Family planning at the forefront: A systematic review of the strategic integration of family planning services into primary care

objectives: With the advent of the Affordable Care Act, consolidating preventive health services has become a strong driving force in public health.  This trend has the potential to increase the accessibility, efficiency and affordability of health care. Historically underutilized and inaccessible, family planning is one area of preventive care that could benefit from an integrative approach. The objective of this systematic review is to evaluate the evidence on best practices for disseminating and implementing family planning services into primary care settings.

methods: Systematic search of electronic databases (PubMed and Embase) for comparative studies of interventions for disseminating and implementing family planning services in primary care settings. One author reviewed titles and abstracts to eliminate irrelevant studies, and two authors reviewed the full text of all potentially eligible studies. We used the mixed methods appraisal tool (MMAT) to assess study quality. We extracted detiled data on study characteristics and used a narrative approach to summarize and synthesize findings.

 results: The search yielded 3968 articles and 11 met the inclusion criteria, including 3 randomized control trials and 9 quasi-experiment intervention evaluations. Preliminary results indicate that a multi-pronged approach, focused on providers and patients, can be most effective. Other important strategies include multiple learning tools, peer-led trainings and regular reminders for physicians.

conclusion: This review identifies several important strategies for successfully disseminating and integrating family planning services into primary care. However, the data are limited to piecemeal family planning services.  More rigorous research to adequately measure successful implementation and dissemination is needed.