Publication Date

1994

Degree Name

MA in International and Intercultural Management

First Advisor

Les Long

Abstract

As members of the international family planning community, we are committed to increasing access to contraception and improving the quality of health services while striving to secure the health of clients. The ability to achieve this aim is often hindered by a variety of factors, some of which are beyond our ability to control, eg. religion, culture, education, economics, geographic location, etc.... However, there are some aspects about the way we deliver family planning services which place a barrier between clients and the high quality of care they deserve, eg. requiring unnecessary laboratory tests, excessive follow-up visits, and unnecessary restrictive age and parity requirements for certain methods. Many of these practices have been promoted as necessities for high quality of care in the past, but we are now beginning to rethink the way in which clients are served by determining which practices and policies are medically necessary and those which are not, based on current information.

This guide has been developed to sensitize the international family planning community to medical barriers and to facilitate understanding of their possible underlying sources. It is not intended to provide a comprehensive scientific analysis of medical barriers nor offer a step by step process to reduce them. However, it is expected that this guide will serve primarily to raise awareness. It will assist the user in critically reviewing his/her work in the field of family planning. It will provide an opportunity for providers to review their service delivery practices and consider safe, alternative means to improve access to quality services. In addition, it is intended to inform policy makers of their role in the process of reducing medical barriers. It is not expected to create changes in and of itself, but serve as part of various parallel activities such as the revision/creation of standardized service delivery guidelines and contraceptive technology update workshops, in hopes of inspiring positive, sustainable change in service delivery practices and in the quality of care provided to clients.

We have provided suggestions for reducing medical barriers at the clinic-level as well as ideas of how to influence restrictive policies and regulations at the policy level. We recognize addressing these restrictions at both levels is both critical and challenging. It is assumed that some of us are in more of a position than others to influence change at the policy and regulatory level. In addition, we acknowledge our efforts to reduce medical barriers to quality family planning services can only be fully effective in a supportive, open-minded political environment.

Strategies for improving client access to family planning will undoubtedly vary from country to country, and even from individual to individual. However, the proposed ideas for interventions are general in nature. They can be adapted to cultural differences, available resources, and needs as determined by the individual in his/her specific context.

Disciplines

Community Health | Public Health Education and Promotion

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