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Sexual Health Services Lucy Emmerson


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jan norton

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Sexual Health Services Lucy Emmerson

  1. 1. On-site sexual health services in education settings
  2. 2. What are they? <ul><li>Outreach from local agencies </li></ul><ul><li>Extension of the school nurse role </li></ul><ul><li>Clinic in a box </li></ul><ul><li>Mobile health buses </li></ul><ul><li>Part of holistic health services </li></ul><ul><li>C-card scheme delivered in education settings </li></ul><ul><li>Chlamydia screening in education settings </li></ul>
  3. 3. What are they? <ul><li>Advice and referral </li></ul><ul><li>Pregnancy testing </li></ul><ul><li>Contraception: EHC, condoms, pills, LARC </li></ul><ul><li>Chlamydia and gonorrhoea testing </li></ul><ul><li>More barriers accessing testing and contraception than accessing advice </li></ul>
  4. 4. How common are they? <ul><li>Survey carried out by the Sex Education Forum </li></ul><ul><li>Completed by Teenage Pregnancy Coordinators </li></ul><ul><li>Sample of 70% of local authorities for schools survey </li></ul>
  5. 5. <ul><li>Between a quarter and a third of secondary schools in the sample have on-site sexual health services (28.7%) – 627 schools </li></ul><ul><li>16% of services in schools are specialised – providing a wide range of contraception </li></ul><ul><li>Considerable regional variation: highest North East and South West, lowest North West and London </li></ul><ul><li>Wide variation between neighbouring authorities </li></ul>
  6. 7. Where are they? <ul><li>High concentration in some rural areas (Northumberland, Rutland and Staffordshire) </li></ul><ul><li>Low concentration in other rural areas (Lancashire, East Sussex) </li></ul><ul><li>High concentration in some urban areas (Bristol, York, Portsmouth) </li></ul><ul><li>Low concentration in other urban areas (Birmingham, Liverpool) </li></ul>
  7. 8. School profile <ul><li>Slightly lower prevalence in all girls (14%) and all boys (10%) schools than co-ed (28.7%) </li></ul><ul><li>17 faith based schools have on-site sexual health services </li></ul><ul><li>Services in special schools and independent schools also mentioned </li></ul><ul><li>2% of services accessible by over 16s only </li></ul>
  8. 10. What about PRU services? <ul><li>34.4% of PRUs in the sample have on-site sexual health services </li></ul><ul><li>Smaller sample as some areas did not provide data </li></ul><ul><li>Higher proportion of specialised services than in schools (27% compared to 16%) </li></ul><ul><li>High level in Yorks & Humber, low level in East Midlands </li></ul><ul><li>No clear distribution patterns </li></ul>
  9. 11. Do on-site services work? <ul><li>Evidence that better access to contraception leads to reduction in teenage conceptions (Santelli, 2007) </li></ul><ul><li>Evidence that SRE and access to services reduces teenage conception rates (DfES, 2006) </li></ul><ul><li>Investment over time: not helpful to link existing conception data with current prevalence of on-site services </li></ul><ul><li>Services in education settings are one piece of the jigsaw </li></ul><ul><li>Evidence of high usage of services by vulnerable young people (UWE, 2008) </li></ul><ul><li>Challenges in evaluation: variation between services – what should the indicators be? </li></ul>
  10. 12. Barriers to development <ul><li>Difficulties agreeing confidentiality protocols: school/health </li></ul><ul><li>Lack of capacity and difficulties in recruiting specialised staff </li></ul><ul><li>Funding needed to extend pilot projects </li></ul><ul><li>Preference for a community-based approach </li></ul><ul><li>Concerns about parental objection </li></ul><ul><li>Concerns from schools: heads and governors </li></ul>
  11. 13. In the media 2007
  12. 14. Headlines June 2008 <ul><li>“ School sex clinics fuel debate on promiscuity” (Observer) </li></ul><ul><li>“ Three cheers for the news that nearly one in three secondary schools are now running sexual health clinics for pupils” </li></ul><ul><li>(Miriam Stoppard, The Mirror) </li></ul><ul><li>“ Give kids guidance… not just the pill” (Sun) </li></ul>
  13. 15. Looking ahead <ul><li>Survey included open questions about plans for future development </li></ul><ul><li>Respondents from 40 local authority areas indicated plans for future development </li></ul><ul><li>16 of the school services were being opened in the period Sept 07 – Jan 08 </li></ul><ul><li>Some areas started with pilot and now rolling out to further schools </li></ul>
  14. 16. Questions <ul><li>In school or near school? How far is too far? </li></ul><ul><li>Sexual health or general health? </li></ul><ul><li>How specialised? </li></ul><ul><li>A menu of options… when to compromise? </li></ul><ul><li>How can onward referral be tracked? </li></ul><ul><li>Targeting resources or work with the willing? </li></ul>
  15. 17. Involving young people <ul><li>Health needs assessment </li></ul><ul><li>Consultation – school council and focus groups </li></ul><ul><li>Youth-led research </li></ul><ul><li>Branding </li></ul><ul><li>Promotion </li></ul><ul><li>Location </li></ul><ul><li>Peer mentors / service advocates </li></ul><ul><li>Evaluation </li></ul>
  16. 18. Recommendations <ul><li>1. Local authorities to take a strategic and coordinated approach to service development in schools </li></ul><ul><li>2. Support school governors and heads to understand the benefits of on-site service provision </li></ul><ul><li>3. Enable professionals to share practice </li></ul><ul><li>4. Develop tools to maximise service effectiveness </li></ul><ul><li>5. Build on the evidence base </li></ul><ul><li>6. Track progress </li></ul><ul><li>7. Celebrate success </li></ul>
  17. 19. Resources <ul><li>Sex Education Forum web resources: </li></ul><ul><li>Email networks </li></ul><ul><li>Forthcoming resource pack </li></ul>Contact Lucy Emmerson Senior Development Officer Sex Education Forum 8 Wakley Street London EC1V 7QE Email: Tel: 0207 843 1164
  18. 20. References click icons for web link… <ul><li>DfES (2006) Teenage Pregnancy Next Steps: Guidance for local authorities and primary care trusts on effective delivery of local strategies. </li></ul><ul><li>Salmon, D and Ingram, J (2008) An Evaluation of Brook Sexual Health Outreach in Schools. Bristol: Centre for Public Health Research, University of the West of England. </li></ul><ul><li>Santelli, J and others (2007) Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use’, American Journal of Public Health (January), vol. 97, no. 1: 150-6. </li></ul><ul><li>Sex Education Forum, (2008) National mapping of on-site sexual health services in education settings: provision in schools and pupil referral units in England, NCB. </li></ul>