A model for planning local contraceptive services

Abstract

Data were collected on abortion referral rates, single young maternity rates and uptake of contraceptive services in order to identify specific areas of unmet need in the Nottingham Health District. Comparisons were made between boroughs and in the City of Nottingham between electoral wards. There was a direct relationship between abortion rate, single young maternity rate and social disadvantage. Analysis of contraceptive usage suggested a more ineffective service in the inner city, which has implications for the more efficient use of resources in the future. Targeting of consumer acceptable services to residents of the inner city and teenagers in general was recommended as a result of the study. For future planning a more useful routine data set was developed to record the activity at family planning clinics.

PIP: Data were collected by age and residence on abortion referral rates, single young maternity rates and uptake of contraceptive services by general practitioners and Health Authority Family Planning clinics to identify specific unmet family planning care needs in the Nottingham Health District. There were 1456 abortion referrals traceable to the district. The boroughs and city wards showed a strong correlation between social disadvantage, determined by a scoring system, and abortion referral rate (p0.001). The 726 young single maternities similarly correlated strongly with social disadvantage by ward or borough (p0.001). There were 2 exceptions: one ward with large numbers of West Indians had higher maternity rates and lower contraceptive uptake, and another with large numbers of university students living in group housing or with parents had higher abortion services and fewer maternities. 79% of contraceptive users were recorded as receiving care from general practitioners: the ratio of general practitioners to clinic patients remained fairly constant in different areas. This scenario of costly but ineffective contraceptive care, high use of abortion services, and the need to support young single parent families suggests that increased awareness by young people of routine and emergency contraceptive services is needed.