A comparison of program and contraceptive use continuation rates in a family planning clinic

Programs and contraceptive use continuation rates were obtained for a rural Georgia family planning clinic. Program continuation is a measurement of maintenance of clinic attendance, while use continuation is related to actual use of effective contraceptives regardless of clinic activity status. Program continuation rates ranged from 0.77 at 12 months to 0.48 at 36 months. Contraceptive use continuation rates were 0.78 at 12 months and 0.58 at 36 months. Women who moved or were otherwise lost to follow-up formed the largest category of discontinuation. The highest rate of discontinuation from clinic attendance occurred after the first visit with secondary peaks around the time of scheduled annual checkups. Women who were younger and had fewer living children had a greater likelihood of discontinuing clinic attendance and contraceptive use. The reasons for and timing of discontinuation from clinic attendance suggest that clinic personnel should place special emphasis on the first visits, arrange referral for women who might have plans to leave the service area before the scheduled return visit, send reminders before first revisits, and follow up patients soon after missed visits. Priority might be assigned to the younger women of low parity who have been shown to be at higher risk of discontinuation. Other factors which might influence continuation include method of contraception, marital status, and race. Program continuation can be determined by analysis of clinic records alone while contraceptive use continuation often requires follow-up of patients. Although the two continuation rates were not equivalent, program and use continuation were roughly parallel through much of the study period. This suggests that a simple review of records in the clinic or on computer tape, when available, to determine program continuation may give an estimate of actual contraceptive use in the population.