Accessing Family Planning Services: Barriers and Facilitators

Publicly funded family planning clinics and programs are designed to provide services to help individuals and couples avoid unintended pregnancy. Yet many minority women, especially young Hispanics, do not use the reproductive health care services available to them. A better understanding of the barriers and facilitators to accessing family planning services among Latina women could help improve outreach efforts to better serve this population. To identify the barriers and facilitators to access, we are conducting focus groups with young adult Latina women and providers in 3 cities with large concentrations of Hispanics. Preliminary results suggest there are structural barriers hindering access, including transportation, limited access to information technology (in particular among recent immigrants), a lack of understanding of eligibility rules, long waiting periods, fear of immigration policing, and concerns about confidentiality. Additionally, some Latina women report difficulty in maintaining continuous care once they age out of teen clinics or no longer receive health insurance from their parents. In response, some (especially immigrants) are turning to the “black market” to obtain contraception, are opting out of hormonal methods or are forgoing needed care. Cultural factors also play a role. Our results suggest that reliance on homeopathic remedies, a tradition of bypassing medical doctors for contraceptive needs, machismo, and language barriers may contribute to lower service utilization. Providers echo many of these findings and report challenges with getting women to access their clinics, to return for needed follow-up care, and with providing adequate referral services for other health care services.