The highest teenage pregnancy rate in
Europe was the shameful statistic that the Blair government decided to address. Teenagers having
babies leads to all sorts of bad outcomes, high rates of prematurity and hence
damaged babies requiring very expensive medical care, and also long term
underemployment of the mothers, who are almost bound to remain on welfare
payments and to need housing subsidies for many years. It is a medical and
social disaster. A big effort was
made in schools and in the health service to provide contraception,
particularly using hormone implants which work for several years (and cannot be
forgotten.)
10 years later the number of teenage births
has approximately halved to around 20 per 1000 girls per year. So we can clap
ourselves on the back for a policy which really has achieved a worthwhile
result.
But, if that is true, how can it be that
very similar sharp declines
starting around 2007 have happened in other countries, such as New
Zealand and the US, which did not have any major policy change in this area. And the decline in the UK started
slightly before the change in health policy. It has been suggested that it has
been the rise of facebook etc. that has led to a decline in sexual activity see Telegraph article ,
but survey data do not support this.
It is of course impossible to look back at
history and be sure of the causes of such trends. It may simply be a case of
pregnancy becoming less fashionable, as also seems to be true of heavy drinking
among teenagers.
In Zambia, the situation is different. The
nationally the rate is about 150 i.e. over 7 times the UK figure, and about 28%
of girls will become pregnant before their 19th birthday. Pregnancy rate in Zambia
Near our clinic there is a secondary
school.. Parents pay fees for their children to attend, and they need uniforms
and books, and they cannot work, so we are talking about the upper
socioeconomic levels of rural Zambian society. And yet there have been a lot of pregnancies recently, and
as a result the school decided that all 400 or so girls should have pregnancy
tests! (Medical ethics are interpreted differently here). 7 of the girls tested positive, on top
of those already found to be pregnant.
Just as in the UK, this will probably put
an end to any prospect of further education for these girls. The girls will be
out of school for a year or so with a huge effect on their eventual attainment.
So why the difference? The girls can attend the local health
clinic for family planning. This is done at a specific clinic on a Monday. At the clinic the staff say that there
is free access to contraception with no questions asked: But that the pupils
are put off coming by ‘stigma’.
Local charities would like to go into the schools and supply/push
contraception, but this is strongly opposed by traditional Zambian society,
which is dominated by Christianity.
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