Service delivery atTitle Xsites inTexasduring theCOVID‐19 pandemic
- 6 November 2022
- journal article
- research article
- Published by Guttmacher Institute in Perspectives on Sexual and Reproductive Health
- Vol. 54 (4), 198-207
- https://doi.org/10.1363/psrh.12211
Abstract
Context The important role of Title X sites in supporting publicly funded reproductive healthcare was elevated during the COVID-19 pandemic, as many people experienced economic uncertainty and changed their fertility preferences. In this study, we assessed changes in service delivery during the first year of the COVID-19 pandemic at Title X-supported sites in Texas, a large state with a high uninsured rate and a diverse Title X network. Methods Using surveys of Title X-funded organizations in Texas from April and November 2020, we examined the percentage of organizations reporting service modifications. With administrative data on 507,947 client encounters between March 2019 and March 2021, we assessed change in client volume at the onset of the pandemic and evaluated the association between regional COVID-19 case rates and the provision of key Title X services. Results In April 2020, most organizations (78%) limited in-person operations while implementing telehealth (74%) and contactless contraception (67%). Network-wide encounter volume declined by 26% at pandemic onset (incidence rate ratio [IRR] = 0.74, 95% confidence interval [CI] = 0.65, 0.84). Health departments experienced the steepest declines in encounter volume (IRR = 0.43, 95% CI = 0.36-0.50). Weekly encounters, particularly for long-acting reversible method placement/removal and sexually transmitted infection testing, decreased as COVID-19 rates increased. Conclusions Investment in public health infrastructure, including providing robust support to health departments as well as rebuilding and expanding the Title X network, is essential to safeguarding access to publicly funded reproductive healthcare during and after the pandemic.Keywords
Funding Information
- Susan Thompson Buffett Foundation
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD042849)
- National Science Foundation (DGE‐1610403)
This publication has 24 references indexed in Scilit:
- Inequities in Employment by Race, Ethnicity, and Sector During COVID-19Journal of Racial and Ethnic Health Disparities, 2021
- Staying Connected In The COVID-19 Pandemic: Telehealth At The Largest Safety-Net System In The United StatesHealth Affairs, 2020
- Early Impacts of the COVID-19 Pandemic: Findings from the 2020 Guttmacher Survey of Reproductive Health ExperiencesPublished by Guttmacher Institute ,2020
- Clinical Presentation and Outcomes of Pregnant Women With Coronavirus Disease 2019: A Systematic Review and Meta-analysisClinical Infectious Diseases, 2020
- Sexually transmitted diseases and infertilityAmerican Journal of Obstetrics and Gynecology, 2017
- Projecting the Unmet Need and Costs for Contraception Services After the Affordable Care ActAmerican Journal of Public Health, 2016
- Public Health’s Falling Share of US Health SpendingAmerican Journal of Public Health, 2016
- Women or LARC First? Reproductive Autonomy And the Promotion of Long‐Acting Reversible Contraceptive MethodsPerspectives on Sexual and Reproductive Health, 2014
- Interest in and experience with IUD self-removalContraception, 2014
- Segmented regression analysis of interrupted time series studies in medication use researchJournal of Clinical Pharmacy & Therapeutics, 2002