Optimizing women's health in a Title X family planning program, Baltimore County, Maryland, 2001-2004

Background: Although women usually obtain family planning services during their reproductive years, their need for comprehensive preventive services that promote wellness beyond reproductive health is often ignored.

Community Context: The Maryland Department of Health and Mental Hygiene sought to improve the general health of women and reduce their risk for adverse pregnancy outcomes by integrating women's health services into the Baltimore County Title X program. Title X is a federal family planning grant program primarily serving low-income, uninsured people.

Methods: After completing a needs assessment, we addressed gaps in women's wellness services in 3 family planning clinics. On-site services included counseling, screening, and referral for nutrition and physical activity, adult vaccination, depression, domestic violence, smoking cessation, substance abuse, and general medical disorders. A local multidisciplinary task force provided leadership for the clinical infrastructure of the project and served as a resource for women's health referrals.

Outcome: Every staff person surveyed reported that the project had a positive effect on the community and should be continued. Clients identified non-reproductive health services they needed but would not have received otherwise. During the 3-year period, patient volume increased 28% for the pilot sites, compared to 1% for the state family planning program overall.

Interpretation: With collaboration from a multidisciplinary community task force, the Title X family planning program can help provide needed preconception, interconception, and general women's health services, especially for women who have difficulty accessing care.