Healthcare Policy
Volume 10, Issue 3, 2015, Pages 48-63

Barriers and facilitators to family planning access in Canada (Article)

Hulme J.* , Dunn S. , Guilbert E. , Soon J. , Norman W.
  • a Department of Family Medicine, McGill University, 515-517 Pine Ave. West, Montreal, QC H2W 1S4, Canada
  • b Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
  • c National Institute of Public Health of Quebec, Canada, Department of Obstetrics and Gynaecology, Laval University, Québec, QC, Canada
  • d UBC Faculty of Pharmaceutical Sciences, Canada, Community Pharmacist Research Network, University of British Columbia, Vancouver, BC, Canada
  • e Department of Family Practice and Midwifery, University of British Columbia, Vancouver, BC, Canada

Abstract

Background: Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Methods: Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. Results: Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. Conclusion: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada.

Author Keywords

[No Keywords available]

Index Keywords

vulnerable population birth control immigrant Family Planning Services nurse health care policy health care personnel sexual education human middle aged scope of practice medical society health service paramedical profession general practitioner Young Adult continuing education Humans conceptual framework consultation male Canada Family Planning Policy female semi structured interview Contraception nurse practitioner sexual health Article Telephone organization and management health care adult health care quality Quality of Health Care government Reproductive Health Health Policy intrauterine contraceptive device family planning pharmacist rural health care Health Services Accessibility health care delivery Rural Health Services

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929668968&doi=10.12927%2fhcpol.2015.24169&partnerID=40&md5=8ee0189c1ec9857ca653b185e8df5f19

DOI: 10.12927/hcpol.2015.24169
ISSN: 17156572
Cited by: 11
Original Language: English