Following its 2013 inquiry into teenage pregnancy, the Scottish Parliament’s Health and Sport Committee recommended a stand-alone Strategy for Scotland on pregnancy and parenthood in young people. A draft Strategy was developed using a collaborative approach involving young people and informed by the recommendations of an expert Pregnancy and Parenthood in Young People Strategy Steering Group. The Strategy is the first in Scotland to focus on pregnancy and parenthood amongst young people and aims to increase the choices and opportunities available to them which will support their wellbeing and prosperity across the life course.
On 7 July 2015 the Scottish Government launched an open consultation on the draft Pregnancy and Parenthood in Young People Strategy, with written responses invited by 29 September 2015. Sixty-six responses were received and a summary of the views expressed in those follows. The views are those of the respondents to this consultation and do not necessarily represent the views of a wider population.
Delaying pregnancy in young people
Respondents considered that key approaches to ensuring agencies are co-ordinated in their approach to taking forward the actions aimed at delaying pregnancy in young people are to: ensure all parties are providing consistent messages and share the same understanding of the issues; improve the consistency of delivery and content of Relationships, Sexual Health and Parenthood Education (RSHPE) in schools; work collaboratively with effective communication and liaison between agencies; and involve young people in aspects of multi-agency work, such as planning strategy and providing feedback.
Other recommendations to ensure co-ordination in approach included: strong leadership; greater articulation of the role of the Third Sector; more explicit links with related legislation and policy; and greater use of public information fora.
National frameworks such as Curriculum for Excellence, the Children and Young People (Scotland) Act 2014 and Getting it Right for Every Child (GIRFEC) were identified as overarching structures within which local systems could develop to take forward the actions. A general view was that whilst local systems are in place, some need to be strengthened and formalised in order to be more effective.
Many examples were provided of local initiatives which respondents considered had potential for taking forward the actions in the draft Strategy. Local systems which engaged with young people were highlighted in particular.
Overall there was much support for the actions in the draft Strategy and their relationship with the outcomes in the logic model, however a few respondents argued for greater national action to underpin local actions towards the outcomes.
Many respondents identified areas which they perceived to be missing from this section of the draft Strategy. Amongst these a recurring theme was that the section needs to recognise more explicitly the role of parents as key educators of their children and the implications this has for delivering preventative messages. Another repeated theme was that the Strategy should place greater emphasis on ensuring consistency across schools in their delivery of RSHPE.
Pregnancy in young people
A common theme was that existing integrated frameworks, such as Community Planning Partnerships (CPPs), do provide appropriate structures for inter-agency working to implement the actions in this section of the Strategy.
Respondents across a wide range of sectors considered that sharing of up-to-date and relevant information between agencies is essential to enable co-ordination in working. Inter-agency joint training was recommended by several respondents as a way of co-ordinating approaches to delivering actions on pregnancy. The need for a common approach and understanding of the issues between agencies, which includes ensuring confidentiality and not stigmatising young parents, was also a shared view.
Existing integrated local frameworks and structures were identified which respondents considered facilitated joint working between agencies in taking forward the actions. Some local authorities highlighted liaison work with local schools which they envisaged would contribute to delivering this section’s actions.
A recurring view was that whilst relevant local systems are in place, some need to be strengthened to enhance their effectiveness in taking forward the Strategy’s actions.
Whilst many respondents considered that the actions in this section meet the outcomes in the logic model, others perceived there to be gaps, such as actions which focus on vulnerable young people and on those not in mainstream education.
A key topic identified repeatedly as omitted from the pregnancy section was information on abortion and in particular the potential impact of abortion on the physical and psychological health of the mother in particular.
Third Sector respondents requested additional actions relating to making young people more aware of their rights relating to maternity, for example, employment, welfare and housing entitlements.
Parenthood in young people
A common theme was that existing integrated frameworks such as CPPs and the Family Nurse Partnership (FNP) provide the structure for ways of working within and between agencies which will help to ensure there is a co-ordinated approach to taking forward the actions in this section. Some respondents shared the view that more could be made of the potential contribution of Third Sector organisations in realising the Strategy in relation to parenthood in young people.
