Abstract
ObjectivesThe aim of this study was to identify key challenges and opportunities to better support non-clinician clinic staff at family planning centers in Southern US states.MethodsWe conducted qualitative interviews with 15 individuals in clinic staff and leadership positions at family planning centers in seven Southern states.ResultsTurnover had negative impacts on both clinic functioning as well as patient care. Participants identified several challenges related to recruitment and retention in family planning health centers in the South, including the conservative contextual landscape, the perceived value of support staff, gaps in communication, and rural locations. In response to these challenges, staff also identified key strategies to better support and retain health center workers. These included prioritizing investment in management, creating career advancement opportunities, prioritizing staff retention, and creating space for self-care. Health center staff and leadership who used these strategies to support and retain staff noted improvements in the effectiveness of staff work as well as increases in patient volume.Conclusions for PracticeStudy findings provide key areas for intervention including providing development opportunities, commitment from leadership to recognize and invest in staff and supporting self-care. Focusing on ensuring internal organizational justice for staff may also facilitate resilience to external challenging environments. Better supporting clinic staff is likely also important for quality services and ensures the full workforce involved in providing family planning care can work at full capacity.
Highlights
Access to quality family planning (FP) care, including abortion, is critical to sexual and reproductive health (SRH) and maternal health outcomes (Espey et al, 2019)
Respondents emphasized that support staff were essential in maintaining the accessibility and quality of services at their clinics
Similar to other studies of abortion providers, we found that FP staff were subject to stigma as well as high levels of stress, which can contribute to turnover as well as challenges in recruitment (Martin et al, 2014; O’Donnell et al, 2007)
Summary
Access to quality family planning (FP) care, including abortion, is critical to sexual and reproductive health (SRH) and maternal health outcomes (Espey et al, 2019). Clinical support staff often have the most interaction with patients and yet are frequently left out of conversations regarding sustaining and expanding access to healthcare. Sustaining these staff are especially important in FP and abortion care, as these fields have been identified as the most challenging to staff in the conservative south and should be a larger part of conversations around sustaining and expanding access to these crucial services (Joffe, 2014; McLemore et al, 2015; Mercier et al, 2016). Individuals frequently choose to receive services at specialized FP clinics for example, because of access to confidential care, respectful, and knowledgeable staff (Frost et al, 2012b)
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