What are the most effective strategies for reducing the rate of teenage pregnancies?

Summary of a HEN network member’s report

The issue

There is growing recognition that teenage pregnancy and early parenthood can lead to poor educational achievement, poor physical and mental health, poverty, and social isolation. Socioeconomic disadvantage can be both a cause and an effect of young parenthood. Increasing efforts have been made to identify factors influencing the rate of teenage pregnancy and effective interventions.


Data from Europe

Rates of teenage pregnancy vary across Europe, with eastern Europe generally experiencing higher rates than western Europe, with the United Kingdom having the highest rate. Patterns of conceptions are not uniform, and recent analysis of the data (1) revealed a number of different patterns in conception and pregnancy rates over the last 30 years. Factors that appear to be relatively strongly associated with teenage birth rates across Europe include: teen marriage rates, the overall wealth and income distribution of a country, along with the average years of education and strength of religion. In addition, higher rates of GDP spending on social and family benefits, and higher proportions of economically active women, correlate positively with abortion levels.

European evidence has shown that a focus on the following may be effective in reducing the rate and negative consequences of teenage parenthood:

  • preventing unintended conceptions (rather than reducing pregnancy levels through higher abortion rates);
  • strengthening secondary preventive efforts – education, employment and support – aimed at helping the mother and child, in particular single mothers;
  • integrating prevention efforts with other related services; and
  • providing sex education before young people become sexually active, with open attitudes and a positive approach to sexual health and relationships.

Data from the United Kingdom

A recent synthesis of review-level evidence (2) on the prevention of teenage pregnancy found good evidence that the following interventions may be effective:

  • school-based sex education, particularly linked to contraceptive services
  • community-based education, development and contraceptive services
  • youth development programmes
  • family outreach.

Policy considerations

Policies should:

  • focus on improving contraceptive use and at least one other behaviour likely to prevent pregnancy and STI infection;
  • provide long-term services and interventions tailored to meet local needs of young people, particularly in high-risk groups;
  • provide clear and unambiguous information;
  • include interpersonal skills development such as negotiation and refusal skills;
  • provide timely intervention, such as when an adolescent receives a negative pregnancy test from a clinic;
  • base programmes on theory-driven approaches with clear behavioural goals and outcomes, using participatory teaching methods;
  • check that interventions and services are accessible to young people;
  • select and train staff committed to programme goals and respectful of confidentiality;
  • work with teenage ‘opinion leaders’ and peer group influencers;
  • make sure interventions are age-appropriate;
  • encourage a local culture where discussion of sex, sexuality and contraception is permitted; and
  • join up services aimed at preventing pregnancy with other services for young people, and work in partnership with the community.

The views expressed in this summary are based on a publication of a HEN Network member agency and do not necessarily represent the decisions or stated policy of WHO/Europe.