BMJ 1995;310:1641-1643 (24 June)

General practice

Contraceptive services for teenagers: do we need family planning clinics?

Martin A K Allaby, senior registrar in public health medicine a

a Department of Public Health Medicine, Northamptonshire Health Authority, Northampton NN1 5DN

Abstract

Objective: To determine whether the effectiveness of contraceptive services for teenagers is related to the balance of service provision between general practitioners and specialist family planning services.
Design: Cross sectional study with routinely collected data from family planning clinics and family health services authorities and published data on births and abortions.
Setting: Eight health districts in the former Oxford region.
Subjects: Girls aged under 16 and women aged 16-19 who attended a contraceptive service during 1991-2 or who gave birth or had an abortion during 1990-2.
Main outcome measures: Attenders at family planning clinics as a percentage of all users of contraceptive services. The conception rate:uptake of contraceptive services ratio was used as a measure of effectiveness.
Results: In comparisons between districts the percentage of all users of contraceptive services who attended a clinic varied from 38% (95% confidence interval 28% to 48%) to 79% (72% to 86%) among 13-15 year olds and from 14% (12% to 15%) to 44% (42% to 46%) among women aged 16-19 years. The conception rate:uptake of contraceptive services ratio varied twofold in the older age group and more than threefold in the younger age group. It was lowest in districts where clinic attenders comprised a large percentage of all users of contraceptive services.
Conclusion: Contraceptive services for teenagers may be more effective in districts where clinics play a large part in delivering the service, particularly for girls aged under 16.

Key messages

  • Key messages

  • Health districts can use the conception rate: uptake of contraceptive services ratio to measure the effectiveness of their contraceptive services for teenagers

  • Districts in which clinics play a major part seem to have a more effective contraceptive service for teenagers than those in which the service is provided mainly by general practitioners

  • Districts that provide only a few clinics and have a high value of the ratio described should consider purchasing additional clinics for young people


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This article has been cited by other articles:

  • Reeves, C, Whitaker, R, Parsonage, R K, Robinson, C A, Swale, K, Bayley, L (2006). Sexual health services and education: Young people's experiences and preferences. Health Education Journal 65: 368-379 [Abstract]  
  • Donnelly, C. (2000). Sexual health services: a study of young people's perceptions in Northern Ireland. Health Education Journal 59: 288-296 [Abstract]  
  • Mellanby, A R, Pearson, V A H, Tripp, J H (1997). Preventing teenage pregnancy. Arch. Dis. Child. 77: 459-462 [Full text]  
  • Macfarlane, A., McPherson, A. (1995). Primary health care and adolescence. BMJ 311: 825-826 [Full text]  
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