Respondents identified national frameworks such as Integrated Children’s Services Plans (ICSPs), the Named Person and the FNP as systems to take forward the actions in this section, in addition to a host of local systems and services.
The actions were considered generally to link to the outcomes in the accompanying logic model although a few respondents perceived this to be dependent on adequate leadership, resources and whether they are implemented universally.
A recurring theme was that the inclusion of, and engagement with, fathers was missing from this section with recommendations that more detail be included on the opportunities available to young fathers and what is expected of them in relation to parenthood. More detail on different aspects of parenting was also called for, including the role of the young person’s parents and grandparents.
Issues relating to behaviour change, such as breastfeeding and smoking, were also identified as requiring inclusion in the Strategy in the parenthood section.
Leadership and accountability
The majority of those who addressed the issue of leadership and accountability supported the proposals that CPPs be responsible for leadership in planning and delivering the Strategy at a local level. A recurring view was that this would promote a holistic approach to addressing the issues and would broaden what some considered to be the current overly narrow focus on health. Another key advantage raised by a few was that CPP leadership would enable sharing of information, resources and skills amongst partners. Some concerns were raised over the capacity of CPPs at present to accommodate the demands of delivering the Strategy at a time of significant competing priorities, particularly related to dovetailing with the Health and Social Care Integration Boards.
Some respondents focused on barriers to local data collection and sharing with the most commonly identified barrier being lack of compatibility between the datasets of different agencies. Common barriers were perceived to be: different methods of data collection and record-keeping; different data sources; lack of consistency across agencies in the nature of data collected; inaccessible information technology systems; out-of-date and missing information; and different protocols on levels of inter-agency sharing and approaches to data protection.
Engagement with young people
Many examples of good practice both national and local were identified by respondents relating to engagement with young people. GIRFEC and Home Starts across Scotland were identified amongst those at national level. Examples of regional and local initiatives included those led by peers; projects to support vulnerable young people; schemes aimed at engaging more effectively with young people; initiatives using social and text media; joint work with education; general support schemes; and initiatives aimed at looked-after young parents.
Additional issues and good practice
Respondents identified issues which they felt merited further attention in the final version of the Strategy. These included: ensuring the target age range is clearer and consistent; ensuring the Strategy’s aims are clear and upfront; addressing the role of the father more comprehensively; paying greater attention to the potential role of peer support; and acknowledging more explicitly the potential role of wider influencers such as local authority staff in community settings who could play a key part in raising awareness and providing information.
Two themes dominated responses about potential impacts of the Strategy on equalities. A recurring view was that the delivery of messages on pregnancy and parenting in young people across the entire local authority school sector is not consistent due to some denominational schools not delivering the information on account of religion or belief.
Another repeated view was that the Strategy requires to set out more targeted action for young people with learning disabilities and other additional needs.
A few respondents considered that the needs of LGBT young people should receive greater attention in the Strategy. Others mentioned addressing the particular needs of those in forced marriages; females with genital mutilation; gypsy and travelling young people; and young pregnant people who may not necessarily identify as female.
Opportunities emerging in the Strategy for those with protected characteristics were identified. It was felt that, because of the Strategy, support staff will be better trained, informed and non-judgemental; the needs of young people will be more fully considered; and support for young men will improve.
To counteract any potential negative impacts on equality respondents recommended: ongoing consultation and engagement with young people and their representative bodies; tailored guidance for specific groups; ongoing staff training to keep them abreast of issues; additional resourcing for special circumstances such as using interpreters; and ensuring national policy is consistently applied, regardless of individual schools’ religious beliefs.
Evidence and research
Many respondents identified what they perceived to be additional high level evidence for consideration alongside that already supporting the draft Strategy. The key topics addressed in the material cited were: school-based sex education; parental involvement in young person’s sexual health; young fathers; young people at transitions; methodological approaches on researching the themes of the Strategy; influence of home-visiting support; wider influences on early pregnancy; young parents and babies in prison; and the wider economics of early pregnancy.
Email: Fiona MacDonald