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PubMedDate not supplied

Title X and its critics.

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Family Planning Services↗
PubMedDate not supplied

Measuring accessibility to family planning services in rural Thailand.

There are a variety of ways to conceptualize and measure accessibility to contraceptive services and supplies. Using detailed data for rural Thailand, a multiplicity of reasonable measures are developed that reflect time and/or distance to various government program outlets. Many of these are only moderately correlated with one another, and to an important extent, different measures show different associations with levels of contraceptive prevalence. Clearly there is a general need in this area of investigation to pay more attention to the measurement of accessibility as a community characteristic and to consider the sensitivity of results to alternate measures.

Adolescent↗
PubMedDate not supplied

Quality of care in family planning services in Morocco.

This study was conducted to heighten awareness of quality of care as a programmatic issue in the Moroccan governmental family planning program and to test modified Situation Analysis instruments for measuring quality of care. Data were collected from 50 service-delivery points in five provinces to measure six elements of quality in accordance with the Bruce/Jain framework. A procedure for calculating quality-indicator scores is presented. Although facilities varied by province and within provinces, most had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service-delivery points scored well on mechanisms to ensure continuity of use. Notable shortcomings included a dearth of materials for counseling and a widespread unavailability of the Ovrette pill. This study raises issues regarding the complexity of measuring quality, the ownership of results, and the appropriateness of a centralized study of quality in a decentralized program.

Adult↗
PubMedDate not supplied

Family planning clinic services in the United States, 1994.

In 1994, almost 6.6 million women received contraceptive services from more than 7,000 subsidized family planning clinics; these providers were located in 85% of U.S. counties. Health department clinics and Planned Parenthood sites served the largest proportions of these women (32% and 30%, respectively), followed by hospital outpatient sites (16%), independent clinics (13%) and community or migrant health centers (9%). The mix of agency types varied considerably by region and state, and the average annual number of contraceptive clients served per clinic also varied from fewer than 500 at community and migrant health centers to more than 2,000 at Planned Parenthood clinics. Nearly two-thirds of all women served (4.2 million) obtained care at one of the 4,200 clinics receiving funds from the federal Title X family planning program. Health department sites were the most likely to receive Title X funding (78%), followed by independent clinics and Planned Parenthood sites (66% each), hospital clinics (28%) and community and migrant health centers (18%). Overall, clinics receiving Title X funds serve an average of 25% more contraceptive clients than do clinics not receiving such funds.

Adolescent↗
PubMed1999

Experiences of families that applied for government-sponsored child health insurance: report of a follow-up study in New York City.

CONTEXT: This study followed up on a summer 1997 advocacy project by the Children's Defense Fund--New York, which assisted families in New York City in enrolling their children in government-sponsored health insurance programs (Medicaid and Child Health Plus). OBJECTIVE: To determine how many participants from the 1997 project acquired insurance, to document their experiences during the application process, and to solicit their suggestions on improving the application process. DESIGN: Guided telephone interviews in summer 1998 with all families from the 1997 program that could be located. PARTICIPANTS: Fifty-five families from New York City that, with the assistance of the Children's Defense Fund--New York, applied for Medicaid or Child Health Plus in summer 1997. RESULTS: Of the 55 families, 46 acquired insurance for their children at some point during the year. A number of families changed insurance status several times during the year, and some insured originally through government-sponsored programs later acquired private insurance. The families experienced many difficulties in dealing with the health insurance bureaucracies. CONCLUSION: The process of applying for Medicaid and Child Health Plus is more difficult and time consuming than may be realized, and many families may go through the application repeatedly. Current efforts to decrease the number of uninsured children in the US must take into account the bureaucratic barriers faced by families that are eligible for these programs and must consider ways to make the application process less formidable.

Child↗