December 2, 2024

Resources on New Quality Family Planning (QFP) Recommendations

NFPRHA celebrates the Office of Population Affairs’ (OPA’s) update of the Providing Quality Family Planning Services in the United States: Recommendations of the US Office of Population Affairs (QFP). The first comprehensive update of the QFP recommendations since 2014, the publication of new guidelines is an essential step toward ensuring that all patients served by the Title X program—and beyond—are offered evidenced-informed, person-centered, equitable, and inclusive services that are grounded in the newest evidence in sexual and reproductive health. NFPRHA promotes the adoption of these recommendations by all providers to optimize access to high-quality, patient-led care. 

To support the dissemination and uptake of the new QFP recommendations, NFPRHA has compiled the following list of current resources to support family planning and sexual health services providers with processing this comprehensive document:

Reproductive Health National Training Center

QFP Guide: QFP Guide is the interactive web-based version of the updated QFP recommendations. It is intended to serve as an easy reference for providers working to deliver high-quality sexual and reproductive health services to people of reproductive age.

QFP At a Glance: This one-pager outlines what the QFP recommendations are, defines its primary audiences, and summarizes what topics the recommendations cover. It also offers an overview of what content is new relative to the prior recommendations released in 2014.

American Journal of Preventive Medicine

Equity in Providing Quality Family Planning Services in the United States: Recommendations of the US Office of Population Affairs: In this special article, Jennifer Blum and colleagues from Mathematica describe the activities that comprised the QFP update, which include conducting two systematic literature reviews and two environmental scans, convening a 25-member expert workgroup, consultations with technical expert panels, hosting listening sessions with persons who use the QFP in their practice, and soliciting input from sexual and reproductive health service recipients through lived experience panels. The authors assert that, by implementing specific strategies to apply a health equity lens during each of these steps, the 2024 QFP has strived to respond to the nation’s increasing awareness of the impact of structural and interpersonal racism, classism, discrimination based on sexual orientation and/or gender identity, and ableism on health and sexual and reproductive health care. 

New Family Planning Recommendations Centered on Advancing Equity for All: Authored by former Deputy Assistant Secretary for the Office of Population Affairs Jessica Swafford Marcella, this editorial is part of the supplement entitled Providing Equitable Sexual and Reproductive Health Services. The editorial is the first space where the political context in which the updated QFP recommendations will be implemented is acknowledged, with Marcella outlining the chilling effects that attacks on abortion, birth control, gender-affirming health services, fertility treatment, and sexual health have on quality service provision and, by extension, health equity. Although the work of family planning and sexual health service providers and administrators evolves as circumstances change, Marcella emphasizes that every facet of the 2024 QFP is guided by evidence and equity. Providers and administrators therefore should lean on the updated recommendations for clarification of what high-quality service delivery for sexual and reproductive health care looks like as they navigate the complexities and uncertainties of current times.

Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services: Diva Vohra and colleagues from Mathematica outline the findings from an Office of Population Affairs (OPA) -supported systematic literature review of screening tools and approaches for assessing needs and desires for pregnancy- and sexually transmitted infection- (STI-) related services. The authors conclude that, although screening tools are important for identifying patients’ needs and desires as well as informing and streamlining care, there was insufficient evidence to recommend any specific screening tool or approach for assessing pregnancy or STI needs and desires in the 2024 QFP. More research is needed to better understand the diversity of provider and patient experiences with screening tools and whether the use of such tools promotes accessible and equitable service provision.

Provider Perspectives on Contraceptive Care: A Systematic Review: Because health care providers directly impact patient experiences and clinical outcomes, it is important to understand how providers offer contraceptive care and the factors influencing this care. In this review article, Jamie Manzer and colleagues summarize the findings of an OPA-supported systematic review of recent research on providers and their perspectives on offering contraceptive counseling, education, and care. Despite best intentions to provide person-centered care and prioritize client autonomy, the review found that providers face numerous barriers that impact their ability to offer quality care. This, in turn, suggests that patients may not be receiving the care or contraceptives they need and desire. These findings highlight a need to better understand the ways in which provider interpersonal interactions coupled with systems-level health care factors impact patient experiences and outcomes, as well as to identify systems- and policy-level solutions. 

Client Perspectives on Contraceptive Care: A Systematic Review: In this OPA-supported systematic review, Jamie Manzer and colleagues summarize recent evidence on patient preferences related to contraceptive care, including how person-centered approaches contribute to patient outcomes. This review found that patients want a range of information about contraceptive methods tailored to their preferences through a variety of formats. Patients also prefer providers with similar demographic backgrounds (gender, race, ethnicity) and life experiences (menstruation, contraceptive use, carceral system encounters) to themselves, and who are willing to offer continuous care. The 2024 QFP’s emphasis on providers offering contraceptive counseling that includes tailored and comprehensive information, supports decision-making, and prioritizes patient autonomy reflects the diverse range in patient preferences reported in the literature. The authors highlight the need for research to go beyond patient preferences—much of the research in the review did not assess satisfaction, perceived experiences, participation in the decision-making process, method switching and discontinuation as desired—and assess the relationship between care delivery and other person-centered outcomes.  

Office of Population Affairs

OPA Program Policy Notice 2024-02: Implementing Quality Family Planning Services Recommendations within Title X Projects: OPA’s Program Policy Notice 2024-02 offers clarification of expectations for Title X grant recipients implementing Providing Quality Family Planning Services in the United States: Recommendations of the US Office of Population Affairs within their Title X projects. The PPN—which applies to Title X grant recipients, subrecipients, and service sites—also outlines where specific QFP recommendations are outside of the scope of the Title X program.

Providing Quality Family Planning Services in the US: Overview: This overview document introduces the updated QFP recommendations and includes a helpful side-by-side table to illustrate the differences between the 2014 and 2024 QFP documents. It also includes a graphic to explain how the process to develop the 2024 QFP was guided by equity principles and used social justice as the cornerstone.