Implementing the UK Government's ten-year teenage pregnancy strategy for England (1999-2010): applicable lessons for other countries

Abstract

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.