M A Allaby1. 1. Department of Public Health Medicine, Northamptonshire Health Authority.
Abstract
OBJECTIVE: To determine whether the effectiveness of contraceptive services for teenagers is related to the balance of service provision between general practitioners and specialist family planning services. DESIGN: Cross sectional study with routinely collected data from family planning clinics and family health services authorities and published data on births and abortions. SETTING: Eight health districts in the former Oxford region. SUBJECTS: Girls aged under 16 and women aged 16-19 who attended a contraceptive service during 1991-2 or who gave birth or had an abortion during 1990-2. MAIN OUTCOME MEASURES: Attenders at family planning clinics as a percentage of all users of contraceptive services. The conception rate:uptake of contraceptive services ratio was used as a measure of effectiveness. RESULTS: In comparisons between districts the percentage of all users of contraceptive services who attended a clinic varied from 38% (95% confidence interval 28% to 48%) to 79% (72% to 86%) among 13-15 year olds and from 14% (12% to 15%) to 44% (42% to 46%) among women aged 16-19 years. The conception rate: uptake of contraceptive services ratio varied twofold in the older age group and more than threefold in the younger age group. It was lowest in districts where clinic attenders comprised a large percentage of all users of contraceptive services. CONCLUSION: Contraceptive services for teenagers may be more effective in districts where clinics play a large part in delivering the service, particularly for girls aged under 16.
OBJECTIVE: To determine whether the effectiveness of contraceptive services for teenagers is related to the balance of service provision between general practitioners and specialist family planning services. DESIGN: Cross sectional study with routinely collected data from family planning clinics and family health services authorities and published data on births and abortions. SETTING: Eight health districts in the former Oxford region. SUBJECTS:Girls aged under 16 and women aged 16-19 who attended a contraceptive service during 1991-2 or who gave birth or had an abortion during 1990-2. MAIN OUTCOME MEASURES: Attenders at family planning clinics as a percentage of all users of contraceptive services. The conception rate:uptake of contraceptive services ratio was used as a measure of effectiveness. RESULTS: In comparisons between districts the percentage of all users of contraceptive services who attended a clinic varied from 38% (95% confidence interval 28% to 48%) to 79% (72% to 86%) among 13-15 year olds and from 14% (12% to 15%) to 44% (42% to 46%) among women aged 16-19 years. The conception rate: uptake of contraceptive services ratio varied twofold in the older age group and more than threefold in the younger age group. It was lowest in districts where clinic attenders comprised a large percentage of all users of contraceptive services. CONCLUSION: Contraceptive services for teenagers may be more effective in districts where clinics play a large part in delivering the service, particularly for girls aged under 16.
Entities:
Keywords:
Adolescents; Adolescents, Female; Age Factors; Clinic Visits; Correlation Studies; Demographic Factors; Developed Countries; England; Europe; Family Planning; Family Planning Programs; Northern Europe; Organization And Administration; Population; Population Characteristics; Program Activities; Program Effectiveness; Program Evaluation; Programs; Research Methodology; Service Statistics; Statistical Studies; Studies; United Kingdom; Youth