When it came to teenage pregnancy, the UK used to be an extreme outlier in Europe, but over the last two decades, it’s narrowed that gap considerably.

Earlier this year, as part of our How to make good things happen series, we were joined by Moira Wallace (who oversaw the original teenage pregnancy strategy for the Social Exclusion Unit) to reflect on its success and hear her four transferable lessons for other social policy areas.

Developed in 1999 by the Social Exclusion Unit, the cross-governmental Teenage Pregnancy Strategy halved teenage conceptions in England by 2014.

The SEU’s first job was to ask why teenage conception rates were so high. They found many reasons: high rates of contributory factors such as child poverty, school absence and alcohol use; poor sex education and low access to contraception; mixed messages about sex; and the fact that no one had responsibility for prevention.

The unit recommended a 10-year programme of prevention and support which was led by a Teenage Pregnancy Unit in the Department of Health. Measures included a national programme to improve sex education and contraceptive access, and funding to support teenage pregnancy coordinators and local action plans in every local authority.

The strategy was cross-departmental, drawing on wider youth and schools policies. It was helped by significant increases in secondary schools’ resourcing and pastoral support, falling rates of school absence, and a large increase in girls staying on in education after 16. Lower alcohol use and changed patterns of socialising also played a role.

Part of the success of the SEU was its freedom to ask the – sometimes basic, but also hard – questions about the problem. What were the root causes? What was the cost of not tackling it? What was happening in the current system? Why was that inadequate?

Understanding and addressing all causes is vital for social problems: merely identifying individual elements and pursuing narrow interventions is rarely enough to make a difference.

Taking time for a full diagnosis produced an action plan that was much more likely to work. If we took the time to do this exploratory thinking in an open way, then we’d ultimately make faster progress.

This case study is an example of delivery using a challenging outcome target. Targets can be used to help galvanise action and focus on the challenge you’re tackling, but should be grounded in reality.

The target of halving teenage conceptions sounded overly ambitious but was based on what other countries were already able to achieve. Setting a target is just the start – you then need to monitor your progress and strengthen the strategy where necessary, as the Teenage Pregnancy Unit did.

Moira argued that, when it comes to data, “you should watch it like a hawk, not like an ostrich”.

There is a tendency to try and isolate individual causes of problems because you can evaluate them.

But in reality, big, complex, social problems require multiple simultaneous interventions, so can be difficult to evaluate. And waiting for perfect evidence can be the wrong thing to do.

It’s great when data from large-scale experiments such as a randomised controlled trial (RCT) is available, and great to plan such studies too, but sometimes as a policymaker it is right to act when you have ‘good enough’ evidence and try to refine the evidence base further as you go.

For Moira there were three must-haves: national leaders and local leaders with a shared purpose. This triple combination was essential for delivery – but missing some of these elements is a common pitfall.

She used the example of a world without local leaders where a teenager was supposedly waiting for central government to announce a teenage pregnancy strategy that would somehow shift their behaviour.

It sounds ludicrous because we know that without local leaders to coordinate local action, things won’t change for the people who are supposed to benefit.

This year at Nesta we've been bringing together policy experts and practitioners who've worked on proven interventions for a programme of events: How to make good things happen.

We've been deep diving into successful policies from the UK and abroad and asking what they can teach us about tackling the policy challenges of the future.

We’ll be sharing more from those ongoing conversations as they happen and if you're interested in joining us for upcoming events in the series get in touch with us: [email protected]