Abstract
Objective(s)
This study examines the on-site availability of long-acting reversible contraception
(LARC) methods, defined here as intrauterine devices and contraceptive implants, at
Federally Qualified Health Centers (FQHCs). We also describe factors associated with
on-site availability and specific challenges and barriers to providing on-site access
to LARC as reported by FQHCs.
Study design
An original survey of 423 FQHC organizations was fielded in 2011.
Results
Over two thirds of FQHCs offer on-site availability of intrauterine devices yet only
36% of FQHCs report that they offer on-site contraceptive implants. Larger FQHCs and
FQHCs receiving Title X Family Planning program funding are more likely to provide
on-site access to LARC methods. Other organizational and patient characteristics are
associated with the on-site availability of LARC methods, though this relationship
varies by the type of method. The most commonly reported barriers to providing on-site
access to LARC methods are related to the cost of stocking or supplying the drug and/or
device, the perceived lack of staffing and training, and the unique needs of special
populations.
Conclusion
Our findings indicate that patients seeking care in small FQHC organizations, FQHCs
with limited dedicated family planning funding and FQHCs located in rural areas may
have fewer choices and limited access to LARC methods on-site.
Implications
Despite the presumed widespread coverage of contraceptives for women as a result of
provisions in the Affordable Care Act, there is a limited understanding of how FQHCs
may redesign their practices to provide on-site availability of LARC methods. This
study sheds light on the current state of practice and challenges related to providing
LARC methods in FQHC settings.
Keywords
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Article info
Publication history
Published online: October 03, 2013
Accepted:
September 24,
2013
Received in revised form:
September 24,
2013
Received:
April 29,
2013
Footnotes
☆Conflicts of Interest: The authors report no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
