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Termination of Pregnancy in Manchester – BME Community

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August 2013 TERMINATION OF PREGNANCY IN MANCHESTER: BME COMMUNITY ENGAGEMENT AND CONSULTATION Toolkit prepared by Manchester BME Network in association with Centre for Local Economic Strategies Presented to NHS Manchester The Centre for Local Economic Strategies is a company limited by guarantee no 4242937 with charitable status no. 1089503. Termination of pregnancy in Manchester: BME community engagement and consultation 1 CONTENTS PAGE NO. 1 INTRODUCTION TO THE TOOLKIT 9 2 SEXUAL HEALTH, CONTRACEPTION AND TERMINATION SERVICES ACROSS MANCHESTER 10 2.1 Introduction 10 2.2 Palantine CASH service and Fresh clinics 10 2.3 Brook clinic 10 2.4 Specialist genitourinary medicine (GUM) clinics 11 2.5 GPs and pharmacies offering local enhanced services 11 2.6 Termination of pregnancy services 13 2.7 Prevention, advice and support services 13 3 MANCHESTER DEMOGRAPHICS BY WARD 15 3.1 Age 15 3.2 Ethnicity 15 3.3 Religion 21 3.4 Socio-economic indicators 25 4 TERMINATION OF PREGNANCY IN MANCHESTER 30 5 FOCUS ON SIX HOTSPOT WARDS 33 5.1 Introduction 33 5.2 Ardwick 33 5.2.1 Ward demographics 33 5.2.2 Termination of pregnancy data in Ardwick 36 5.2.3 Contraception and termination support services in Ardwick 37 5.2.4 Women’s support groups and BME community groups in Ardwick 37 5.3 Harpurhey 38 5.3.1 Ward demographics 38 5.3.2 Termination of pregnancy data in Harpurhey 41 5.3.3 Contraception and termination support services in Harpurhey 41 5.3.4 Women’s support groups and BME community groups in Harpurhey. 41 5.4 Cheetham 43 5.4.1 Ward demographics 43 5.4.2 Termination of pregnancy data in Cheetham 46 5.4.3 Contraception and termination support services in Cheetham 46 5.4.4 Women’s support groups and BME community groups in Cheetham 46 5.5 Longsight 48 5.5.1 Ward demographics 48 5.5.2 Termination of pregnancy data in Longsight 51 5.5.3 Contraception and termination support services in Longsight 51 5.5.4 Women’s support groups and BME community groups in Longsight 51 5.6 Hulme 53 5.6.1 Ward demographics 53 5.6.2 Termination of pregnancy data in Hulme 56 5.6.3 Contraception and termination support services in Hulme 56 5.6.4 Women’s support groups and BME community groups in Hulme 56 5.7 Moss Side 57 5.7.1 Ward demographics 57 5.7.2 Termination of pregnancy data in Moss Side 60 5.7.3 Contraception and termination support services in Moss Side 60 5.7.4 Women’s support groups and BME community groups in Moss Side 60 Manchester BME Network Termination of pregnancy in Manchester: BME community engagement and consultation 2 6 SUPPORTING BME WOMEN TO ACCESS SEXUAL HEALTH SERVICES: CHALLENGES AND OPPORTUNITIES 61 7 SEXUAL HEALTH 62 7.1 Introduction 62 7.2 Information and advice about sexual health 62 7.3 Knowledge and use of contraception methods 62 7.4 Accessibility of sexual health services (contraception) 62 7.5 Barriers in accessing services (contraception) 63 7.5.1 Language and communication barriers 63 7.5.2 Gender of sexual healthcare professional 64 7.5.3 Anonymity and confidentiality 64 7.6 Suggestions to improve contraception services 64 7.6.1 Better information to newcomers 64 7.6.2 Simpler language 64 7.6.3 Sensitivity to cultural needs 64 7.6.4 Community provision 65 7.6.5 Reaching foreign students 65 8 TERMINATION OF PREGNANCY 66 8.1 Perceptions of termination of pregnancy 66 8.1.1 Religious beliefs 66 8.1.2 Family and partner’s influence 66 8.1.3 Stigmatism 66 8.2 Reasons for having a termination 67 8.2.1 Age 67 8.2.2 Religion and culture 67 8.2.3 Health 67 8.3 Experience of termination services 67 8.3.1 Emotional support 67 8.3.2 Privacy 68 8.4 Suggestions of how termination services may be improved 68 8.4.1 Aftercare support 68 8.4.2 Information and awareness 68 9 MONITORING CHANGE IN BME WOMEN’S SEXUAL HEALTH NEEDS 70 9.1 Ethnic diversity 70 9.2 What has driven this change? 70 9.3 What is the balance between migration and births? 70 9.4 Issues with monitoring and reporting 70 9.4.1 Unreported language diversity (Census 2011) 70 9.4.2 Monitoring ethnicity 71 9.4.3 Termination of pregnancy services 71 9.5 Future developments 71 FIGURES Figure 1: Location of GPs and pharmacies offering enhanced services 12 Figure 2: Age distribution for the population of Manchester 15 Figure 3: Ethnic diversity of Manchester 15 Figure 4: Population of minority groups in Manchester 16 Figure 5: Asian/Asian British population in Manchester 16 Figure 6: Black/Black British population in Manchester 17 Figure 7: Wards with highest Asian/Asian British population in Manchester 17 Figure 8: Number of Asian/Asian British in Manchester 18 Figure 9: Wards with highest Black/Black British population in Manchester 18 Figure 10: Number of Black/Black British in Manchester 