A new nationally representative survey shows that the national network of publicly funded family planning clinics—which helps millions of women avoid unintended pregnancies and plan the timing of wanted pregnancies—gives women vital access to contraceptive and other preventive care, according to "Variation in Service Delivery Practices Among Clinics Providing Publicly Funded Family Planning Services in 2010," by Jennifer Frost et al. More than half of publicly funded clinics (54%) reported offering their clients at least 10 of 13 reversible contraceptive methods in 2010, an increase from 35% in 2003. Many offer on-site provision of the most widely used contraceptives and have implemented protocols to make it easier for women to initiate and continue use of their chosen method.
"Publicly funded family planning clinics play a critical role in providing millions of women basic sexual and reproductive health services," says lead author Jennifer Frost. "This care allows women and couples to avoid unintended pregnancies, plan their families and obtain a wide range of preventive care services that protect their health and well-being."
In addition to contraceptive services, publicly funded family planning clinics reported providing other important health care, including pregnancy testing (99%), STI testing (97%) and treatment (95%), HIV testing (92%) and cervical cancer screening (83%). In order to meet women's need for high-quality care, clinics have striven to incorporate the latest screening and testing technologies into their practices, and this study documents improvements in that area since 2003. However, the study also found that many clinics are struggling to meet clients' needs. For example, nearly six in 10 clinics reported that they have trouble stocking the full range of contraceptive methods because of cost, and many clinics have been unable to integrate the most advanced cervical cancer and HIV screening methods into their practices.
The study also examined variation in service provision among clinics and found that clinics receiving some funding from the federal Title X family planning program—half of clinics, which serve two-thirds of contraceptive clients receiving care from the clinic network—do more to meet women's need for contraceptive services than do other clinics. Compared with other clinics, Title X–funded clinics tend to provide more contraceptive methods and are more likely to have protocols in place that enable their clients to easily initiate and continue use of their chosen contraceptive method. Additionally, staff at these clinics spend more time with individual clients, especially those who have special needs because they are adolescents, have limited English proficiency, or have complex medical or personal circumstances.
The study found a similar variation between clinics that specialize in the provision of contraceptive and reproductive health services and those that provide family planning in the context of comprehensive primary care. Compared with primary care facilities, specialized clinics provide a wider range of methods—including highly effective long-acting reversible contraceptives—and are more likely to offer methods on-site, rather than requiring women to make a second trip to a pharmacy to obtain the method they choose. This suggests that for some women, access to specialized family planning clinics may be key to successfully initiating and continuing to use contraceptives.
For more information on services provided in sites that receive Title X funding, see "Going the Extra Mile: The Difference Title X Makes," by Rachel Benson Gold, in the current issue of the Guttmacher Policy Review.
Click here for the newly updated Facts on Publicly Funded Contraceptive Services in the United States.