Variation in Service Delivery Practices Among Clinics Providing Publicly Funded Family Planning Services in 2010


Rachel Benson Gold
Lori F. Frohwirth
Reproductive rights are under attack. Will you help us fight back with facts?

Key Points

Key Points

• Publicly funded family planning clinics provide critical contraceptive services and related preventive care to millions of poor and low-income women each year.

• Between 2003 and 2010, the proportion of these clinics offering relatively new contraceptive methods (such as Mirena IUDs, implants, patches, vaginal rings and extended-regime oral contraceptives) increased significantly.

• More than half of clinics (54%) reported offering clients at least 10 of 13 possible reversible contraceptive methods in 2010, an increase from 35% in 2003.

• Clinics with a reproductive health focus offer a greater range of contraceptive methods on-site than do those with a primary care focus: Some 67% and 41%, respectively, offer at least 10 methods, and 75% and 57% offer at least one long-acting reversible contraceptive (LARC)
method. Clinics with a reproductive health focus are also more likely than primary care–
focused clinics to have protocols that help clients initiate and continue using methods, including providing oral contraceptive supplies and refills on-site; using the “quick start” protocol for pill users; and allowing clients to delay pelvic exams.

• Clinics that receive at least some support through Title X provide more contraceptive methods, on average, and are much more likely to have dispensing protocols that enable clients to easily initiate and continue their method, compared with clinics that do not get Title X funding. For example, 86% of Title X–funded clinics provide oral contraceptive supplies and refills at the clinic, whereas only 39% of non-Title X–funded clinics do so. Their staff spend significantly more time with clients in the course of a visit and spend even more time with clients with special needs, such as adolescents, those with limited English proficiency and those presenting with complex medical or personal issues.

• Regardless of their service focus, clinics that receive Title X funds are more likely than those that do not to provide methods on-site or to have protocols making it easier for clients to initiate pill use.

• Clinics located in states that have expanded Medicaid coverage for family planning services are more likely to provide clients with a broad range of contraceptive choices and to have extended service hours than are clinics in states with no Medicaid expansion