19 Manchester BME Network Termination of pregnancy in Manchester: BME community engagement and consultation 3 Figure 11: Wards with highest Asian/Asian British; Chinese population in Manchester 19 Figure 12: Number of Chinese/Chinese British in Manchester 20 Figure 13: Religious diversity in Manchester 21 Figure 14: Number of Christians per ward in Manchester 22 Figure 15: Number of Muslims per ward in Manchester 23 Figure 16: Number of Hindus per ward in Manchester 24 Figure 17: Number of Income Support claimants in each lower super output area in Manchester 25 Figure 18: Percentage of households in each ward experiencing three or four dimensions of deprivation in Manchester 26 Figure 19: Percentage of people in Manchester over sixteen with no qualifications 27 Figure 20: Number of economically inactive people in Manchester who are unemployed 28 Figure 21: Index of Multiple Deprivation scores for lower super output areas across Manchester 29 Figure 22: Number of terminations of pregnancy in Manchester between 2007 and 2009 30 Figure 23: Termination of pregnancy compared to population 30 Figure 24: Termination trend by ethnicity and age 31 Figure 25: Age distribution of Ardwick population 33 Figure 26: Ethnicity of Ardwick 34 Figure 27: Religious diversity of Ardwick 34 Figure 28: Unemployment and economic inactivity in Ardwick 35 Figure 29: Percentage of households in three or four dimensions of deprivation in Ardwick 35 Figure 30: Percentage of Ardwick population with no qualifications 36 Figure 31: Terminations of pregnancy in Ardwick 2007-2009 36 Figure 32: Age distribution of Harpurhey population 38 Figure 33: Ethnicity of Harpurhey 38 Figure 34: Religious diversity of Harpurhey 39 Figure 35: Unemployment and economic inactivity in Harpurhey 39 Figure 36: Percentage of households in three or four dimensions of deprivation in Harpurhey 40 Figure 37: Percentage of Harpurhey population with no qualifications 40 Figure 38: Terminations of pregnancy in Harpurhey 2007-2009 41 Figure 39: Age distribution of Cheetham population 43 Figure 40: Ethnicity of Cheetham 43 Figure 41: Religious diversity of Cheetham 44 Figure 42: Unemployment and economic inactivity in Cheetham 44 Figure 43: Percentage of households in three or four dimensions of deprivation in Cheetham 45 Figure 44: Percentage of Cheetham population with no qualifications 45 Figure 45: Terminations of pregnancy in Cheetham 2007-2009 46 Figure 46: Age distribution of Longsight population 48 Figure 47: Ethnicity of Longsight 48 Figure 48: Religious diversity of Longsight 49 Figure 49: Unemployment and economic inactivity in Longsight 49 Figure 50: Percentage of households in three or four dimensions of deprivation in Longsight 50 Figure 51: Percentage of Longsight population with no qualifications 50 Figure 52: Terminations of pregnancy in Longsight 2007-2009 51 Figure 53: Age distribution of Hulme population 53 Figure 54: Ethnicity of Harpurhey 53 Figure 55: Religious diversity of Hulme 54 Figure 56: Unemployment and economic inactivity in Hulme 54 Figure 57: Percentage of households in three or four dimensions of deprivation in Hulme 55 Figure 58: Percentage of Hulme population with no qualifications 55 Figure 59: Terminations of pregnancy in Hulme 2007-2009 56 Figure 60: Age distribution of Moss Side population 57 Figure 61: Ethnicity of Moss Side 57 Figure 62: Religious diversity of Moss Side 58 Figure 63: Unemployment and economic inactivity in Moss Side 58 Figure 64: Percentage of households in three or four dimensions of deprivation in Moss Side 59 Manchester BME Network Termination of pregnancy in Manchester: BME community engagement and consultation 4 Figure 65: Percentage of Moss Side households with no qualifications 59 Figure 66: Terminations of pregnancy in Moss Side 2007-2009 60 Figure 67: Experience of sexual health service 61 TABLES Table 1: Peak age for termination of pregnancy for different ethnic groups 31 Table 2: Number of terminations by Black/Black British women 32 Table 3: Number of terminations by Asian/Asian British women 32 Table 4: Number of terminations by Chinese, Mixed and Other White women 32 Table 5: Top two wards for each BME group 33 Table 6: Consultation 61 APPENDICES 1 Sexual health and contraception services i 2 Umbrella support groups in Manchester vi Manchester BME Network Termination of pregnancy in Manchester: BME community engagement and consultation 5 EXECUTIVE SUMMARY The Manchester BME (Black and Minority Ethnic) Network was commissioned by NHS Manchester to undertake community engagement and consultation with women from BME communities across the City. The consultation aimed to better understand the women’s sexual health needs, and to promote and increase access to sexual health and contraception services amongst BME communities.
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