Jennifer Hulme1, Sheila Dunn2, Edith Guilbert3, Judith Soon4, Wendy Norman5. 1. Resident Physician, McGill University, Montreal, QC. 2. Clinician Researcher and Associate Professor, Department of Family and Community Medicine, University of Toronto, Toronto, ON. 3. Senior Medical Advisor, National Institute of Public Health of Quebec, Clinical Professor, Department of Obstetrics and Gynaecology, Laval University, Québec, QC. 4. Assistant Professor, UBC Faculty of Pharmaceutical Sciences, Director, Community Pharmacist Research Network, University of British Columbia, Vancouver, BC. 5. Assistant Professor, Department of Family Practice and Midwifery, University of British Columbia, Vancouver, BC.
Abstract
BACKGROUND: Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. METHODS: Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. RESULTS: Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. CONCLUSION: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada.
BACKGROUND: Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. METHODS: Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. RESULTS: Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. CONCLUSION: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada.
Authors: I K Warriner; O Meirik; M Hoffman; C Morroni; J Harries; N T My Huong; N D Vy; A H Seuc Journal: Lancet Date: 2006-12-02 Impact factor: 79.321
Authors: Wendy V Norman; Sarah Munro; Melissa Brooks; Courtney Devane; Edith Guilbert; Regina Renner; Tamil Kendall; Judith A Soon; Ashley Waddington; Marie-Soleil Wagner; Sheila Dunn Journal: BMJ Open Date: 2019-04-20 Impact factor: 2.692
Authors: Asiya Patel; Jennifer Dean; Sara Edge; Kathi Wilson; Effat Ghassemi Journal: Int J Environ Res Public Health Date: 2019-02-26 Impact factor: 3.390
Authors: Roopan Gill; Gina Ogilvie; Wendy V Norman; Brian Fitzsimmons; Ciana Maher; Regina Renner Journal: J Med Internet Res Date: 2019-05-29 Impact factor: 5.428
Authors: Courtney Devane; Regina M Renner; Sarah Munro; Édith Guilbert; Sheila Dunn; Marie-Soleil Wagner; Wendy V Norman Journal: Pilot Feasibility Stud Date: 2019-11-08