Family planning clinic services in the United States: Patterns and trends in the late 1990s

Context: Publicly funded family planning clinics are a vital source of cont raceptive and reproductive health care for millions of U.S, women. If is im portant periodically to assess the number and type of clinics and the numbe r of contraceptive clients they serve. Methods: Service data were requested for agencies and clinics providing pub licly funded family planning services in the United States in 1997 The numb ers of agencies, clinics and female contraceptive clients were tabulated ac cording to various characteristics and were compared with similar data for 1994. Finally, county data were tabulated according to the presence of fami ly planning clinics and private physicians likely to provide family plannin g care and according to the number of female contraceptive clients served c ompared with the number of women needing publicly funded care. Results: In 1997, 3,117 agencies offered publicly funded contraceptive serv ices at 7,206 clinic sites. Forty percent of clinics were run by health dep artments, 21% by community health centers, 13% by Planned Parenthood affili ates and 26% by hospitals or other agencies. Overall, 59% of clinics receiv ed Title X funding. Agencies operated an average of 2.3 clinics, and clinic s served an average of 910 contraceptive clients per year. Altogether, clin ics provided contraceptive services to 6.6 million women-approximately two of every five women estimated to need publicly funded contraceptive care. T he total number of providers and the total number of women served remained stable between 1994 and 1997; at the local level, however, clinic turnover was high. Some 85% of all U.S. counties had one or more publicly funded fam ily planning clinics; 36% had one or more clinics, but no private obstetric ian-gynecologist. Conclusions: Publicly funded family planning clinics are distributed widely throughout the United States and continue to provide contraceptive care to millions of U.S. women. Clinics are sometimes the only source of specializ ed family planning care available to women in rural counties. However, the high rate of clinic turnover and the lack of significant growth in clinic n umbers suggest that limited funding and rising costs have hindered the furt her expansion and outreach of the clinic network to new geographic areas an d hard-to-reach populations.