Contraceptive services for teenagers: do we need family planning clinics?

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.