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Exploring multiple influences on equity: a mixed methods study of low-income women's access to family planning services in the South

Anna Newton-Levinson, MPH, Emory University

Young women, those of lower socioeconomic status, women of color, as well as women living in Southern states continue to bear the highest burdens of unintended pregnancy in the U.S. Existing literature indicates that these same populations also have lower rates of contraceptive use, with lower rates often attributed to unequal access to FP services.

Although there is growing identification of barriers to FP care, much is unknown about how women themselves perceive and prioritize different factors in choosing to seek FP services in relation to their lived experiences, including how personal factors and women's social context influence their priorities and decisions in whether and where they seek care. There is also limited understanding of which elements exert most influence on whether FP care meets women's needs.

Through an exploration of women's care seeking processes and priorities, the proposed study will move beyond traditional health system approaches to identify other elements that facilitate equitable access to FP services. Employing a transformative mixed methods design incorporating life history interviews, this study will examine, in a more holistic way than before, how low-income women in Georgia articulate their priorities with respect to seeking FP care. The study will investigate how women's priorities and care seeking processes are influenced by: 1) personal factors, 2) the health care system, and 3) elements of their social context. By identifying multi-level influences on women's access to FP services, this research will produce actionable recommendations for increasing equity for public health interventions, clinical care providers, and policy.

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