Equity-focused Strategies to Improve Family Planning Service Delivery

The Equity-focused Strategies to Improve Family Planning Service Delivery project aims to benefit the family planning field by developing actionable and equity-focused recommendations for those who work to improve clients’ experiences of care at Title X-funded health centers.

The project, funded through a grant from the Office of Populations Affairs (OPA) of the U.S. Department of Health and Human Services (HHS), helps publicly funded family planning providers identify innovative, effective strategies to improve clients’ experiences. We focus especially on populations that have been underserved by family planning providers, including people of color, individuals with limited English proficiency, adolescents, LGBTQ+ individuals, and populations in resource-limited areas (including rural areas and states that limit access to sexual and reproductive health services).

This project builds on research conducted under the Trends in Family Planning Service Provision project.

Background

The Title X Family Planning Program, administered by OPA, is the only federal program designed to support comprehensive family planning and related preventive health services for individuals with low incomes. Title X services can include contraceptive methods and counseling, assistance to achieve pregnancy, care for sexually transmitted infections (STI), and more. In 2022, more than 2.6 million family planning clients received care at over 4,000 Title X-supported service sites in the United States.

The context within which Title X clinics operate has changed dramatically in recent years. Program policy changes have led a significant number of clinics to leave and return to the program, the COVID-19 pandemic transformed how services were provided, and new state-level policies have limited access to sexual and reproductive health services for many. Meanwhile, there has been a growing understanding and acknowledgement within the field of the systemic and structural barriers (e.g., less access to care, bias and discrimination from health care providers, community mistrust of past reproductive research, under-resourced communities, etc.) that cause disparities in receipt of high-quality sexual and reproductive health care, including for people of color and LGBTQ+ individuals.

This context underscores the critical need to help publicly funded family planning centers improve equitable access to high-quality services and ensure that everyone who visits a Title X clinic—particularly those who are historically underserved—receives client-centered care.

Research Approach

To identify strategies for improving family planning services, the research team is collecting and analyzing in-depth data from family planning clients (via surveys and interviews) and providers (via interviews with clinic staff), as well as analyzing existing data sources such as the National Survey of Family Growth.