Pregnancy and parenthood in young people: strategy update

National Progress, Achievements and Activity To Date

Strand 1: Strong Leadership and Accountability

Between March 2016 and September 2017 progress against Strand 1 has been as follows:

Action	Progress
1.1 Needs Assessment	Local areas have carried out needs assessments or have a plan in place for doing so
1.3 National Leadership	The National Lead was appointed in April 2016
1.4 Local Leadership	A Local Lead has been identified, or is in the process of being identified, for each Local Authority area.

Additional progress:

• A delivery structure has been developed which will provide a cohesive framework for the policy delivery nationally (see Figure 1). This structure sets out the various groups responsible for taking forward different elements and actions within the strategy. Some groups support the implementation of the strategy as a whole, for example the PPYP Steering Group, others relate to a specific action within the Strategy, such as the Consent and Healthy Relationships Short Life Working Group.

The delivery structure makes clear links with the governance for the Family Nurse Partnership ( FNP) Programme. FNP is the key programme for supporting young, first time mothers in Scotland, and the PPYP Strategy aims to support all young parents, so it is vital that the two programmes of work are closely linked, working together to achieve the best possible start for all our young parents and their children.

Figure 1: PPYP Strategy Delivery Structure

• The publication of the PPYP Outcomes Framework, which ensures ease of access to the evidence http://www.healthscotland.com/ofhi/PPYP/content/Tools_PPYP.html

• The Evaluation and Monitoring Group is developing the Evaluation and Monitoring Framework for the first five years of the strategy, including identifying appropriate data sources for key indicators.

Strand 2: Giving Young People More Control

Between March 2016 and September 2017 progress against Strand 2 has been as follows:

Action	Progress
2.1 Key messages on consent and healthy relationships in young people	A short life working group on 'consent and healthy relationships' has been formed and is drafting the key messages in preparation for consultation with young people. It is anticipated that the key messages will be available by the end of 2017/18.
2.2 Demonstrate partnership working to support the RSHP education guidance locally	The Scottish Government is supporting a partnership approach for the development of an up‑to‑date, national age and stage appropriate RSHP education resource for Scotland, for children and young people aged 3-18.

Additional progress:

• The development of a paper which presents the key evidence in relation to pregnancy and parenthood in young people and, in particular, the importance of education and attainment (Appendix A).

One of the key actions for this first period of implementation has been communicating to stakeholders this evidence and, in particular, the importance of education as key to helping young people plan for their future and reducing the risk of pregnancy at a young age.

Through the Scottish Attainment Challenge and National Improvement Framework, the Scottish Government has committed to working to achieve equity in educational outcomes, by ensuring every child has the same opportunity to succeed – with a focus on closing the poverty-related attainment gap. In achieving equity we are also increasing life chances for our young people, supporting them in their aspirations and ambitions. This work, therefore, is key to supporting young people in preventing or delaying pregnancy by providing choices and opportunities through learning and positive engagement with school.

The Scottish Government has committed to investing £750m to support pupil attainment through the Attainment Scotland Fund over the lifetime of this Parliament, including £120m Pupil Equity Funding direct to headteachers in 2017-18. This investment will support those children and young people affected by the poverty related attainment gap. It will make a significant impact on those young people vulnerable to pregnancy at a young age, as we know that poor attendance at school, low attainment or achievement, few or no aspirations and free school meals entitlement are key indicators for risk of teenage pregnancy. ^[6]

Strands 3&4: Pregnancy and Parenthood in Young People

Between March 2016 and September 2017 progress against Strands 3&4 has been as follows:

Action	Progress
3.1 / 4.6 / 4.7 Information on pregnancy / social and health needs / welfare and housing	A pregnancy and parenthood digital resource, funded by Scottish Government, is being developed by Young Scot
3.7 A guide for professionals based on PHE's ' Getting maternity services right for pregnancy teenagers and young fathers'	A short life working group, supported by NHS Health Scotland, is in the process of developing the guide for Scotland. It is anticipated that the Guide will be published by the end of 2017/18.

• Actions 3.1 / 4.6 / 4.7: In 2017, Young Scot were awarded with just over £100,000 from the Scottish Government through the Children, Young People, Families Early Intervention and Adult Learning and Empowering Communities Fund ( CYPFIEF & ALEC Fund) in order to take forward the 'Empowering Scotland's Young Parents' project. This piece of work will create a trusted source of information for young people on pregnancy and parenthood. It will help young people to understand pregnancy, including information on how to prevent pregnancy, as well as the importance of seeking advice and support if they discover that they are pregnant. The resource will respond to the needs highlighted in the Strategy, including the importance of support around early identification of pregnancy and pregnancy options.

In addition to the work on pregnancy, the project will develop resources for young parents. This experiential resource will provide information and advice on areas of need identified by young parents, using media which are attractive and accessible to young people. This project will engage with young people from the very beginning, as well as utilising upcoming research from Strathclyde University ^[7] on the information needs of young mothers. Importantly, this work will help to address the stigma and discrimination that young parents often experience by educating young people about their rights in relation to pregnancy and parenthood, and by promoting positive attitudes to young parents.

The project is linking closely with the FNP programme to ensure a joined up approach to supporting all young parents in Scotland.

• Action 3.7: The Maternity Guide will reflect the services provided in NHS Scotland and the voices of Scotland's young parents and professionals. It will provide advice for professionals on how to support young parents as they go through the antenatal and post natal journey, describing approaches that will help young people to feel more comfortable and confident within services and with professionals, putting parents and the child at the centre of service planning and delivery.

This work will also include development of resources for young people so that they understand their rights in relation to high quality maternity care. This will, in line with recommendations of The Best Start ^[8] , help to ensure they are aware of the choices they are entitled to and that they are well informed in order that they are able to make their own decisions about their treatment and care.

Additional progress:

• The development of resources to support improvements in access to, and provision of, contraception post-partum for all women, including young mothers, is underway.

A short life working group is considering improvements in access to, and provision of, post-partum contraception ( PPC), linking with the ambitions of the Sexual Health and BBV ^[9] and Refreshed Maternity ^[10] Frameworks. Whilst the working group is considering improvements to post-partum contraception as a universal approach for all women, this work will be of direct benefit to young mothers who wish to take control of their reproductive health. Central to this work is ensuring that post-partum contraception is considered as part of the antenatal journey. Women should be fully involved in their choices around accessing contraception, and where PPC is chosen their preferred option should ideally be provided immediately post-delivery (or as close to as possible).