Cutting teenage pregnancy rates in Hull

In Hull, teenage pregnancies have reduced by 35 per cent since the city council started using digital maps to plan its contraception and community based services. Gail Teasdale, integrated services manager for Children and Young People’s Services at Hull City Council, who leads the strategy locally, explains how the council gets its results…

Just over a decade ago, national statistics singled out Hull as having one of the highest teenage pregnancy rates in the country. Pregnancy rates among under 18s were almost twice the national average.  Repeat pregnancies among teenage girls were also high – over 20 per cent of all under 18 conceptions - and again well above national figures. Teenagers in the city were failing to heed warnings about under-age sex and policy makers locally agreed that new action was needed to tackle the problem.

On the back of a government strategy to reduce soaring numbers of unplanned pregnancies among teenagers nationally, Hull City Council launched an initiative to cut rates locally focusing on improving sex education and increasing access to contraception services. With 20 out of 22 wards in Hull recording higher than average levels of deprivation, often an indicator of high conception rates in under 18s, we knew it was a challenging task.

The council, working jointly with the Hull PCT, started using Ordnance Survey digital maps to plan contraception and sexual health advice services.  Presenting the information visually on digital maps immediately revealed the hot spots to target with high teenage pregnancy rates emerging in a number of different postcodes and at six of the 14 local schools. It was clear that our services had to be targeted in these areas.  However, the data also revealed that while 14,000 young people were already getting information and advice, only 2,000 were making it to contraception services. To understand the reasons behind this we showed the maps to young people to get their views on the proposed location of services and got some interesting results.

Hull is like a collection of small villages and we found that some young people would not move off their estate to access services while others preferred the anonymity of a city centre location which was just a bus ride away.  By using maps they were able to tell us more about the unofficial boundaries that exist in the city and where they would go to access contraception advice.  Sexual health is often the last subject that young people want to talk about and therefore it is essential that we locate our services in an area and venue where they feel comfortable.

As a result, we decided to adopt a hub and spoke model for teenager contraception services, which included a more anonymous drop in centre at Conifer House in the heart of the city, and a selection of outreach services located in schools, youth centres and other venues they frequented on a regular basis. 

The council puts substantial effort into collecting the correct information from

many different sources ranging from pharmacies and clinics to schools to plan its contraception and sexual health advice services.  Our work has been helped by the Public Sector Mapping Agreement (PSMA) which widens access to Ordnance Survey digital mapping products and enables us to share geographic information between the different public sector agencies we are working with.

While there is no magic solution to tackling teenage pregnancy, the strategy has had a major impact on reducing rates locally. Latest figures show that Hull recorded a 35 per cent drop in conception rates among under 18s, compared to 24 per cent achieved nationally.  Five out of the six schools the council has been working with have seen a reduction in rates with the sixth remaining static. The policy has also proved to be a value for money investment. Hull spends £800,000 a year on the programme but saves more than £8 million by reducing teen pregnancy rates and preventing children from going into care, both of which have huge cost implications.

In Hull, mapping has proved critical to ensuring not only that contraception services are located in the right place, but to help communicate complex data to different audiences and to evidence that the strategy is effective.  As a result, we are planning to use the same process to tackle other health concerns around obesity and smoking.

Gail Teasdale, integrated services manager, Children and Young People’s Services at Hull City Council is responsible for teenage pregnancy, sexual health, substance misuse, emotional health and wellbeing and underage smoking.