title: The organization and delivery of family planning services in community health centers.
abstract: BACKGROUND
  Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services.
  
  
  METHODS
  This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning.
  
  
  RESULTS
  Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services.
  Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center.
  
  
  CONCLUSIONS
  Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care.
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC. Electronic address: goetzdc@gwu.edu.
authors.forename: Debora Goetz
authors.initials: DG
authors.lastname: Goldberg
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Susan F
authors.initials: SF
authors.lastname: Wood
authors.affiliation: Johnson Group Consulting, Inc., Hinesburg, Vermont.
authors.forename: Kay
authors.initials: K
authors.lastname: Johnson
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Katherine Holly
authors.initials: KH
authors.lastname: Mead
authors.affiliation: Public Health, Department of Physical Education, School, and Public Health, Central Washington University, Ellensburg, Washington.
authors.forename: Tishra
authors.initials: T
authors.lastname: Beeson
authors.affiliation: National Family Planning and Reproductive Association, Washington, DC.
authors.forename: Julie
authors.initials: J
authors.lastname: Lewis
authors.affiliation: Department of Health Policy, George Washington University, Washington, DC.
authors.forename: Sara
authors.initials: S
authors.lastname: Rosenbaum
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005193:Family Planning Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008507:Medically Underserved Area; D011203:Poverty; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D012111:Residence Characteristics; D012736:Sex Education; D011795:Surveys and Questionnaires; D014481:United States