“They really hear you out”: Lessons on providing contraceptive care from a community-based sexual health clinic

Abstract

Individuals in Canada may obtain prescription contraception from a family doctor, a walk-in clinic, or sexual health clinic. While there are guidelines for best practice in contraceptive care, the quality of this care varies widely. Access to any contraceptive care is also a concern, partly due to increasing pressures on physicians’ time. These issues have led to calls to expand contraceptive care into the purview of nurses and other qualified health professionals, a ‘task-sharing’ approach. Here, we use data from semi-structured interviews with providers and patients at a sexual health clinic in British Columbia to examine the benefits of such an approach as implemented in this particular clinic. We conducted semi-structured interviews with physicians, nurses, volunteer peer contraceptive educators, and patients about their experience providing or obtaining care at the clinic, and thematically analyzed the resulting data. Interviewees identified four key benefits in the clinic’s approach: the value of a specialized sexual health clinic where providers had a wealth of experience providing sexual health care; the time and attention given by providers relative to practitioners at other types of clinics; the increased efficiency facilitated by a task-sharing approach; and the inclusive and supportive environment. Although some aspects of this clinic’s strategy are not transferrable to all settings, implementing elements of this model in other settings could increase access to quality contraceptive care.