C Junda Woo1, Hasanat Alamgir2, Joseph E Potter3. 1. University of Texas School of Public Health, San Antonio Regional Campus, TX, USA. Electronic address: junda.woo@sanantonio.gov. 2. University of Texas School of Public Health, San Antonio Regional Campus, TX, USA. 3. Population Research Center, University of Texas at Austin, TX, USA.
Abstract
OBJECTIVE: We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. STUDY DESIGN: We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). RESULTS: (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. CONCLUSIONS: Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. IMPLICATIONS: Requiring low-income family planning patients to switch healthcare providers has adverse consequences.
OBJECTIVE: We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. STUDY DESIGN: We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). RESULTS: (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. CONCLUSIONS: Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. IMPLICATIONS: Requiring low-income family planning patients to switch healthcare providers has adverse consequences.
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