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Implementation & Accountability

Reduce Teen and Unplanned Pregnancy

Implementation & Accountability


Because of the significant variety among proven interventions, states and communities have leeway to find programs that suit local values, opportunities, and budgets. [1] The key is to select strategies that have documented effectiveness, assure that they are implemented well, and recognize the critical importance of a strong commitment to continuous program improvement.

  • Match expectations with sufficient resources. Be clear about the goals, purpose and target audience for specific programs. Provide sufficient resources to ensure fidelity to the evidence-based model, or modify expectations to accommodate variances.
  • Pay careful attention to the quality of implementation when effective model programs are taken to scale.
  • Provide sufficient investment to support monitoring and technical assistance processes over time. 
  • Support local capacity. Provide technical assistance, monitoring and oversight to local programs and agencies. Create opportunities for local-to-local communication, best-practices sharing, and local input on state policy decisions.
  • Support ongoing evaluation and continuous program improvement.

The Louisiana Adolescent Health Initiative (AHI) facilitates and coordinates a multi-disciplinary approach to adolescent health care, disease prevention and health promotion in the state. AHI serves as a repository of adolescent information in Louisiana, and assists local communities to identify needs and potential resources, prioritize problems, develop solutions and evaluate impact. AHI also coordinates and collaborates with internal and external agencies to infuse adolescent voices into statewide planning and policy-making efforts. Collaborative bodies include a steering committee, a Family Planning Advisory Board, a Teen Pregnancy Prevention Task Force, and a youth leadership team.


[1] Suellentrop, K (2010). What Works 2010: Curriculum-Based Programs That Help Prevent Teen Pregnancy. The National Campaign to Prevent Teen and Unplanned Pregnancy: Washington, DC.


Reducing teen and unplanned pregnancies requires investment and action by a range of stakeholders at the state and community levels. State leadership is necessary to build consensus for a coordinated strategic effort, and to ensure accountability for results among all stakeholders. Prevention programs alone cannot be expected to impact outcomes on a broad scale. Success depends on a combination of programs and the broader efforts of parents, families, faith communities, and the media to influence social norms, values, and popular culture.

  • Set clear goals and objectives. Establish targets for reducing teen and unplanned pregnancies, and identify critical legislative, budgetary, regulatory, and programmatic actions that will support achievement of the targets.
  • Build on existing efforts. Be aware that federal block grant agreements, such as the Maternal and Child Health block grant, require states to establish goals related to teen and/or unplanned pregnancy. Likewise, independent local efforts may be underway that offer important lessons and leadership for a statewide effort. Find out what these are and incorporate them into the state plan. 
  • Promote collaboration and assign responsibility for outcomes based on the appropriate roles, resources and capacity of public and private stakeholders; including parents and youth. 
  • Hold programs accountable for achieving realistic outcomes that are based on evidence. Match expectations with sufficient resources to achieve results.
  • Measure and report progress to stakeholders and the public.

Michigan held a public event to highlight progress toward implementing the Governor’s Blue Print to Prevent Unintended Pregnancies. The state surgeon general joined community members and stakeholders to report success in securing a Medicaid waiver to expand access to family planning services, engaging parents through a pilot educational program, and establishing a provider task force to develop guidelines for medical providers on counseling women about family planning.

The Massachusetts Executive Office of Health and Human Services (EOHHS) launched EHSResults in 2007 to foster transparency, accountability, and cross-agency collaboration throughout the Secretariat. EHSResults identifies strategic goals, provides performance information for better internal decision making, and shares progress with the public. One objective is to educate youth about teen pregnancy, which aligns to goals for promoting positive youth development and building safe communities. 


The New Mexico Children’s Cabinet issues an annual progress report toward five child outcomes: healthy, educated, safe, supported and involved. The report includes the rate of live births among teens ages 15-17 per 1,000 population as an indicator for healthy outcomes. Budget data is presented by outcome area, state agency, and program/service to show how state and federal funding is aligned to the Cabinet’s goals.

A checklist of questions to ask in order to improve accountability and monitoring.

A checklist of questions to ask in order to increase the likelihood of successful implementation.