Debora Goetz Goldberg1, Susan F Wood2, Kay Johnson3, Katherine Holly Mead2, Tishra Beeson4, Julie Lewis5, Sara Rosenbaum6. 1. Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC. Electronic address: goetzdc@gwu.edu. 2. Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC. 3. Johnson Group Consulting, Inc., Hinesburg, Vermont. 4. Public Health, Department of Physical Education, School, and Public Health, Central Washington University, Ellensburg, Washington. 5. National Family Planning and Reproductive Association, Washington, DC. 6. Department of Health Policy, George Washington University, Washington, DC.
Abstract
BACKGROUND: Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services. METHODS: This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning. FINDINGS: Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services. MAJOR CHALLENGES: Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center. CONCLUSIONS: Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care.
BACKGROUND: Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services. METHODS: This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning. FINDINGS: Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services. MAJOR CHALLENGES: Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center. CONCLUSIONS: Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care.
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