Access to Contraceptives in School-Based Health Centers: Progress and Opportunities

Area of Science:

• Adolescent Health
• Public Health
• Reproductive Health

Background:

• The U.S. faces high adolescent pregnancy rates compared to other industrialized nations.
• School-based health centers (SBHCs) are crucial for improving youth access to reproductive health services.
• Contraceptive provision by SBHCs can significantly reduce unplanned pregnancies among adolescents.

Purpose of the Study:

• To examine the characteristics and predictors of contraceptive provision in U.S. SBHCs.
• To analyze changes and identify barriers to contraceptive provision in SBHCs between 2001 and 2017.

Main Methods:

• Cross-sectional study utilizing National School-Based Health Care Census data (2001-2017).
• Analysis focused on contraceptive dispensing by adolescent-serving SBHCs and prohibitive policies.
• Multivariate regression assessed associations between provision and factors like region, operational years, and staffing.

Main Results:

• Less than half of adolescent-serving SBHCs provided on-site contraceptives.
• Contraceptive provision was associated with SBHCs in Western/Northeastern regions, longer operation, and diverse provider teams.
• Policy barriers preventing contraceptive access primarily originated from school or school district regulations.

Conclusions:

• SBHCs are an effective model for adolescent contraceptive access, yet direct provision is not widespread.
• Understanding predictors and barriers is key to increasing contraceptive services in SBHCs.
• Addressing school- and district-level policies can enhance SBHCs' capacity to provide contraception.