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chapter Introduction -- chapter 1 Variation in teenage conception rates -- chapter 2 Reducing rates of teenage conceptions -- chapter 3 England's teenage pregnancy strategy: rationale, development and first phase implementation -- chapter 4 The second phase of implementation: reviewing, redoubling effort and reaching the target -- chapter 5 Translating evidence into action: the ten key factors for an effective strategy -- chapter 6 Improving the lives of teenage mothers, young fathers and their children -- chapter 7 Sharing lessons internationally to galvanise action.

Teenage pregnancy is a cause and consequence of inequality, limiting the life chances of young parents and their children. It is an issue of global concern, with many countries developing programmes of prevention. This review focuses on the experience of the England strategy, launched in 1999 to address the historically high rates. It is one of the few examples of a successful long term, multi-agency programme, led by national government and locally delivered which, between 1998 and 2018, reduced the under-18 conception rate by 64%. It sets out the case for helping young people delay early pregnancy, the international evidence for prevention, how evidence is translated into a 'whole system' approach and the priorities for further reducing inequalities. Questions are included to encourage both investigation into local programmes on teenage pregnancy prevention, and reflection on individual practice. The review concludes with summarizing the next steps for England and the lessons that can be shared more widely.

In 1999, the UK Labour Government launched a 10-year Teenage Pregnancy Strategy for England to address the country's historically high rates and reduce social exclusion. The goal was to halve the under-18 conception rate. This study explores how the strategy was designed and implemented, and the features that contributed to its success. This study was informed by examination of the detailed documentation of the strategy, published throughout its 10-year implementation. The strategy involved a comprehensive programme of action across four themes: joined up action at national and local level; better prevention through improved sex and relationships education and access to effective contraception; a communications campaign to reach young people and parents; and coordinated support for young parents (The support programme for young parents was an important contribution to the strategy. In the short term by helping young parents prevent further unplanned pregnancies and, in the long term, by breaking intergenerational cycles of disadvantage and lowering the risk of teenage pregnancy.). It was implemented through national, regional and local structures with dedicated funding for the 10-year duration. The under-18 conception rate reduced steadily over the strategy's lifespan. The 2014 under-18 conception rate was 51% lower than the 1998 baseline and there have been significant reductions in areas of high deprivation. One leading social commentator described the strategy as 'The success story of our time' (Toynbee, The drop in teenage pregnancies is the success story of our time, 2013). As rates of teenage pregnancy are influenced by a web of inter-connected factors, the strategy was necessarily multi-faceted in its approach. As such, it is not possible to identify causative pathways or estimate the relative contributions of each constituent part. However, we conclude that six key features contributed to the success: creating an opportunity for action; developing an evidence based strategy; effective implementation; regularly reviewing progress; embedding the strategy in wider government programmes; and providing leadership throughout the programme. The learning remains relevant for the UK as England's teenage birth rate remains higher than in other Western European countries. It also provides important lessons for governments and policy makers in other countries seeking to reduce teenage pregnancy rates. BACKGROUND METHODS RESULTS CONCLUSIONS ; oa article

Purpose: Teenage pregnancy is an issue of inequality affecting the health, wellbeing and life chances of young women, young men and their children. Consequently, high levels of teenage pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence based Strategy, resourced over a long duration, with an associated reduction of 48% in the under-18 conception rate. This paper seeks to identify the lessons applicable to other countries. Methods: The paper focuses on the prevention programme. Drawing on the detailed documentation of the ten-year Strategy it analyses the factors that helped and hindered implementation against the WHO ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programmes with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's teenage pregnancy Strategy. Results: The development and implementation of the Strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programmes. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Conclusion: Although the Strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low and medium income countries seeking to address high teenage pregnancy rates.

This article is based on the interviews of nine young, socially disadvantaged fathers from the UK. Young fathers are more likely to experience socioeconomic deprivation and disrupted pathways towards parenthood, which affect their participation in socially accepted trajectories of 'father involvement'. Whilst this has received some attention in research, studies have largely neglected to examine the lived experiences of such fathers directly. The current article aims to address this gap, building upon the limited body of research that exists exploring the impact of socioeconomic and relational barriers on father involvement. In this study, three interrelated themes demonstrate the cyclical nature of generational disadvantage, reduced socioeconomic circumstances and disrupted relationships, providing a different perspective on the decreased levels of involvement exhibited by young fathers in prior research. The findings also enlighten our understanding of how these fathers can be better supported in policy and practice, thereby contributing to current academic debate.