Provider Perspectives on Contraceptive Care: A Systematic Review

Introduction: Contraceptive care is critical piece of quality sexual reproductive healthcare. Providers directly impact client experiences and clinical outcomes; it is important to understand how providers offer contraceptive care and the factors influencing this care. This systematic review summarizes recent research on providers, their perspectives, experiences, barriers, and facilitators to offering contraceptive counseling, education, and care.

Methods: In May 2023, a systematic review was conducted in PubMed, Cochrane Database of Systematic Reviews, and Scopus to identify articles published between December 1, 2016, and May 1, 2023. Studies that explored the barriers and facilitators providers experience when offering contraceptive counseling, education, and/or care and how those differ by clinic setting, provider characteristics, and/or client demographics were included.

Results: A total of 22 studies met the inclusion criteria. Only three studies reported provider demographic characteristics. Most studies were conducted in urban locations with five delivering care to clients with low income. Care provision varied based on clinic setting, provider characteristics, and client characteristics. Care also included client-centered, efficacy-based, shared decision-making, and directive counseling approaches. Providers identified real or perceived challenges among their clients as a barrier to quality care provision, in addition to insufficient time; inability to offer same-day method insertion; and a lack of training in cultural humility, long-acting methods, and providing care to clients with intellectual disabilities.

Discussion: Despite intentions to provide client-centered care and prioritize client autonomy, providers face numerous barriers that impact their ability to offer quality care in alignment with client needs and desires.

Trial registration: Prospero-CRD42023414456 crd.york.ac.uk/PROSPERO/display_record.php?RecordID=414456.