Perspectives on Sexual and Reproductive health | |
U.S. Agencies Providing Publicly Funded Contraceptive Services in 1999 |
TABLE 1. Percentage distribution of agencies that provide publicly funded contraceptive care, by agency type; and percentage distribution of agencies, by selected characteristics, according to agency type, 1999 | ||||||
Characteristic | All | Community/migrant health center | Health department | Hospital | Planned Parenthood | Other |
(N=3,117) | (N=468) | (N=530) | (N=1,429) | (N=137) | (N=553) | |
Type of agency | 100 | 18 | 46 | 15 | 4 | 17 |
Reproductive health focus | ||||||
Yes | 56 | 8*** | 67 | 56 | 99*** | 62 |
No | 44 | 92 | 33 | 44 | 1 | 38 |
Receive Title X funding | ||||||
Yes | 61 | 23*** | 87 | 26*** | 82** | 55*** |
No | 39 | 77 | 13 | 74 | 18 | 45 |
% of clients who are contraceptive clients | ||||||
1-24 | 31 | 71*** | 21 | 37* | 1*** | 19 |
25-49 | 26 | 20** | 35 | 31 | 4*** | 13*** |
>=50 | 43 | 9*** | 44 | 33 | 95*** | 68*** |
Total | 100 | 100 | 100 | 100 | 100 | 100 |
*Different from proportion for health departments at p<.05. **Different from proportion for health departments at p<.01. ***Different from proportion for health departments at p<.001. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. Note: Ns are weighted. |
TABLE 2. Percentage of family planning agencies offering various contraceptive methods, and mean number of methods offered, by agency type, reproductive health focus and Title X funding | ||||||||||
Method | All agencies | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrant health center | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
Oral contraceptive | 99 | 97 | 100 | 100 | 100 | 99 | 99 | 99 | 100 | 98 |
Injectable | 98 | 97 | 98 | 99 | 100* | 98 | 98 | 99 | 99 | 97 |
Male condom | 94 | 88** | 100 | 85*** | 99 | 94* | 96 | 93 | 99 | 88*** |
Spermicide | 89 | 73*** | 95 | 88 | 97 | 86* | 92 | 84** | 96 | 78*** |
Diaphragm | 87 | 71*** | 90 | 92 | 100*** | 86 | 92 | 79*** | 90 | 81** |
Emergency contraception | 80 | 69 | 78 | 87* | 100*** | 84 | 84 | 74** | 84 | 73** |
Natural family planning | 79 | 78 | 83 | 76 | 80 | 75 | 80 | 78 | 83 | 73* |
Female condom | 55 | 56 | 47 | 64* | 86*** | 61* | 58 | 52 | 56 | 55 |
IUD | 51 | 45 | 42 | 79*** | 97*** | 49 | 56 | 45* | 52 | 50 |
Implant | 47 | 41 | 43 | 64** | 88*** | 38 | 50 | 44 | 52 | 40** |
Cervical cap | 30 | 26 | 20 | 42** | 69*** | 37** | 32 | 26 | 30 | 28 |
Tubal sterilization | 25 | 31*** | 10 | 71*** | 17 | 17 | 24 | 26 | 17 | 36*** |
Vasectomy | 24 | 25 | 22 | 36 | 39** | 17 | 21 | 28 | 24 | 24 |
Mean no. offered | 8.5 | 7.9 | 8.2 | 9.7*** | 10.7*** | 8.4 | 8.8 | 8.2** | 8.8 | 8.2** |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. |
TABLE 3. Percentage of agencies following specific policies or procedures for providing various contraceptive methods, by type of agency, reproductive health focus and receipt of Title X funding | ||||||||||
Policy or procedure | All agencies | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrang health center | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
Pill | ||||||||||
Provide at clinic | 74 | 51*** | 92 | 29*** | 99*** | 81* | 81 | 65*** | 90 | 49*** |
Provide prescription only | 14 | 29*** | 4 | 36*** | 0*** | 12 | 10 | 20** | 4 | 30*** |
Provide initial supply, prescription for later cycles | 12 | 20*** | 3 | 35*** | 1 | 8 | 9 | 14 | 6 | 21*** |
Emergency contraceptive pill | ||||||||||
Provide at clinic | 81 | 54*** | 92 | 54*** | 100*** | 95 | 86 | 74** | 92 | 61*** |
Do not require complete visit before providing to a new client | 56 | 38** | 60 | 41* | 86*** | 64 | 62 | 47** | 64 | 41*** |
Provide/prescribe ahead of time | 21 | 24* | 8 | 22* | 83*** | 27** | 22 | 18 | 19 | 23 |
Prescribe over the phone | 16 | 23** | 3 | 38*** | 38*** | 15** | 15 | 18 | 11 | 26*** |
