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Monday, 29 January, 2001, 19:26 GMT
Emergency contraception - the Salford experience
Emergency contraception being used by all ages
Emergency contraception being used by all ages
By BBC News Online's Mike McKay

A pioneering scheme in Greater Manchester has been testing demand for emergency contraception.

But unlike the national scheme, the Manchester project has been issuing the pills to girls under 16 as well as older women.

The Manchester, Trafford and Salford Health Action Zone launched their experiment over a year ago in areas recording some of the highest teenage pregnancy rates in Europe.

Since it began, more than 9,000 women between the ages of 13 and 56 had used the service. The majority - 53% - were aged between 20 and 29, while just 3% were aged below 16.

Eighty pharmacists have been specially trained to offer help and emergency contraception to women in the pilot areas.

A pharmacist can make out the prescription. And the service is free.

Political worries

Health professionals set the project going quietly, aware of the potential political backlash if there were mistakes.

They feared headlines about funding underage sex but were convinced they had to find new ways of reaching vulnerable and ignorant teenagers.

In all areas of sexual health, you have to anticipate political and media flak

Alayne Robin

"In all areas of sexual health, you have to anticipate political and media flak,"says Alayne Robin, Young Person's sexual health co-ordinator with the NHS's North-West Executive.

"But if we are going to reduce unwanted pregnancies among young women, particularly teenagers, we have to change the whole cultural background - and that's what the HAZ pilot in Manchester has been trying to do."

The background to the pilot was an alarming rise in teenage pregnancies. Conception among under sixteens in Salford stood at 11.6 per thousand between l994 - 96.

In some wards it was significantly worse. Langworthy, for example, recorded 28 pregnant girls out of just over a 1 ,000 under sixteens - the higest rate in Europe.

But the HAZ scheme was not a soft-touch for sexually promiscuous youngsters, say its promoters.

Rigorous questioning

Applicants face a searching question and answer session from the pharmacist. The under age women are encouraged to consult a guardian or parent and the pharmacist has to be sure the girls understand the implications of their decision.

If uncertain, the pharmacist can consult a family planning expert or an appointed doctor.

Pregnant woman in hospital
Not yet known if pregnacy rates are dropping

"There is no evidence to prove that providing this help to young women has inspired more promiscuity among young people, and we are encouraged by the response the scheme has met,"says Alayne Robin.

"We realise that providing this help for under sixteens is a sensitive question - but all the evidence is that providing practical help, education and a common sense approach to teenage sexuality has a positive effect,"she adds.

Some of the highest rates of teenage pregnancy occur in districts with high levels of socio-economic deprivation. Health Action Zones were introduced by the Government to tackle health inequalities. But their days are numbered.

In a couple of years, they will cease to exist. What worries some professionals is, where will future funding come from? The national scheme may not require a prescription - but applicants will have to pay for the pill. And on some deprived estates, that would be a deterrent, say HAZ officials.

Has the Manchester scheme cut teenage pregnancies?

"Frankly,we don't know - yet,"said a spokesman for Manchester, Trafford and Salford HAZ. "We believe it will - but we'll know the answer to that when a team from Nottingham University complete evaluation and assessment of all the date we've collected over the last year or so."

Only then will they know if the Manchester pilot has passed the Langworthy test.

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