Fostering primary and secondary prevention in public policy for pregnant adolescents

J Health Soc Policy. 1989;1(1):89-98. doi: 10.1300/J045v01n01_08.

Abstract

The diverse factors associated with sexuality among adolescents and the specific issues related to contraception in this developmentally diverse group result in complexity in policy formation. The future of an adolescent may be determined solely on the basis of access to supportive physical and emotional services funded by public and private sector monies. The purpose of this paper is to briefly present contemporary and social policies regarding pregnant adolescent health care. Suggestions as to how these policies can be translated into public adolescent health models are provided. The strategies will be related to primary and secondary public policy interventions.

PIP: Public policy models which are strategically focused and longterm and are flexible, diverse, and creative, and discusses. The emphasis is on current social policies on adolescent and adolescent pregnancy health care and suggested improvements in viability or related primary and secondary public policy interventions that are possible. There are primary prevention models, the provision of sterilization for mature minors with children, incentives to providers for primary prevention, pregnancy marketing among high risk groups, improving access to adolescent preventive services, secondary pregnancy prevention policies, and adolescent Aid to Families with Dependent Children (AFDC) recipient outreach. It is concluded that policies must be carefully developed because of the complexity of the issues. Problems are present for adolescents seeking care. Entitlement programs such as Title XIX and Medicaid are not current with client needs nor is processing expedited. Cost reimbursement strategies need to be developed. Shortterm policies are of limited value. Recommended birth control methods need to be tailored to adolescents with multiple partners and those at risk of sexually transmitted diseases. Thus, the IUD is contraindicated. The availability of supportive emotional and physical services directly determines the future in a society that has a prominent sexually active adolescent population. Politically sensitive school-based clinical may not be as effective as public health affiliated and/or academically affiliated institutions which are not controversial and have both private and public support. Policy development should be promoted within health departments and legislatures in interagency agreements rather than within school administration. Without controversy and harassment, utilization is maximized. Client enhancement strategies for self-care health behavior have been successful abroad. Cash incentive strategies must not be perceived as bribes. Family size might be limited if state, local, or regional funds were made available for tubal ligation. Adolescents would be serviced better if funding ceilings allowed for adolescent reproductive health services. Periodic mailings to at-risk groups, such as AFDC adolescents, with location of health services, benefits of family planning, and access/transportation to services is an effective strategy. Multidimensional service approaches are efficient, help follow up, and may help shift financial support. Reducing the number of school dropouts and building self-esteem and self-sufficiency are recommended secondary strategies.

MeSH terms

  • Adolescent
  • Family Planning Services*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy in Adolescence*
  • Primary Prevention*
  • Public Policy*