Family Planning Clinic Clients Research Articles

Utilization of Family Planning Services in Karnali Academy of Health Science, Jumla

Introduction: Family planning is an integral part of maternal health as its uptake is a significant factor in the reduction of maternal mortality and in ensuring positive child health outcomes specially in developing countries, however, its usage remains low.
 Objectives: To describe prevalence and pattern of contraceptive use, among women accessing family planning facilities.
 Study design: A retrospective review of hospital records of family planning clinic clients at the teaching hospital was conducted.
 Results: Total 2811 clients accepted a family planning service during the period. Contraceptive prevalence rate was 21%. Modal age group of clients (81%) was below 20 years old. Injection Depo was the most common method (69%) and implant was less used method (8%) among the temporary method of family planning.
 Conclusion: There is an identified need for promotion of uptake of family planning methods. Involvement of young women, uneducated women and men in contraception counseling and services is essential to improve its uptake and continuity.

Specialized Family Planning Clinics in the United States: Why Women Choose Them and Their Role in Meeting Women's Health Care Needs

BackgroundPublicly funded family planning clinics provide contraceptive care to millions of poor and low-income women every year. To inform the design of services that will best meet the contraceptive and reproductive health needs of women, we conducted a targeted survey of family planning clinic clients, asking women about services received in the past year and about their reasons for visiting a specialized family planning clinic. MethodsWe surveyed 2,094 women receiving services from 22 family planning clinics in 13 states; all sites included in the survey were clinics that specialize in contraceptive and reproductive health services and were located in communities with comprehensive primary care providers. ResultsSix in 10 (59%) respondents had made a health care visit to another provider in the past year, but chose the family planning clinic for contraceptive care. Four in 10 (41%) respondents relied on the family planning clinic as their only recent source for health care. The four most common reasons for choosing a specialized family planning clinic, reported by at least 80% of respondents, were respectful staff, confidential care, free or low-cost services, and staff who are knowledgeable about women's health. ConclusionsSpecialized family planning clinics play an important role as part of the health care safety net in the United States. Collaborations between such clinics and comprehensive primary care providers, such as federally qualified health centers, may be one model for ensuring women on-going access to the full range of care they need.

139. Partner Violence and Care-Seeking Patterns Among Female Family Planning Clinic Clients

Physical and sexual violence from an intimate partner (IPV) is common among female family planning clinic clients and associated with higher health care service utilization. We surveyed such clients to examine the associations of lifetime and recent IPV with care-seeking patterns in order to identify patterns that indicate greater IPV risk.

O3-S3.06 Rescreening for chlamydial infection using home-based, self-obtained vaginal swabs: a randomised controlled trial in family planning clinic clients

BackgroundFamily planning clinics provide contraceptive and preventive services for millions of low-income individuals. Screening and treatment for Chlamydia trachomatis infection in these clinics is a major part of the chlamydia...

Linking family planning with HIV/AIDS interventions: a systematic review of the evidence

To conduct a systematic review of the literature and examine the effectiveness, optimal circumstances, and best practices for strengthening linkages between family planning and HIV interventions. Systematic review of peer-reviewed articles and unpublished program reports ('promising practices') evaluating interventions linking family planning and HIV services. Articles were included if they reported post-intervention evaluation results from an intervention linking family planning and HIV services between 1990 and 2007. Systematic methods were used for searching, screening, and data extraction. Quality assessment was conducted using a 9-point rigor scale. Sixteen studies were included in the analysis (10 peer-reviewed studies and six promising practices). Interventions were categorized into six types: family planning services provided to HIV voluntary counseling and testing (VCT) clients, family planning and VCT services provided to maternal and child health clients, family planning services provided to people living with HIV, community health workers provided family planning and HIV services, VCT provided to family planning clinic clients, and VCT and family planning services provided to women receiving postabortion care. Average study design rigor was low (3.25 out of 9). Most studies reported generally positive or mixed results for key outcomes; no negative results were reported. Interventions linking family planning and HIV services were generally considered feasible and effective, though overall evaluation rigor was low.

