Increasing Access to Contraception Toolkit
Welcome to the Toolkit
Every individual has a right to the information and resources they need to make informed decisions about their health and happiness. This right extends to decisions related to pregnancy and/or building a family. This toolkit supports family planning providers in ensuring access to the full range of contraceptive methods for clients who could become pregnant, but who wish to avoid pregnancy at this time. This toolkit supports agency-level improvement on the contraceptive care measures developed by the Office of Population Affairs (OPA) and endorsed by the National Quality Forum.
This toolkit includes a series of training guides and complementary resources that support implementation of best practice recommendations outlined in the Contraceptive Access Change Package. Each training guide consists of a PowerPoint slide deck with talking points and an accompanying discussion guide. The resources in this toolkit can be used in any order according to an agency’s needs and priorities. Training guides can be adapted and revised as needed, and may be used to:
- Convene staff from one or more family planning agencies for a standing meeting (e.g., monthly) to discuss each best practice (in order or as needed) from the Contraceptive Access Change Package.
- Convene a one-time meeting with agency staff about this topic.
The toolkit walks agencies through a process to increase contraceptive access. These action steps are organized around the four best practice recommendations of the Contraceptive Access Change Package and include:
- Assess baseline contraceptive access
- Develop an improvement plan
- Best Practice 1: Stock a broad range of contraceptive methods
- Best Practice 2: Discuss pregnancy intention and provide client-centered counseling
- Best Practice 3: Develop systems for same-visit provision of all contraceptive methods
- Best Practice 4: Utilize diverse payment options to reduce cost as a barrier
- Sustain and spread improvements
Find more implementation strategies, tools, and resources for increasing contraceptive access in Same-Visit Contraception: A Toolkit for Family Planning Providers.
This toolkit was adapted from a contraceptive access learning collaborative facilitated by the FPNTC in 2017.
As a first step, agencies can assess the current level of client access to contraception by: comparing site-level practices to established best practice recommendations; and looking at Family Planning Annual Report (FPAR) data.
| Action Steps | Supportive Resources |
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Review the best practice recommendations outlined in the Contraceptive Access Change Package. |
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Assess clients’ baseline access to the full range of contraceptive methods. |
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Calculate baseline contraceptive care measures using site-level FPAR data. |
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Undertaking a participatory process for developing an improvement plan ensures staff have ownership and understand their respective roles in achieving change.
| Action Steps | Supportive Resources |
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Facilitate a discussion with agency staff about the need for expanding access to contraception. |
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Facilitate a discussion with agency staff to develop a site-level plan for increasing access to contraception. |
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Title X-funded projects are expected to provide a broad range of acceptable and effective family planning methods and services. Although some methods can be obtained without a provider or by prescription, provider-dependent methods need to be stocked on-site so clients can access them without delays. At a minimum, at least one type of each Food and Drug Administration-approved provider-dependent method (i.e., hormonal IUD, copper IUD, implant, and injectable) should be stocked on-site. Other methods should also be readily available, either stocked on-site or through a pharmacy.
| Action Steps | Supportive Resources |
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Facilitate a discussion with agency staff about how to increase, if necessary, the number of types of contraceptive methods available on-site. |
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OPA recommends that agency staff:
- Discuss a reproductive life plan with every family planning client.
- Ask the question, “Do you think you would like to have (more) children someday?” to open the door for further discussion of reproductive health needs—including contraception.
- Use inclusive and affirming language that supports clients of all identities in their reproductive health and family building goals.
- Adhere to client-centered counseling principles outlined in Quality Family Planning (QFP) to help clients identify the most appropriate contraceptive methods.
| Action Steps | Supportive Resources |
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Facilitate a discussion with agency staff about how to consistently assess pregnancy intention and support clients through client-centered counseling. |
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Facilitate a conversation with agency staff about utilizing client-centered language to foster an affirming environment for each client and their respective identities. |
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Facilitate a discussion with agency staff to address common concerns providers may have about providing the full range of methods, such as providing adolescents with long-acting reversible contraception (LARC). |
Address Common Concerns for Providing Long-Acting Reversible Contraception (LARC) to Adolescents Training Guide |
According to the Centers for Disease Control and Prevention (CDC) and OPA, clients should have access to their contraceptive method of choice without unnecessary delays. “Same-visit” provision of contraception means providing immediate access to contraceptive methods using Quick Start. Clients should not be required to return for a separate appointment on another day—or even later the same day—to initiate contraception.
| Action Steps | Supportive Resources |
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Facilitate a discussion with agency staff about how to implement or streamline same-visit provision of the full range of methods, including IUDs and implants. |
Develop Systems for Same-Visit Provision of All Contraceptive Methods (Best Practice 3) Training Guide |
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Learn more about the rationale for offering same-visit contraception, watch case study videos, and access tools and resources to support implementation. |
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The Title X Family Planning Program provides services and information to all clients who want and need them, with priority given to low-income or uninsured individuals. Removing cost barriers ensures clients can choose a method that is most appropriate and desirable for them.
| Action Steps | Supportive Resources |
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Facilitate a discussion with agency staff about strategies for ensuring cost is not a barrier for the agency or the client. |
Utilize Diverse Payment Options to Reduce Cost as a Barrier for the Facility and the Patient (Best Practice 4) Training Guide |
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Facilitate a discussion with agency staff about financial management best practices. |
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Implementation is not a one-time activity and does not end after initial improvement plan changes are made. Using a quality improvement approach, staff should prepare for how changes will be sustained at the site, and, once successful, how to spread them to other sites in the network.
| Action Steps | Supportive Resources |
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Learn more about quality improvement approaches. |
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Facilitate a discussion with agency staff about how to sustain and spread changes made to increase access to contraception. |
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