'A snapshot of services'. Access, standardisation, education: Ministry of Health community clinics, South Tarawa, Kiribati.

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Background: Maternal health care, and sexual and reproductive services are high priorities in the Kiribati Ministry of Health Plan and key targets areas in the Sustainable Development Goals. They are fundamental to reducing unsafe abortion, maternal and perinatal mortality, and improving social, financial and physical wellbeing. This review was conducted to determine strengths and gaps of sexual and reproductive health services across the 14 community clinics in South Tarawa, Kiribati. Methods: An investigative approach using a questionnaire and an audit of basic resources, information and equipment was carried out in each of the 14 clinics over a 5-day period. Findings: This review found specific areas for improvement are required across the 14 clinics if the key targets of the SDGs are to be met. Specifically, these are access, standardisation and education. Clinics are impacted by the availability of contraceptive commodities and staff characteristics. There was reduced access to cervical screening. Equipment was not standard in all clinics affecting safety, services and quality of care. There was a lack of standardized care evident in differences in numbers of antenatal visits, tetanus toxoid immunisation and scanning frequency in pregnancy. Staff identified areas for further education and training. Conclusion: Despite challenges and limitations, community clinic staff demonstrated commitment in serving their communities to provide primary health care services. Recommendations include ensuring all frontline staff were knowledgeable, confident, and skilled to improve the quality of services. Improvements to maternal, sexual and reproductive health are likely to increase access, safety, and health outcomes for women and their families.