Services for men at publicly funded family planning agencies, 1998-1999.

Men's reproductive health needs are receiving increased attention, but most family planning clinic clients are female, and clinics have reported barriers to serving men. A 1999 survey of publicly funded agencies that administer family planning clinics asked several questions about current policies and services and the number of men served in 1998. Data on 17 services were collected, as well as the proportion of clients who were male and agencies' barriers to serving men. The services most commonly offered to men in 1999 were condom provision and sexually transmitted disease (STD) counseling (95% of all agencies), contraceptive counseling (93%), and STD treatment (90%) and testing (89%). The proportions offering various male reproductive health services were lowest among hospital-based clinics. Eighty-seven percent of agencies served some male contraceptive or STD clients in 1998; those that did served a mean of 255 men and a median of 50. The male client caseload increased between 1995 and 1998 at 53% of agencies, and four out of five agencies were interested in serving more men in the future. The most commonly reported barriers to serving men were men's unawareness that services were available (58%) and inadequate agency funding (55%). Although most clients of publicly funded family planning agencies are women, a nonnegligible number are men. Additional efforts are needed to determine the best way to deliver reproductive health services to men.

Low literacy: a hidden problem in family planning clinics

ObjectivesLow literacy is highly prevalent among UK adults. This study assessed functional health literacy among family planning clinic clients and whether this was associated with sexual health knowledge and behaviours....

Emergency Contraception in Honduras: Knowledge, Attitudes, and Practice Among Urban Family Planning Clients

Emergency contraception (EC) has the potential to improve women's reproductive health significantly. In Honduras, where nearly one-fourth of pregnancies are unplanned, the need for EC is substantial. To increase awareness of this option, nongovernmental organizations launched countrywide EC outreach activities in 2001-03. We conducted pre- and postintervention cross-sectional surveys among a total of 2,693 family planning clinic clients to assess EC knowledge, attitudes, and practice at baseline and at two years postintroduction. EC awareness increased over time, but remained at just 20 percent at follow-up. Respondents generally demonstrated a positive attitude and low rates of concern about EC. Awareness of and willingness to use EC were strongly associated with age, educational status, and city of residence. Public-sector acceptance of the method is essential to increase awareness of and access to EC. This study is intended to fill an information gap regarding EC in Latin America and the Caribbean and to be useful in determining educational messages and target audiences for future awareness campaigns in Honduras.

Men's use of sexual health services

Context and objectivePrevious research on users of sexual health services has focused primarily on women. However, a focus on men also is needed to address sexual ill-health. This paper uses...

Services for Men at Publicly Funded Family Planning Agencies, 1998-1999

Men's reproductive health needs are receiving increased attention, but most family planning clinic clients are female, and clinics have reported barriers to serving men.A 1999 survey of publicly funded agencies that administer family planning clinics asked several questions about current policies and services and the number of men served in 1998. Data on 17 services were collected, as well as the proportion of clients who were male and agencies' barriers to serving men.The services most commonly offered to men in 1999 were condom provision and sexually transmitted disease (STD) counseling (95% of all agencies), contraceptive counseling (93%), and STD treatment (90%) and testing (89%). The proportions offering various male reproductive health services were lowest among hospital-based clinics. Eighty-seven percent of agencies served some male contraceptive or STD clients in 1998; those that did served a mean of 255 men and a median of 50. The male client caseload increased between 1995 and 1998 at 53% of agencies, and four out of five agencies were interested in serving more men in the future. The most commonly reported barriers to serving men were men's unawareness that services were available (58%) and inadequate agency funding (55%).Although most clients of publicly funded family planning agencies are women, a nonnegligible number are men. Additional efforts are needed to determine the best way to deliver reproductive health services to men.

