ADOLESCENT USE OF NORPLANT IMPLANTS - CLINIC SERVICES, POLICIES AND BARRIERS TO USE

Introduction: The purpose of this article is to review the experiences of family planning clinic providers in making Norplant available to a dolescents. We look specifically at the proportions of women receiving the implant from these providers who are teenagers, the policies adop ted regarding implant education and whether or not parental consent is required for minors. Pricing policies and the implications of high me thod cost for teenagers are discussed. Finally, some of the policies a dopted by state agencies related to adolescent use of the implant are reviewed. Methods: The data come from two national surveys conducted b y the Alan Guttmacher Institute (AGI). The first, a survey of family p lanning agencies, collected data from 616 family planning providers of clinic services (response rate 69%). The second surveyed the Medicaid , health and welfare agencies in all 51 jurisdictions about policies r elated to Norplant. Results: Over one-quarter of all contraceptive imp lants inserted by family planning agencies were provided to teenagers. Teenagers were routinely informed about the implant in about 85% of t hose clinics offering implant services. Few state agencies notify wome n about the implant. Twenty-three percent of all family planning agenc ies providing implant services report that parental consent must be ob tained prior to implant insertion. The Medicaid program has paid for a majority of implant insertions at family planning agencies. Conclusio ns: Teenagers who rely on publicly funded family planning clinics for contraceptive services face a variety of barriers in obtaining Norplan t. High method cost, parental consent requirements and issues related to Medicaid eligibility are likely to deter some teenagers who might o therwise choose Norplant.