Community health centers' role in family planning.

F qualifi ed health centers, also known as community health centers (CHCs), care for our nation’s neediest populations. By latest count, 1,128 federally qualifi ed health centers operate more than 8,500 sites serving 20.2 million men, women, and children.1 These numbers are expected to grow with expanded funding via the Patient Protection and Aff ordable Care Act. Community health centers are charged with providing a wide scope of preventive health services to people of all ages—including prenatal care, immunizations, cancer screening, and family planning.2 Community health centers form an integral part of the communities they serve. In some areas, these health centers off er the only medical resources available for miles around. Community health centers have demonstrated excellent outcomes in reproductive health. Community health center patients are less likely to have preterm births or lowbirthweight babies,3 and are more likely to obtain Pap tests and mammograms than other lowincome patients.4 However, CHCs’ eff ectiveness at providing family planning services is unclear. A 2001 study5 by the Guttmacher Institute found that only 60% of CHC sites provided contraception. Community health centers provided contraception to about 28% of their female patients of reproductive age. More recent studies by Guttmacher and others found that while most publicly funded clinics off ered oral contraceptives, CHCs were less likely to provide the most eff ective contraceptive methods (namely the IUD and implant) and were not as likely to follow evidencebased contraceptive practices such as quick start (that is, sameday initiation of contraception).6 The role of CHCs in caring for our nation’s most underserved populations is unquestioned. Community health centers serve one in fi ve lowincome women7 and are also more likely than other publicly funded family planning providers to serve men, special