
Br ort
ou h
gh
to
E n
Pe ccle
nd s
le
bu
r
Ba y
rto
n
W
Sw W
in
ea
s t i n to to n
e
n
an
N
o
d
Se rth
ed
le
y
I
C rlam
la
re
C mo
W adi nt
s
al
k d he
en ad
So
W
ut
or
h
S
sl
ey win Ker
an to sal
n
d
S
Bo
o
ot uth
hs
to
w
n
0
- 40 -
Trajectory for recovery
Teenage conception rate - performance and recovery trajectory
Number of conceptions
300
250
200
150
100
50
0
98
19
99
19
00
20
01
20
02
20
03
20
Target/trajectory
04
20
05
20
06
20
07
20
08
20
09
20
Performance to-date
10
20
Recovery trajectory
Recovery conception numbers
1998
Target/trajector
y
Performance todate
250
1999
252
2000
219
2001
236
2002
216
2003
2004
2005
2006
2007
2008
2009
2010
220
217
208
195
180
161
143
125
238
232
214
196
178
160
142
124
Recovery
trajectory
232
Quarterly rates – rolling data
All tables Source: ONS
Under 18 conception data has a 2 year time lag although live birth data for
2005 suggests the under 18 conception numbers are not decreasing at the
required accelerated rate to meet the target of 50% reduction by 2010.
Interventions being embedded now with the NRF sexual health funding, will
be unlikely to impact on figures for the next year, at least
- 41 -
Live Birth data
Live Births Salford 1998-2005
120
Live Birth no.
100
total live
births
under 18
80
60
live births
under 16
years
40
20
0
1998 1999 2000 2001 2002 2003 2004 2005
live births
16 and 17
years
Source: PCT Child Health Data Year
Next Steps in the Teenage Pregnancy Strategy Guidance document (July
2006) suggests deprivation, educational attainment and school attendance
are important factors in reducing the under 18 conception rate.
Factor of deprivation
Salford's rate is below the expected rate given deprivation levels. Note
corresponding local authorities are our statistical neighbours.
- 42 -
What are you doing now
Current Action
Action
Predicted Effect
Development of KISS young people’s Increased uptake of sexual health
sexual health services in teenage services.
pregnancy hotspots.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Audit and extension of condom Increased uptake of sexual health
distribution scheme.
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Funding for Voluntary and community Increased uptake of sexual health
sector groups to deliver sexual health services.
projects in hotspot wards (March Increased identification and treatment
2007, 2008)
of Sexually transmitted infections.
Decrease in teenage conception rate
Enhanced publicity for Sexual health Increased uptake of sexual health
services (March 2007, 2008)
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Employment of Youth Worker – Increased uptake of sexual health
Sexual Health Development (in post services.
Jan 2007)
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Employment of additional capacity Decrease in teenage conception rate
SRE for schools (in post)
Employment of additional Young Increased uptake of sexual health
Persons Sexual health Nurse (in post) services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
A Deep dive self-assessment will be High impact actions identified –
carried out in the next quarter, with added to plan
stakeholders
in
the
Teenage Increased uptake of sexual health
pregnancy strategy in Salford. This services.
self-assessment document is being Increased identification and treatment
provided by the Teenage Pregnancy of Sexually transmitted infections.
unit and will provide further insight Decrease in teenage conception rate
into areas for targeted development
(by Dec 2006)
Teenage Pregnancy being scrutinised Raise profile of teenage pregnancy
in City Council Health Scrutiny amongst elected members and
process
secure services to deliver decrease in
teenage conception rate, based on
published recommendations
Introduction of national Chlamydia Increased uptake of sexual health
- 43 -
Screening Programme
services.
Increased identification and treatment
of Chlamydia and other sexually
transmitted infections.
Decrease in teenage conception rate
Insufficient to meet the target
Additional Action
Action
Additional action (target driven) is
required from schools and local
education authority to increase
educational attainment and school
attendance. (Action by LEA)
The introduction of the social and
emotional
aspects
of
learning
programme in Primary schools should
impact on children’s aspirations. A
similar approach is to be adopted for
high schools addressing the issue of
low staying on rates in post 16
education.
Workforce training on sex and
relationships and sexual health issues
also requires further development,
with the introduction of NVQ level 2
equivalent course, Certificate in
Sexual Health and Young People, to
be delivered in 2007.
Increased support for the strategy
from the voluntary and community
sectors, e.g. Bumps to Babies
Project, run by Duchy Youth Project,
and Youth Service need to be built on
and developed further (beyond March
2007).
Development of new young people’s
sexual health services , in 2007.
Predicted Effect
Decrease in teenage conception rate,
by
increased
participation
in
education, employment and training
of young people.
This would also impact on raising
aspiration.
Increased uptake of sexual health
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Decrease in teenage conception rate
Increased uptake of sexual health
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Securing the funding for support To impact on reducing repeat
services for teenage parents and their conceptions (20% of all under 18
children (Teenage Pregnancy Team) conceptions are repeat conceptions)
(decisions by March 2007)
Development of a network of young To impact on reducing repeat
parents groups across the city.
conceptions (20% of all under 18
conceptions are repeat conceptions)
Reduce risk of social exclusion
- 44 -
Young people to develop their own
quality standards for sexual health
services and benchmark against
them.
Increased uptake of sexual health
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Challenge
and
Support
from Decrease in teenage conception rate
Government Office North West
including twinning high and low
performing areas
Ensure that internal ring fence is Decrease in teenage conception rate
maintained around the Teenage
Pregnancy Local Implementation
Grant (in 2008).
Aspirational Action
Action
Secure funding and implement Teens
and Toddlers project
Secure funding and continue Young
Mums to be Course
Development
of
sexual health
services in high schools via extended
schools
Development
of
sexual
services in FE colleges
health
All teenage parents to be able to
access
appropriate
supported
accommodation.
Reduce number of young people,
including teenage parents and
pregnant teenagers, (Connexions,
Salford City Council PSA target)
Predicted Effect
Decrease in teenage conception rate
Reduction in repeat conceptions
Decrease in teenage conception rate,
by increased participation in
education, employment and training
of young people.
Increased uptake of sexual health
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Increased uptake of sexual health
services.
Increased identification and treatment
of Sexually transmitted infections.
Decrease in teenage conception rate
Reduction in repeat conceptions
Decrease in teenage conception rate
Reduce risk of social exclusion
Reduction in repeat conceptions,
decrease in teenage conception rate
And reduction in risk of social
exclusion by increased participation in
education, employment and training
of young people.
- 45 -