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Title X Service Delivery Improvement

The Office of Population Affairs (OPA) supports activities to improve the delivery of family planning and other related preventive health services to women and men who need them.

National Survey of Family Growth

OPA is one of the major planners and funders of the National Survey of Family Growth (NSFG), a nationally representative survey of men and women of reproductive age. The NSFG, which is conducted by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, provides valuable information to federal agencies, policymakers, and researchers on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health. The survey remains a key source of data for estimating the number of women at risk of unintended pregnancy in the United States and the number and characteristics of women who use family planning services. OPA, as the lead agency for the Healthy People 2020 family planning objectives, relies heavily on estimates derived from the NSFG to provide reliable data for many of these objectives. To access public use data files or download reproductive health briefs and reports, visit the NSFG website.

Monitoring Changes in Attitudes and Practices among Family Planning Providers and Clinics

OPA is also collaborating with the CDC’s Division of Reproductive Health (DRH) to conduct a follow-up survey on attitudes and practices among a random sample of 10,000 public- and private-sector family planning providers and clinic administrators. The goals of the survey are to:

  • Describe differences in attitudes and practices among various providers and clinic types;
  • Compare attitudes and practices related to family planning in relation to those measured in the previous survey (2013-2014); and
  • Identify gaps between evidence and practice to inform development of educational interventions, trainings, and provider tools to improve future family planning and related health service delivery.

Improving Service Delivery Through Health Information Technology (Health IT)

Annual submission of the Family Planning Annual Report (FPAR) is required of all Title X family planning services grantees for purposes of monitoring and reporting program performance. FPAR is the only source of annual, uniform reporting by all Title X family planning services grantees and data have historically been reported in aggregate at the grantee level. For the past four years, OPA has been developing an interoperable, standards-based reporting system that can be used to collect a set of defined and agreed upon data elements from all Title X service sites. This new data reporting system, also known as “FPAR 2.0” within the Title X context, will be the first of its kind in the reproductive health sector and is expected to enrich the current data available from Title X grantees and service sites. Additionally, it will improve OPA’s ability to assess service delivery related to women’s health, family planning, and related preventive health issues. Further, building health IT infrastructure may support providers and clinics in quality improvement efforts.

Read more about improving service delivery through the FPAR and Health Information Technology Health IT Initiative.

Clinical Performance Measures for Contraceptive Care

OPA has developed clinical performance measures for contraceptive care that assess the provision of contraception to all women of reproductive age in need of contraceptive services, including postpartum women. In 2016, the National Quality Forum (NQF) endorsed three measures. These measures include:

OPA’s focus is to facilitate voluntary quality improvement activities in any setting that provides contraceptive care services. The NQF endorsement of these measures is a significant step towards prioritizing and improving the quality of family planning care provided to women and men of reproductive age. In addition, OPA has funded a three-year project to develop a patient-reported outcome performance measure, which will focus on filling another critical gap in performance measures (that is, the need for validated measures of client experience with contraceptive services). This patient-reported measure will complement the three NQF-endorsed contraceptive care measures.

Service Delivery Infrastructure

In 2016, OPA conducted a Title X Sustainability Assessment of grantees and services sites in an effort to understand the readiness of the Title X network to respond to the evolving healthcare system in the United States. OPA is using the quantitative data collected through these OMB-approved surveys to develop targeted technical assistance and training resources. Two separate survey tools assessed Title X grantees and Title X service sites on a range of topics related to sustainability. The more in-depth 2016 Title X Sustainability Assessment Tool for service sites collected site-level data on site characteristics, enrollment activities, linkages to primary care, electronic health record (EHR) systems, quality improvement efforts, revenue indicators, and cost analyses.

Content created by Office of Population Affairs
Content last reviewed on September 20, 2017