Study indicates England's strategy to reduce teenage pregnancies is working

The number of under-18s conceiving and having babies in England has declined since the implementation of the government’s national teenage pregnancy strategy in 1999, according to an Article in this week’s issue of The Lancet.

Conception rates for women younger than 18 years in England are among the highest in Western Europe. In 1999 the government launched a 10-year strategy that aimed to halve the rate of teenage conceptions by 2010.

The article reports on the independent academic evaluation of the strategy, which was carried out by a team of researchers from the London School of Hygiene and Tropical Medicine, UK (LSHTM, UK) and University College London. As part of the evaluation, the team analysed data from 148 local authority areas in England and calculated changes in under-18 conceptions, abortions, and birth rates between the 5-year period before implementation of the strategy (1994-98) and the period immediately after implementation (1999-2003). They found that the teenage pregnancy rate peaked in 1998 and then declined after the start of the national teenage pregnancy strategy in 1999. Between the two periods, the conception rate dropped by about 3.2% (from 44.3 to 42.9 per 1000 women aged 15-17 years), the abortion rate increased by around 7.5% (from 18 to 19.4 per 1000) and the birth rate fell by 11% (from 26.4 to 23.6 per 1000).

Lead author Dr Paul Wilkinson (LSHTM, UK), states: “The overall fall [in teenage pregnancies] has been steady rather than precipitous, and its pace is below that needed to meet the ambitious national targets. Nonetheless, it represents a welcome reversal of the previously rising trend in the period immediately preceding the implementation of the strategy and a change of course from the largely static rates of the past two decades in the UK.”

The team found that the decline in conceptions was greater in areas where more strategy-related resources had been targeted. It was also generally greater in rural areas, in more deprived areas, and in areas with lower educational achievement.

Professor Kaye Wellings (LSHTM, UK), who led the study, states: “The fall in conceptions runs counter to the recent trend of stable or increasing rates in some other European countries. What’s more, in contrast to many other health promotion strategies, the teenage pregnancy strategy has been successful in targeting the worst off, rather than just the well to do. Our findings give grounds for confidence that the strategy is on course, and has had an impact in these early years. However, sustained efforts will be needed to address the root causes of teenage pregnancy, particularly those relating to the broader socio-economic and cultural determinants.” (Quote by e-mail; does not appear in Article)

In an accompanying Comment Christine Galavotti and Diane Green (US Centers for Disease Control and Prevention, Atlanta, GA, USA) states: “The data presented indicate that teen births are indeed on the decline. Whether this can be attributed to the national strategy remains an open question, however linking future declines with more direct measures of extent and quality of strategy implementation, and identifying the most influential components, will be necessary to strengthen the national program to sustain this positive trend." (Quote by e-mail; exact version does not appear in published Comment)

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EMBARGO: 00:01H (London time) Friday November 24, 2006. EMBARGO: In North America, 18:30H EST Thursday November 23, 2006.

Contact: Lindsay Wright, Press Officer, London School of Hygiene & Tropical Medicine, UK. T) 020 7927 2073

Comment: Dr Christine Galavotti, US Centers for Disease Control and Prevention, Atlanta, USA. T) 770-488-6401 cxg2@cdc.gov


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