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Peggy Vander Meulen, RN, MSN Throughout the Reproductive Life Course: Opportunities and Challenges Empowering Girls and Women Global Technical Meeting April 2 & 3, 2014 Washington, D.C.
Objectives
Today will discuss:
Barriers to accessing and utilizing family planning services Methods to overcome barriers Importance of Racial Equity
Background
Michigan high Black infant mortality
2003 Kent County highest Black IMR Black : White disparity ratio = 4 : 1 Two-thirds from LBW / PTB
Close ICP = 3 to 4 x more likely LBW
Background
Enroll 450 pregnant & IC women / year
Community engagement
Barriers - Systems
Conservative attitudes towards FP
No urban FP clinics in GR
Limited public transportation Racism (individual, systemic, internal)
Barriers - Personal
Fear racial discrimination / mistrust
Interventions - Systems
Advocacy
Annual FP Conference
FP Toolkit & EC-friendly pharmacies Healthy Womens Resource Guide Preconception kits & counseling Racial Equity workshops & toolkits
Interventions - Services
Extensive staff training
Percent
40
30 Grand Rapids Black IMR Strong Beginnins 20 18.3 17.9 17.6 16.7
10
9.8
9.1
9.5
8.5
7.1
RN / SW: Professional expertise, technical competence, credibility CHW (peer mentor): Personal expertise, cultural competence, trust
Talk early, talk often about FP and reproductive health
Conclusions Implications for Practice Address clients attitudes and motivation (not only give information) Build on clients strengths & life goals Include partners Use culturally appropriate education Overcome practical barriers, and Address racism & discrimination
in order to give women the support they need to access and utilize family planning services and delay subsequent pregnancies for the minimum 18 months recommended