Role of Federally-Qualified Health Centers (FQHCs) in Delivering Family Planning Services to Adolescents

PURPOSE:  The purpose of this paper is to provide the first ever national examination of the role of community health centers (CHCs) in providing comprehensive family planning services to adolescents, looking at the range of services offered and the factors associated with provision of these services. 

METHODS:  This study employed a mixed-methods approach comprising a national survey of CHCs and in-depth case studies with health centers in six communities to examine the organization and delivery of family planning services.  The primary outcome of interest was a family planning adolescent services index, comprised of nine services.  We analyzed the influence of state-level policies related to family planning services, funding for adolescents, and organizational characteristics on the provision of these services in CHCs. 

RESULTS: The study found substantial variation in the provision of family planning services at community health centers, with a mean of 6.33 out of a maximum score of 13 on the family planning adolescent services index. Title X funding and location within a favorable state policy environment were significantly associated with higher scores on the family planning adolescent services index (p-value<0.001 and 0.002, respectively).  Barriers to providing family planning care to teens included lack of funding, lack of knowledge and limitations on school-based clinical services.

CONCLUSIONS: CHCs have the opportunity to play a significant role in providing quality family planning to low-income, medically underserved adolescents.  Additional funding, resources and a favorable policy climate would further improve CHCs ability to serve the family planning needs of this special patient population.