Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA.
J Rural Health. 2022 Jun;38(3):639-649. doi: 10.1111/jrh.12612. Epub 2021 Aug 6.
Access to the full range of contraceptive options is essential to providing patient-centered reproductive health care. Women living in rural areas often experience more barriers to contraceptive care than women living in urban areas. Therefore, federally funded family planning clinics are important for ensuring women have access to contraceptive care, especially in rural areas. This study examines contraceptive provision, factors supporting contraceptive provision, and contraceptive utilization among federally funded family planning clinics in 2 Southern states.
All health department and Federally Qualified Health Center clinics in Alabama and South Carolina that offer contraceptive services were surveyed in 2017-2018. Based on these surveys, we examined differences between rural and urban clinics in the following areas: clinic characteristics, services offered, staffing, staff training, policies, patient characteristics, contraceptive provision, and contraceptive utilization. Differences were assessed using Chi-square tests of independence for categorical variables and independent t-tests for continuous variables.
Urban clinics had more staff on average than rural clinics, but rural clinics reported greater ease in recruiting and retaining family planning providers. Patient characteristics did not significantly vary between rural and urban clinics. While no significant differences were observed in the provision of long-acting reversible contraceptives (LARCs) overall, a greater proportion of patients in urban clinics utilized LARCs.
While provision of most contraceptives is similar between rural and urban federally funded family planning clinics, important differences in other factors continue to result in women who receive care in rural clinics being less likely to choose LARC methods.
获得全面的避孕选择对于提供以患者为中心的生殖健康护理至关重要。与居住在城市地区的女性相比，居住在农村地区的女性在获得避孕护理方面往往面临更多的障碍。因此，联邦政府资助的计划生育诊所对于确保女性获得避孕护理非常重要，尤其是在农村地区。本研究考察了南方两个州的联邦政府资助计划生育诊所的避孕提供、支持避孕提供的因素以及避孕利用情况。
2017 年至 2018 年，对阿拉巴马州和南卡罗来纳州提供避孕服务的所有卫生部门和联邦合格医疗中心诊所进行了调查。基于这些调查，我们考察了农村和城市诊所在以下方面的差异：诊所特征、提供的服务、人员配备、人员培训、政策、患者特征、避孕提供和避孕利用。使用卡方检验和独立 t 检验评估了农村和城市诊所之间的差异。
城市诊所的平均员工人数多于农村诊所，但农村诊所报告称在招聘和留住计划生育提供者方面更容易。农村和城市诊所的患者特征没有显著差异。虽然长效可逆避孕措施（LARC）的总体提供情况没有显著差异，但城市诊所的更多患者使用了 LARC。
虽然农村和城市联邦政府资助的计划生育诊所提供的大多数避孕措施相似，但其他因素的重要差异仍导致在农村诊所接受护理的女性不太可能选择 LARC 方法。
