Quality of contraceptive services in Finland

Abstract

Objective - To investigate whether the quality of contraceptive services in Finland varies by the type of care provider. Design - A cross sectional questionnaire survey. Participants - A random sample of 3000 Finnish women aged 18-44 years (response rate 74%) in 1994. Results - Almost all women (94%) had used contraception at some time and 75% were current users. Although self care was common (29% had obtained their latest method outside the health services), 83% had sometimes used the health services for contraception. For their last visit, 55% of women had chosen a health centre (a publicly administered and funded health service), and 33% a private unit. In the health centre, the care provider was usually a general practitioner or a public health nurse, whereas in private care the providers were gynaecologists. Women who used private care were more likely to be from higher social classes and urban areas. After adjustment for a women's background, the two groups were similar for most indicators of the quality of care, but access to care and woman's experiences of treatment were better with private care. Conclusions - In terms of availability and choices the current system of contraceptive services in Finland is adequate. It is not always an integral part of municipal primary health care, and many women prefer private care for gynaecological services; this may cause problems of comprehensiveness and equality of care.