Substantial Proportions of Contraceptive Clinic Clients Would Try Methods That Can Cause Amenorrhea

Womens attitudes toward menstruation and toward contraceptives that can cause amenorrhea differ significantly across settings and ethnic groups. According to a survey of a thousand female family planning clinic clients more than half of respondents in Scotland and China and of nonblack respondents in Africa do not like having periods; at least three-quarters of black Africans however report that they like having them. One-third to three-fourths of women in each area would consider trying a contraceptive method that can induce amenorrhea; however the vast majority of health care providers from those clinics believed that menstruating while using contraceptives is important to their clients. Even so most providers said that they would recommend a contraceptive method that can stop bleeding. (excerpt)

HIV Counseling and Testing: Women's Experiences and the Perceived Role of Testing as a Prevention Strategy

It is unclear why women decide to undergo testing for HIV, and how positive and negative testresults impact their sexual behavior. A sample of 360 family planning clinic clients in New York City were randomly assigned to receive a four- or eight-week intervention aimed at reducing sexual risk or to serve as controls. Information on their HIV testing experiences was gathered through interviews at baseline and one month, six months and one year after the intervention. At baseline, 67% of women had been tested for HIV. The predominant reason for not being tested was anxiety about the result. Regardless of their testing status at baseline, more than 40% of the women believed that getting tested is a good way to prevent acquiring HIV. Women in the intervention who had been tested multiple times or had last been tested more than six months ago were more likely than women in the control group to initiate HIV testing by the one-month follow-up (relative risk, 2.9 and 6.1, respectively). Rates of mutual testing (being tested at the same time as one's partner) were significantly greater among women who participated in an intervention than among controls at the one-month and six-month interviews. HIV test counseling must emphasize that testing is not a prevention strategy in and of itself. Mutual testing, although not without risks, offers the safest possible alternative for monogamous couples who choose to forgo condoms.

The prevalence of anemia among clients of family planning clinics in Egypt

A hospital-based study of the prevalence of anemia among clients of family planning clinics in Egypt was carried out in collaboration with a number of university hospitals. The study aimed to estimate the prevalence of anemia among the clients of family planning clinics and to determine the underlying risk factors for developing anemia in this population, with special emphasis on the role played by different contraceptive methods. The study was designed as a cross-sectional study and was carried out in seven family planning clinics of Alexandria, Mansoura, Cairo, Al-Azhar, Ein Shams, El Minia, and Assiut University Hospitals during August 1993 to March 1994. A total of 1039 clients of family planning services who fulfilled the selection criteria were recruited in the study. A standardized interview questionnaire was used to record pertinent information on study subjects. As well, laboratory investigations were made to determine the hemoglobin level and the presence of bilharzial infection. The prevalence of anemia in the studied population reached 49.6%, with variations among centers. Anemia was more prevalent among urban compared to rural residents (55.7% and 42.0%, respectively). Anemia was more common in Lower Egypt, followed by urban governorates and Upper Egypt. Other independent determinants associated with high prevalence of anemia included: young age (20–39 years), lack of obesity, heavy menstrual periods, low parity, use of the intruterine device (IUD), low intake of iron-rich foods, and bilharzial infection. Use of IUD were significantly associated with the highest prevalence of anemia among all contraceptive users (64.9%), and IUD users had the lowest level of hemoglobin compared to nonusers or users of other methods. Given the increasing prevalence of IUD use in Egypt, a major recommendation of this study would be to introduce the prescription of iron supplementation tablets as part of IUD services provided in family planning clinics, both to new users and to current users. Other recommendations include early treatment of menstrual disturbances and parasitic infections (including schistosomiasis), as well as improvement of the nutritional status of women at high risk for developing anemia, through mass media campaigns addressing dietary patterns and the health benefits of intake of iron-rich, inexpensive food items.

Letters to the Editor

Unrecognized genital ulcer disease may be a significant co-factor in HIV transmission in South Africa. The prevalence of genital ulcers was investigated in three groups of women in KwaZulu/Natal South Africa: 327 antenatal clinic patients and 189 family planning clinic clients in rural Hlabisa and 145 sex workers operating at truck stops on the main route from Durban to Johannesburg. 21 sex workers (14%) 6 pregnant women (2%) and 5 family planning clients (3%) had at least 1 genital ulcer; all were vulval. None of the sex workers or pregnant women and only 2 family planning clients were aware they had a genital ulcer. Most of these women reported abnormal urogenital symptoms and had other sexually transmitted infections that may have masked ulcer-related discomfort. 75% of these women were HIV-infected. This too may affect the symptomatology and natural history of genital ulcer disease.

