The national framework for sexual health improvement focuses on prioritising the prevention of poor sexual health, addressing its wider determinants and meeting the needs of more vulnerable groups.
The Sexual and Reproductive Health Profiles have been developed by Public Health England to support local authorities and public health leads to monitor the sexual and reproductive health of their population and the performance of local public health related systems. The profiles provide a snapshot of sexual and reproductive health across a range of topics including teenage pregnancy, abortions, contraception, HIV and sexually transmitted infections (STIs). Wider influences on sexual health such as alcohol use, and other topics relating to teenage pregnancy such as education and deprivation level are also included.
In addition, Public Health England's Sexual Health Balanced Scorecard (currently unavailable) provides a snapshot of sexual health at a local level. Interactive maps and charts enable comparisons to be made regionally and nationally across a range of indicators relating to teenage pregnancy, abortions, contraception, sexually transmitted infections and other relevant issues. The aim is to provide a key source of sexual health information for public health, commissioning and performance management colleagues at a local, regional and national level. This particular tool allows users to view and compare key and supporting indicators to provide a wider view of sexual health at a Local Authority level.
Key findings from the national profiles include:
Sexually transmitted infections are the main preventable cause of infertility. When left untreated, they facilitate HIV transmission by increasing both HIV infectiousness and HIV susceptibility.
Derby performs comparably with the national average across the following HIV and STI indicators:
Derby performs significantly better than the national average across the following indicators:
Derby performs significantly worse than the national average across the following HIV and STI indicators:
Abortions highlight a lack of access to good quality contraception and advice, as well as problems with individual use of contraceptive methods. In Derby, the rate of abortions amongst females aged 15-44 is significantly lower than the national average (14.7 per 1,000 compared with 16.5), but higher than the regional average (13.3). However, Derby performs significantly worse than the national average for the proportion of women under 25 having an abortion after a birth (39.4%), and for the percentage of NHS-funded abortions under 10 weeks gestation (76%).
Derby performs comparably with the national average across the following reproductive health indicators:
Previous research suggests that teenage pregnancy is associated with poorer outcomes for both young parents and their children. Teenage mothers have a higher risk of poor mental health than older mothers, and are more likely to bring up their child in poverty. In addition, babies born to women under 20 are at a 30% greater risk of neonatal mortality and stillbirth, and a 44% higher risk of infant mortality.
Derby performs comparably with the national average across the following indicators:
Despite this, the percentage of conceptions to those under 18 that led to an abortion is significantly lower than the national average (31% compared with 51%). This is reflected in the fact that the proportion of births where the mother is under 18 (1.5%) is significantly higher than the national average (0.9%).
Wider Determinants of Health
The wider determinants of sexual health include factors such as poverty, crime and alcohol. In Derby, the rate of alcohol-specific hospital admissions amongst young people under 18 (36.9 per 100,000) is comparable with the national average (36.6).
Derby performs significantly worse than the national average across the following:
Key findings for Derby from a Sexual Health Needs Assessment undertaken in Derbyshire during 2013, include: