Accessibility of Family Planning Services: Impact of Structural and Organizational Factors
- 373 Downloads
Objectives: This study sought to determine whether selected structural and organizational characteristics of publicly available family planning facilities are associated with greater availability.
Methods: A survey was sent to 726 publicly available family planning facilities in four states. These included local health departments, federally qualified health centers (FQHC), Planned Parenthood sites, hospital outpatient departments, and freestanding women’s health centers. Usable responses were obtained from 526 sites for a response rate of 72.5%. Availability variables included the provision of primary care services; the contraceptives offered; professional staffing; scheduling, waiting time, and transportation; and cultural congruence and competency. The structural and organizational variables were state, type of organization, and funding source.
Results: Some states were more likely to offer emergency contraception while others were more likely to have weekend hours. FQHCs were most likely to provide primary care and Planned Parenthood sites most likely to offer emergency contraception. Title X funding was associated with increased likelihood of providing emergency contraception and staffing by midlevel practitioners and registered nurses.
Conclusions: This study found that availability varied by structural and organizational variables, many of which are determined by federal and state policies. Revising some of these policies might increase utilization of family planning facilities.
KeywordsFamily planning Unintended births Teenage births Community health centers Title X
This research was funded by the Centers for Disease Control and Prevention, MM-0606-03/03. The authors wish to thank the officials and staffs in the four states whose collaboration made this study possible: Alabama, Ohio, Oklahoma, and Washington. They also wish to acknowledge the assistance of Marie-Claire Rosenberg in conducting the facilities survey.
- 1.Institute of Medicine. Access to Health Care in America. Washington, DC, National Academy Press, 1993.Google Scholar
- 2.Goodman DC, Klerman LV, Johnson KA, Chang C, Marth N. Geographic Access to Family Planning Facilities and the Risk of Unintended and Teenage Pregnancy. Matern Child Health J. (refernce to be filled in)Google Scholar
- 3.Cutright P, Jaffee FS, Impact of Family Planning Programs on Fertility: The U.S. Experience. New York, NY, Praeger Publishers, 1977.Google Scholar
- 6.Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J. Fertility, Family Planning, and Reproductive Health of U.S. Women: Data from the 2002 National Survey of Family Growth. Hyattsville, MD, National Center for Health Statistics, 2005.Google Scholar
- 9.Sonenstein FL, Punia S, Scarcella CA. Future Directions for Family Planning Research: A Framework for Title X Family Planning Service Delivery Improvement Research. Washington, DC, Urban Institute, 2004.Google Scholar
- 10.Gold RB. Doing More for Less: Study Says State Medicaid Family Planning Expansions are Cost-Effective. The Guttmacher Report on Public Policy 2004:7.Google Scholar
- 12.McFarlane DR, Meier KJ. The Politics of Fertility Control. New York, NY, Seven Bridges Press, 2001.Google Scholar
- 13.Johnson KA, Posner, SF, Biermann J, Cordero J, Atrash HK, Parker CS, Boulet S, Curtis MG. Recommendations to Improve Preconception Health and Health Care—United States. A Report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55: No. RR-6.Google Scholar
- 14.Henry J. Kaiser Family Foundation and Alan Guttmacher Institute. Medicaid: A Critical Source of Support for Family Planning in the United States. Issue Brief, April 2005.Google Scholar
- 15.Alan Guttmacher Institute. Insurance Coverage of Contraceptives. State Policies in Brief. February 14, 2006. Accesses at: http:/www.guttmacher.org/statecenter/spibs/February 28, 2006.Google Scholar
- 16.Abma J, Chandra A, Mosher W, Peterson L, Piccinino L. Fertility, Family Planning, and Women’s Health: New Data from the 1995 National Survey of Family Growth. Hyattsville, MD, National Center for Health Statistics, 1997.Google Scholar