Menstrual Changes and Other Side Effects May Discourage U.S. Women from Using Injectable

This article reports the findings of a study of discontinuation of depot medroxyprogesterone acetate (DMPA) injectables among low-income family planning clinic clients in Texas. The sample included 536 women who began use in 1993 shortly after its approval. The women attended 17 different clinics. 50% were Black 25% were White and 25% were Hispanic. There were an average of 1.9 pregnancies and 1.2 births. 25% had never been pregnant. 33% had never given birth. Women completed questionnaires at the time of injection and on return visits at 3 6 and 9 months after the first injection. 29% were still using the method after 1 year. Two women reported pregnancies. At each follow-up about 70% of women reported side effects associated with use. 38-46% reported weight gain and 17-22% reported headaches. 3-4% reported abnormal menstrual symptoms (amenorrhea and spotting). The number of women reporting unpleasant weight gain skin problems and amenorrhea increased over time. The number of women reporting very long menstrual periods decreased over time. The cumulative life table discontinuation rate was 36% at 3 months 54% at 6 months 65% at 9 months and 71% at 12 months. Discontinuers were more likely than continuers to have reported concerns about side effects prior to method choice dissatisfaction with the health effects of DMPA regret about their choice and status as married. The most likely complaint for discontinuing at 3 months was weight gain followed by headaches depression and frequent menstrual periods. At 6 months discontinuers were more likely to report frequent menstrual periods and increased cramping. At 9 months discontinuers were more likely to report weight gain followed by nervousness and amenorrhea. 41-50% at each time period gave an adverse health-related reason for stopping use. Most switched methods. Counselors should provide a detailed description of likely effects.

Barriers to Condom Use Among Women Attending Planned Parenthood Clinics

Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's Perception, Peer's Perception, Pleasure/Intimacy, Communication, and Low Perceived Need. Multivariate analyses revealed significant group differences on only two barrier factors: Pleasure/Intimacy and Low Perceived Need. Low Perceived Need accounted for 13.5% of the variance in condom use. Women with low perceived need to use condoms were more likely to use oral contraceptives.

Mandatory Premarital HIV Testing: The Illinois Experience-Reply

In Reply. — These reactions to our article on mandatory premarital testing for HIV by Drs Dykers, Silverman, and Stemp reflect widely varying approaches to establishing public policy that will maximally prevent and control further spread of this disease. The goals of mandatory premarital screening for HIV are the same as those listed by Dr Silverman for premarital syphilis screening. The effective screening program is, therefore, the one that best achieves those goals. The first of these goals, the identification and prevention of cases of infection, has already been discussed in our article. Screening other, comparable populations would identify significantly more individuals. While the seroprevalence rate for marriage license applicants was 0.02% during the first 18 months of the requirement, this is significantly lower than the 0.09% observed among childbearing women in Illinois, the 0.26% observed among clients of family planning clinics, and the 2.73% among clients of sexually transmitted

Patterns of contraceptive method of use by California family planning clinic clients, 1976-84.

Trends in contraceptive method of use by California family planning clients, 1976-84, are reviewed. Although use of foam and condoms doubled from 1976 to 1980 and was sustained, interest peaked but markedly declined for the diaphragm. Oral contraceptive (OC) use declined overall and most notably for older women, but there are indications in 1983 and 1984 of a slight OC "come back". Older women were more likely to choose methods free from medical side effects than were younger women.

Trends in contraceptive method of use by California family planning clinic clients aged 10-55, 1976-1979.

The types of primary contraceptive method chosen by women seeking services in California family planning clinics are reviewed for the years 1976-1979. Of most significance was the decline in the use of oral contraceptives (OC) and the concurrent rise in nonprescription methods at all ages. A striking difference in OC use between the earlier and latter time periods was noted for women age 40 and older.