closure of a planned parenthood

Case Study #10: Closure of a Planned Parenthood Clinic
1.Assess the impact of the closing of a major health care provider in a community
2. Discuss the information required to do a family planning needs assessment in a community
3. Describe the strategies used to meet the family planning needs in a community
4.Apply the core public health functions to health planning

Location: In a southwestern state on the borders of Mexico. Surrounded by farmland, river frontage, desert, and rocky mountains.

Population: Current total population of 150,000 people, 37,000 of the population are women of childbearing age. The population is expected to double in 15 years given the rapidly exploding population, the increase in numbers of legal and illegal immigrants from Mexico. Per capita income of just over $13,000 per year, more than 20% of the population is below the poverty level.

Available Health Resources:
Hospital-Based clinic for women and children
Two community health centres
Two Planned Parenthood clinics (Now Closed and building is SOLD)
Several Public Health Clinics
Health Council composed of health and social service professionals.

Case: The two planned parenthood clinics have closed down due to lack of funding after a year and a half without success to comply with state and federal family planning contracting requirements.

According to the nursing manager of the country, Doris, “The birth rate in this county of 20.1 is higher than the nation. Nineteen percent of all the births are to teens and 40% to single mothers. Twenty to 40% of all pregnancies in the county are unintended.”

The county health officer, Dr. Jim Franks, suggested filling the gaps of the other family planning providers in the county. However, the clinics either had waiting lists or refused to see uninsured people. Dr. Franks calls the medical directors at the community health centers and at the hospital-based clinic for women. He also had started to list all of the family practice and OB/GYN physicians in the community. Doris contacts the director of the now-closed Planned Parenthood clinic to negotiate the release of space, supplies, staff, and equipment to their public health offices if necessary.

A meeting is held with other health care providers in the community, the director of the Planned Parenthood clinic, the president of the Planned Parenthood Board of Directors, a representative for the county health council, and state public health officials. Shared values and common goals are developed that empower the diverse group to focus on the problem-solving process and tackle this seemingly insurmountable problem. However, there was no individual from the community to participate in this meeting to directly address the problems.

Root cause of Main Topic:
Two Planned Parenthood clinics closing due to lack of funding

Issues:
Two planned parenthood clinics closing in a small community due to lack of funding
Population is expected to double in 15 years
High poverty level in community
High pregnancy rates for teens
High rates of single mothers living in community

Possible solutions:
Secure funding to start a free clinic
Secure funding to keep one Planned parenthood clinic open
Add more staff to other clinics in the community to help with the influx of new patients
Keep the community informed as to what is happening to slow down panic
Send out information to the community for new resources they can access

1Q) What impact will the closing of Planned Parenthood have on this community? What are the short- and long-term consequences of limiting access to family planning services?
1A Planned Parenthood provides essential services that improve women’s health especially those belonging to low socio-economic status. If it is closed then the population residing in this community would not access hospital- based clinics and eventually this leads to serious consequences. The short- term consequence of limiting access to family planning services leads to high child mortality and lack of family planning leading to high fertility rates and maternal deaths. High child mortality is not only a cause but also a consequence of lack of family planning and lack of proper assistance through health facilities. Long- term consequences like population explosion, poverty and increase the prevalence of diseases.
2Q) What have you assessed so far? Describe the population affected. What other resources for family planning might be available?
2A We have assessed the importance of planned parenthood services in the community. The statistics describe birth rates in the county are 20.1 % higher than the whole nation. From which 19% and 40% births are teens and single mothers respectively. The resources might be available like clinical records.
3Q) Who are the key players around family planning issues in the community? What agendas will you expect from the key players? How would you bring them to the table?
3A Dr. Frank, Doris, Planned Parenthood board of directors and the chairperson of the county health council are the key players around family planning issues in the community. Within the week the meeting was held between key players and other health care providers in the community, The agenda will Dr. Frank start making the list of family practice and OB/GYN physicians and furthermore Doris contact the director to negotiate the release of space, supplies, staff and equipment.
4Q) Discuss the significance of community participation. Who is missing from this group?
4A The Significance of community participation, Shared values and common goals were developed that empowered the diverse group to focus on the problem – solving process.
5Q) Give examples of each of the three core public health functions applied in this case. Discuss standardized approaches to planning community-oriented public health programs that you might apply here.
5A The three core public health functions applied in this case are: –
· Counties
· Clinics
· Family planning services
· Family planning

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