Pill/injectable follow-up | ||||||||||
Remind client of next visit | 58 | 50* | 63 | 58 | 39*** | 59 | 59 | 57 | 59 | 56 |
Contact client if a visit is missed | 53 | 69** | 49 | 55 | 24*** | 53 | 45 | 63*** | 50 | 58 |
Permit pelvic exam to be delayed for method provision | ||||||||||
Pill | 56 | 43** | 63 | 36*** | 88*** | 59 | 61 | 49** | 65 | 41*** |
Injectable | 42 | 39 | 43 | 33 | 72*** | 45 | 42 | 43 | 47 | 36* |
Implant | 23 | 27 | 21 | 21 | 34* | 20 | 18 | 29* | 22 | 24 |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. Note: Percentages are based on agencies that provide each method. |
TABLE 4. Percentage of agencies that provide various STD services, by STD | |||||
STD | Screening | Testing | Treatment | ||
Total | Routine | High-risk clients only | |||
Any | 99 | 85 | 72 | 99 | 98 |
Chlamydia | 99 | 73 | 26 | 89 | 98 |
Gonorrhea | 97 | 72 | 26 | 90 | 96 |
Syphilis | 88 | 44 | 44 | 88 | 85 |
HIV | 87 | 32 | 55 | 85 | 35 |
Urinary tract infection | 75 | 42 | 33 | 80 | 76 |
Human papillomavirus | 67 | 38 | 29 | 66 | 66 |
Herpes | 60 | 23 | 37 | 72 | 69 |
Agencies supplied their own definition of high risk. |
TABLE 5. Percentage of agencies offering various noncontraceptive services, by agency type, reproductive health focus and receipt of Title X funding | ||||||||||
Service | All | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrant health centers | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
Perinatal/pediatric care | 89 | 98 | 96 | 98 | 47*** | 65*** | 84 | 97*** | 89 | 90 |
Immunizations | 78 | 95 | 95 | 69*** | 6*** | 43*** | 67 | 92*** | 78 | 79 |
Well-baby care | 66 | 94*** | 70 | 68 | 3*** | 39*** | 50 | 86*** | 61 | 73** |
Postpartum care | 62 | 79*** | 53 | 91*** | 43 | 49 | 55 | 71*** | 56 | 72*** |
Prenatal care | 56 | 78*** | 47 | 85*** | 33** | 37 | 48 | 66*** | 49 | 67*** |
Genetic counseling | 20 | 12 | 18 | 54*** | 3*** | 12 | 26 | 14*** | 21 | 20 |
Infertility | 51 | 53 | 44 | 72*** | 43 | 49 | 53 | 48 | 51 | 51 |
Counseling | 51 | 52 | 44 | 72*** | 43 | 49 | 53 | 48 | 50 | 51 |
Treatment | 17 | 23*** | 2 | 64*** | 10** | 10** | 15 | 19 | 11 | 26*** |
Gynecologic care | 53 | 68*** | 34 | 87*** | 86*** | 48* | 49 | 57 | 47 | 62*** |
Colposcopy | 44 | 60*** | 24 | 80*** | 85*** | 39** | 39 | 49* | 38 | 53*** |
Mammography | 26 | 32** | 14 | 68*** | 4** | 20 | 25 | 26 | 18 | 38*** |
General health | 95 | 98 | 95 | 97 | 87* | 95 | 93 | 98* | 94 | 97 |
Nutrition counseling | 84 | 85 | 88 | 92 | 40*** | 76* | 80 | 89** | 83 | 85 |
Midlife women's health | 61 | 76*** | 45 | 78*** | 85*** | 69*** | 55 | 70*** | 54 | 72*** |
Sports/work physicals | 58 | 95*** | 34 | 78*** | 40 | 68*** | 44 | 75*** | 45 | 78*** |
Primary health care | 53 | 97*** | 27 | 83*** | 17* | 60*** | 35 | 76*** | 38 | 77*** |
Smoking cessation | 53 | 65** | 48 | 78*** | 27*** | 40 | 46 | 62*** | 48 | 62** |
Mental health | 28 | 54*** | 8 | 58*** | 5 | 33*** | 15 | 44*** | 16 | 46*** |
Abortion | 12 | 8** | 0 | 44*** | 56*** | 8** | 14 | 8* | 9 | 16* |
Surgical | 9 | 4* | 0 | 31*** | 56*** | 8** | 13 | 5*** | 8 | 11 |
Medical | 9 | 7** | 0 | 37*** | 27*** | 6* | 11 | 6 | 7 | 12* |
Other | 86 | 87* | 96 | 90 | 27*** | 72*** | 83 | 90* | 86 | 86 |
Case management | 70 | 79 | 71 | 86** | 26*** | 59* | 64 | 78*** | 67 | 75* |
WIC program | 66 | 58*** | 91 | 47*** | 5*** | 38*** | 65 | 66 | 75 | 52*** |
Day care | 7 | 9 | 4 | 14* | 0*** | 9 | 7 | 7 | 7 | 7 |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. Note: WIC=the Special Supplemental Food Program for Women, Infants and Children. |
TABLE 6. Percentage of agencies that receive various types of funding to support contraceptive services, and mean number of funding sources reported, by agency type, reproductive health focus and receipt of Title X funding | ||||||||||
Funding source | All agencies | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrant health center | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
Medicaid | 82 | 90* | 81 | 89 | 93** | 67* | 80 | 84 | 85 | 77 |
Title X | 61 | 23*** | 87 | 26*** | 82** | 55*** | 74 | 44*** | 100 | 0*** |
Maternal and child health block grant | 37 | 18*** | 50 | 25*** | 27*** | 34** | 43 | 29** | 43 | 26*** |
Social services block grant | 18 | 11 | 16 | 17 | 38*** | 23 | 25 | 9*** | 24 | 8*** |
State Children's Health Insurance Program | 17 | 34*** | 11 | 31** | 6 | 6 | 11 | 25*** | 12 | 24** |
Community/migrant health funding | 14 | 64*** | 5 | 8 | 2 | 0*** | 4 | 27*** | 7 | 26*** |
Temporary Assistance for Needy Families | 12 | 14 | 12 | 11 | 12 | 8 | 12 | 11 | 13 | 9 |
Other federal | 7 | 12 | 4 | 3 | 6 | 11 | 5 | 8 | 4 | 10* |
Other state | 25 | 16 | 19 | 21 | 31* | 50*** | 26 | 23 | 21 | 32** |
Local | 42 | 13*** | 59 | 28*** | 43** | 33*** | 47 | 35** | 49 | 30*** |
Client fees | 85 | 85 | 89 | 71** | 98*** | 83 | 89 | 80* | 89 | 79** |
Private insurance | 58 | 87*** | 40 | 78*** | 77*** | 58** | 54 | 64* | 52 | 69*** |
Private contributions | 32 | 28 | 21 | 26 | 96*** | 54*** | 37 | 26** | 33 | 30 |
Mean no. of sources | 4.9 | 5.0 | 4.9 | 4.3* | 6.1*** | 4.8 | 5.1 | 4.7* | 5.3 | 4.2*** |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. |
TABLE 7. Percentage distribution of clients, by payment category, according to agency type, reproductive health focus and receipt of Title X funding | ||||||||||
Payment category | All | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrant health center | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
Medicaid | 25 | 40*** | 22 | 47*** | 18 | 16** | 22 | 35** | 20 | 41*** |
Reduced/no fee | 57 | 44*** | 66 | 33*** | 55*** | 71 | 58 | 49* | 63 | 34*** |
Full-price | 19 | 16 | 12 | 20* | 28*** | 14 | 19 | 16 | 17 | 25* |
Total | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 100 |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. |
TABLE 8. Mean fees charged for various contraceptive services, by client's income level, according to agency type, reproductive health focus and receipt of Title X funding | ||||||||||
Client's income | All agencies | Type of agency | Reproductive health focus | Title X funding | ||||||
Community/migrant health center | Health department | Hospital | Planned Parenthood | Other | Yes | No | Yes | No | ||
75% of poverty | ||||||||||
First visit | $36 (2-178) | $23 | $29 | $62*** | $42* | $32 | $46 | $28** | $36 | $36 |
Three-month pill supply | 20 (2-75) | 17 | 15 | 34* | 31*** | 20* | 20 | 19 | 18 | 21 |
Injectable | 36 (3-200) | 32 | 24 | 54*** | 41*** | 34** | 39 | 33 | 29 | 39* |
Implant insertion | 321 (3-1,001) | 165 | 132 | 494*** | 372*** | 387*** | 381 | 267 | 283 | 354 |
275% of poverty | ||||||||||
First visit | 79 (10-360) | 77 | 81 | 94 | 76 | 68** | 82 | 75 | 80 | 78 |
Three month pill supply | 30 (2-133) | 32 | 26 | 28 | 43*** | 34** | 31 | 26* | 30 | 30 |
Injectable | 46 (5-200) | 42 | 45 | 55 | 53** | 44 | 49 | 40*** | 46 | 45 |
Implant insertion | 514 (10-1,001) | 364* | 587 | 510 | 484 | 452 | 509 | 523 | 425 | 734* |
*p<.05. **p<.01. ***p<.001. Significance levels refer to difference between the specified proportion and the proportion for health departments. Refers to Title X funding of contraceptive services at one or more of an agency's clinic sites. Notes: Numbers in parentheses represent the range of fees reported. Between 66% and 76% of agencies reported charging no fee for providing these services to women at 75% of poverty; 5-12% do not charge women at 275% of poverty. Means are based on those that do charge a fee. |
© copyright 2002, The Alan Guttmacher Institute. |