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Quality, mainstream services with proactive and targeted outreach: A model of contraceptive service provision for young people
  1. Paula Baraitser, MBBS, MFFP, Senior Clinical Medical Officer1,
  2. Rachael Fettiplace, Medical Student2,
  3. Frances Dolan, SRN, FP Cert, Sexual Health Outreach Worker3,
  4. Helen Massil, MRCOG, MFFP, Director/Consultant4 and
  5. Sarah Cowley, BA, PhD, Professor of Community Practice Development5
  1. Department of Reproductive Health, Community Health South London NHS Trust, St Giles Hospital, London, UK
  2. Kings and St Thomas' Schools of Medicine and Dentistry, London, UK
  3. Department of Reproductive Health, Community Health South London NHS Trust, St Giles Hospital, London, UK
  4. Department of Reproductive Health, Community Health South London NHS Trust, St Giles Hospital, London, UK
  5. Florence Nightingale School of Nursing and Midwifery, Kings College London, London, UK
  1. Correspondence Paula Baraitser, SCMO, Department of Reproductive Health, Community Health South London NHS Trust, St Giles Hospital, St Giles Road, Camberwell, London SE5 7RN, UK. E-mail: Paula.Baraitser{at}chsltr.sthames.nhs.uk

Abstract

Introduction High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service.

Methods Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service.

Results The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold.

Conclusion This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.

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