Table 1 Description of Healthcare Access Framework and Application to Contraceptive Care

Approachability

The ability to perceive the need for care. Related to community members’ health knowledge and health literacy, the transparency of available health services, and providers’ outreach endeavors.

• Sex education

• Accuracy of contraceptive knowledge

• Information about available family planning services and how and where to access this care

Acceptability

The ability to seek care. Related to cultural and social factors that determine how people think and feel about healthcare services.

• Beliefs, social norms, stigma, and fear of judgment surrounding sex, contraceptive use, and pregnancy

• Comfort with family planning conversations

• Decision-making priorities

•Trust in family planning providers and the confidentiality of care

Availability and Accommodation

The ability to physically reach care in a timely manner. Related to the geographic location of services, the hours of operation and availability of appointments, facility accessibility, and availability of transportation needed to reach care.

• Family planning clinics’ physical location and health center density

• Shortages in family planning providers

• Limited clinic hours of operation

• Same-day, on-site availability of contraceptive services

Affordability

The ability to pay for care. Related to the price of health services and community members’ income and other assets such as time, health insurance, and social capital.

• Cost and insurance coverage of contraceptive care

• Patients’ income and access to health insurance

• Local and federal family planning funding

Appropriateness

The ability to engage with care. Related to the fit between patient needs and the care offered, how adequately providers are trained to meet patient needs, and the interpersonal quality of the care provided.

• Providers’ ability to meet the contraceptive needs and priorities of their community

• Provider’s family planning knowledge and training

• Provider preparedness to provide comprehensive and unbiased contraceptive care

• On-site availability of multiple contraceptive options

•Providers’ decision-making model