Slide 1

Slide 2

Prevention of teenage pregnancies, best practice from the Netherlands Ineke van der Vlugt Programme coordinator Rutgers Nisso Groep

Slide 3

Presentation 1.Teenage pregnancies in the Dutch context 2.Facts and figures 3.Key determinants of teenage motherhood 4.Prevention of teenage pregnancies 5.Relative factors of success 6.Improvement strategies in the last years

Slide 4

1. Teenage pregnancies in the Dutch context -Social democratic Christian government -Liberal pragmatic attitude towards sexuality of youth -Good access to contraceptives and abortion -Sexual youth services for under 24s (Sense) -Under 21 the morning-after pill is free -Positive attitude to family planning (average age is 28) -High contraceptive use (double Dutch) -Long history of sexuality education -Since 2006 prevention of teenage pregnancies topic in Dutch policy

Slide 5

Birth and abortion rate 1980-2007 per 1,000 girls 15-19 years Source: LAR 2007

Slide 6

Teenage pregnancies and abortions per 1,000 girls 19 yrs van Lee & Wijsen (2008)

Slide 7

Ethnic differences in teenage abortion ratio per 1,000 girls 19 yrs van Lee & Wijsen (2008)

Slide 8

Changes in contraceptive use first intercourse highschool youth 12-17 yrs de Graaf, Meijer, Poelman, & Vanwesenbeeck, 2005 Brugman, Goedhart, Vogels & van Zessen, 1995

Slide 9

3. Key determinants of teenage pregnancies Aspects of personal lifestyle and sexual development: -Lack of aims or perspective -External locus of control -Lack of adequate sexuality education -Traditional gender roles -Conflicting messages -Ineffective contraceptive use (including emergency pill) -Unplanned sex Indirect determinants: -Lack of warmth or abundance of problems at home -Intergenerational transference -Latent desire, ambivalence

Slide 10

Conclusion Prevention of teenage pregnancies is Difficult or Not important !

Slide 11

4. Preventative interventions in response Sexuality education in the Netherlands -Comprehensive and starting at an early age -Relationship & Sexuality in primary school -Long Live Love in secondary school -Integrated sexual health in vocational training -Contraceptive support in youth friendly services, in school and youth welfare In cooperation with public health centres

Slide 12

Comprehensive approach: Six domains of sexuality education Safe Sex Sexuality Relation- ships Sexual violence Reproduction pregnancy Physical, social and emotional development Sexuality education

Slide 13

Comprehensive approach: stakeholders Sexual health care services Media Others School teachers Parents Youth/ RAP Youth sexual health

Slide 14

Specific interventions Girls Choice, attractive game for girls (10-15 year old girls) Girls Talk, gender specific counselling programme (14- 18 year old girls) Your life, your choice! Gender specific counselling programme 18 24 year old adolescents) Contraceptive suitcase and materials

Slide 15

5. Relative factors of success (content based): -Focus on sexual and reproductive health (not only on risks) -Different levels: knowledge, attitude, emotions, intentions, interaction, skills -Respecting gender- and cultural diversity -Personal fit (aims, barriers, doubts, risks) -Contraceptive choices, advantages and disadvantages, use and customary behaviour, help after failure (emergency pill) -Familial planning, responsibility when getting a child (motherhood and fatherhood)

Slide 16

6. Improvement strategies in the last years -Monitoring Sex under 25 -Special programme Sexual Health of Young People (government funding) -Research on determinants of teenage pregnancies -Developing evidence based programmes -Cooperation with public health centres -Youth participation -Starting media campaigns -Focus on implementation monitors -Building up an integrated programme for young people in their different stages of life

Slide 17

Slide 18

Thanks a lot for your attention ! i.vandervlugt@rng.nl

Slide 19